Hospital acquired infections in a large north Ugandan hospital.

INTRODUCTION Hospital care is a precious gift in Uganda, therefore little concern is given to hospital safety and very seldom Hospital Acquired Infection (HAI) risk is evaluated. Within a quality improvement hospital program the Board of Lacor Hospital, a large Missionary Hospital of north Uganda, ordered an HAI control program to be established. The first step of this program was an HAI prevalence survey whose results are presented in this paper. METHODS A one day prevalence survey was performed on patients admitted at least 48 hours before the survey: short training was offered to qualified nurses and hospital doctors. Lacking a suitable microbiological diagnostic service, clinical definitions of HAI were adopted. Questionnaires were completed by the nurses and data were analyzed and presented to the hospital personnel four days after the survey. A HAI control program was agreed and started soon after. RESULTS The hospital has 44.000 admissions yearly with 482 beds and main hospital specialties, 410 patients were surveyed Overall HAI prevalence was 28%, more in surgery (47%) and less in pediatrics (21%). Blood stream infections were the most frequent, followed by surgical wound infections and Urinary Tract infections, several lower respiratory tract infections and few gastrointestinal one. HAI prevalence was associated with length of stay in hospital, intravenous cannulas, urinary catheters and emergency surgery. Patients with severe low nutrition status, anemia and complications of the main disease bringing them to hospital experienced higher HAI prevalence. DISCUSSION This paper shows that HAI can be measured also in absence of microbiological service and that Hospital staff are ready to evaluate this problem. This high HAI prevalence was not expected by the staff and has been a starting point for an hospital HAI control plan.