1. By: Walelegn Worku Abera Kumie Takele & Feleke Moges Yehuala
Point prevalence of hospital acquired infections in two teaching hospitals of Amhara region in Ethiopia
By: Walelegn Worku
Abera Kumie Takele & Feleke Moges Yehuala

2. Introduction
HAI is a major public health concern ,It increased morbidity, mortality, and cost. (Geffers & Gastmeier 2011)
In developing countries, the risk is 2 to 20 times higher and the proportion of patients has been estimated to be 25% - 40% or more.(D. Pittet et al. 2008) , (Pittet, Allegranzi & Boyce 2009)
In Ethiopia Ministry of Health Ethiopia Health care associated infections are estimated 40%
(Federal Democratic Republic of Ethiopia Ministry of Health 2010).
In Ethiopia Specific researches on SSI patients:
Tikur Anbesa Hospital: 6.1% (Gashaw M.etal 2000)
Felgehiwot Hospital: 10.2% (Wondimagegn M. et al 2010)
Jimma Hospital: 11.4% (Demisew A. et al 2009)

3. In low and middle income countries the burden of Hospital acquired Infections are unknown due to:-
lack of reliable data
use of different definitions and
use of different methodologies
(Lul Raka 2010)
There is no such a comprehensive research method conducted in the study area.
It can give a good insight for planners and policy makers
Objectives
To determine the magnitude of Hospital Acquired Infections in Amhara Region teaching Hospitals, Ethiopia

4. Methods and Materials Study setting/ area/context Amhara region.
Table 1 : Method summery to determine the prevalence of HAI
Target population
Inclusion and Exclusion
Study design
Sample size
Sampling method
Data collection tool
Data analysis
All admitted Inpatient
Patients admitted >48 hours included
Patients in Emergency room , severely ill were excluded
Cross-sectional
908
All inpatients admitted in to wards >48 hrs
-questionnaire
- physical examination
-Chart review
-Laboratory taste
(CDC criteria tool)
Descriptive analysis

5. Data Quality
A three-day training for the team based on CDC definitions criteria
The tool was validated by “Gold Standard” cases.
Double data entry
Ethical considerations
Authorization: UOG ,AAU ,Regional and Hospitals
Protection of human subject: Risks and benefits
Informed consent
Confidentiality:

6. Result and Discussion
A total of 908 patients were included in this point prevalence survey.
The median age of the patient was 27 years (inter- quartile range of 16 to 40 years).
A total of 135 (14.9 % )HAI (95% CI, 12.7—17.1).
Five patients had two types of HAI.
The overall HAI was 15.41% (95% CI, 13.13%–17.93%).

7. Table 2: Proportion of specific site infections among hospital acquired infection of teaching hospitals in Amhara region, Ethiopia, (135 Patients)

8. The results of this survey are similar to previously conducted survey in Uganda and Tunisia 17%.
(Ogwang,2013 & Kallel H,2005)
This point prevalence finding was lower than a research conducted Albania 19.11%. (Faria S, 2007)
May be methodologies and study period gap
Much higher than a study conducted in other developed countries,
(Krieger,2015, Magill,2015)
Developing countries.
(Fatugase OM,2014, Kumar A,2014)

9. Klebsiella spp. and Staphylococcus aureus were the most commonly isolated organism to HAI.
This finding was also in line with a study conducted in Nigeria. (Thu TA, etal 2011)
Limitations
Due to resource constraint and comparisons with other researches with different specific site infections and patient populations
A research in Turkey on the validity PP rate of HAIs was similar to the prevalence rate calculated by the Rhame and Sudderth formula using the data of prospective- active incidence survey (Ustun C, 2011)

10. Conclusion
In this survey there was high prevalence of hospital acquired infection.
Surgical site infection and pneumonia were the most common infection type in this study.
Klebsiella spp. and Staphylococcus aureus were the most commonly isolated or for HAI
Recommendations
Managers should give more attention to promote infection prevention practices for better control of hospital acquired infection in teaching hospitals.

11. References Acknowledgement EPHA Participants
1. Geffers C, Gastmeier P. Nosocomial infections and multidrug-resistant organisms in Germany: epidemiological data from KISS (the Hospital Infection Surveillance System). Dtsch Ärztebl Int ;108(6): doi: /arztebl
2. Benedetta Allegranzi, Julie Storr, Gerald Dziekan, Agn`es Leotsakos, Liam Donaldson, Didier Pittet. The First Global Patient Safety Challenge “Clean Care is Safer Care”: from launch to current progress and achievements. J Hosp Infect. 2007;65(s2):115–123.
3. Benedetta Allegranzi, Sepideh Bagheri Nejad, Christophe Combescure, et al. Burden of endemic health- care-associated infection in developing countries: systematic review and meta-analysis. Lancet ;377:228–241.
4. WHO. Report on the Burden of Endemic Health Care-Associated Infection Worldwide. Geneva , Switzerland; who.int/about/licensing/copyright_form/en/index.html.
Acknowledgement
EPHA
Participants
AAU and UoG material and finance

12. Thank you!