Evaluation of surveillance for surgical site infections in Thika Hospital, Kenya.

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dc.contributor.authorWanyoro, A. K.
dc.contributor.authorAiken, A. M.
dc.contributor.authorMwangi, J.
dc.contributor.authorMulingwa, P.
dc.contributor.authorWanjohi, J.
dc.contributor.authorNjoroge, J.
dc.contributor.authorJuma, F.
dc.contributor.authorMugoya, I K
dc.contributor.authorScott, J. A. G.
dc.contributor.authorHall, A. J.
dc.date.accessioned2013-10-29T12:24:57Z
dc.date.available2013-10-29T12:24:57Z
dc.date.issued2013-02
dc.descriptionDOI:10.1016/j.jhin.2012.11.003en_US
dc.description.abstractBACKGROUND: In low-income countries, surgical site infections (SSIs) are a very frequent form of hospital-acquired infection. Surveillance is an important method for controlling SSI but it is unclear how this can best be performed in low-income settings. AIM: To examine the epidemiological characteristics of various components of an SSI surveillance programme in a single Kenyan hospital. METHODS: The study assessed the inter-observer consistency of the surgical wound class (SWC) and American Society of Anesthesiologists (ASA) scores using the kappa statistic. Post-discharge telephone calls were evaluated against an outpatient clinician review 'gold standard'. The predictive value of components of the Centers for Disease Control and Prevention - National Healthcare Safety Network (CDC-NHNS) risk index was examined in patients having major obstetric or gynaecological surgery (O&G) between August 2010 and February 2011. FINDINGS: After appropriate training, surgeons and anaesthetists were found to be consistent in their use of the SWC and ASA scores respectively. Telephone calls were found to have a sensitivity of 70% [95% confidence interval (CI): 47-87] and a specificity of 100% (95% CI: 95-100) for detection of post-discharge SSI in this setting. In 954 patients undergoing major O&G operations, the SWC score was the only parameter in the CDC-NHNS risk index model associated with the risk of SSI (odds ratio: 4.00; 95% CI: 1.21-13.2; P = 0.02). CONCLUSIONS: Surveillance for SSI can be conducted in a low-income hospital setting, although dedicated staff, intensive training and local modifications to surveillance methods are necessary. Surveillance for post-discharge SSI using telephone calls is imperfect but provides a practical alternative to clinic-based diagnosis. The SWC score was the only predictor of SSI risk in O&G surgery in this context.en_US
dc.identifier.citationThe Journal of hospital infection (Impact Factor: 3.01). 01/2013en_US
dc.identifier.urihttp://ir-library.ku.ac.ke/handle/123456789/7543
dc.language.isoenen_US
dc.subjectEpidemiologyen_US
dc.subjectKenyaen_US
dc.subjectSub-Saharan Africaen_US
dc.subjectSurgical site infectionen_US
dc.subjectSurveillanceen_US
dc.titleEvaluation of surveillance for surgical site infections in Thika Hospital, Kenya.en_US
dc.typeArticleen_US
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