Table 2. Included Studies from Low-Middle Income Countries (LMICs)


Author, Year, Country


Aguilar- 2008


Aguilar- 2010


Aiken 2013


Kenya/Low Nascimento Brazil/Middle Nascimento, Brazil/Middle


Interrupted time series


Single hospital Adults (3,343)


Multiple


Ed: Education materials Ex: Policy Ev: Surveillance, data feedback, audit


Before/After Single unit Adults (117)


GI surgery


Ex: Protocols Ev: Surveillance, audits, and data feedback


Design, Setting, Population (No.)


Before/After Single hospital Adults (308)


Surgical Specialty


GI surgery Interventions Ex: ACERTO protocol IPC Measures


ACERTO: preoperative nutritional support if malnourished, early postop feeding, no mechanical bowel preparation, Avoidance of excess IVF, drains & nasogastric tubes, early mobilization


ACERTO: preoperative nutritional support if malnourished, early postop feeding, no mechanical bowel preparation, avoidance of excess IVF, drains and nasogastric tubes, early mobilization


SAP policy


Compliance Increase


SSI Def. SSI Outcome


Not reported Decreased by 66% Pre: 9/78 (11.5%) Post: 9/230 (3.9%) P=.01 OR=3.2 (95% CI, 1.2–8.4)


Not reported Not reported Decrease Pre: 8/42 (19%) Post: 2/75 (2.7%) P < .001


Increase


CDC 2008


Decreased for superficial SSI only:


Clean, clean-contaminated Pre: 69/1,130 (6.1%) Post: 83/2,046 (4.1%) P=.01


Contaminated and dirty: Pre: 10/76 (13.2%) Post: 17/91 (2.2%) P=.006 Total SSI (P values not provided):


Clean, clean-contaminated Pre: 82/1,130 (7.3%) Post: 102/2,046 (5%) Contaminated and dirty: Pre: 18/76 (23.7%) Post: 17/91 (18.7%)


Anchalia 2011


India/Low-middle


Before/After Single hospital Population: not reported


Askarian 2011


Iran/Middle


Brisibe 2015


Nigeria


El Mhamdi 2014


Tunisia/Middle


Before/After Single hospital Adult (144)


Before/After Single unit Adults: number not reported


Before/After Single hospital Mixed population (508)


Multiple


En: Multidisciplinary committee


Ed: Training Ex: Protocols Ev: Surveillance, data feedback


Multiple


Ex: WHO safety checklist Ed: Training


OB/GYN


En: Commitment of the hospital management


Ex: Contract outsourcing, revolving fund scheme, policy


Multiple


Ex: WHO checklist Ev: Direct observation by senior physician


SAP, instrument sterilization


SAP, preoperative bathing, diabetes control, no/clip hair removal, iodine skin prep, closing operating room doors and limiting staff, instrument sterilization, sterile dressing change, surveillance


SAP policy Not reported CDC 1999


Decreased from 13% to 4.4% P values not provided.


Increase


Not reported No change Pre: 10.4% Post: 5.3% P=.10


Instrument sterilization


Not reported Not reported Overall: No change P=0.230 (Decreased in non-booked CS; P=.032)


Increase


Not reported Decrease Pre: 25/185 (13.5%) Post: 14/323 (4.3%) P < .001


(Continued)


Infection Control & Hospital Epidemiology


291


Page 1  |  Page 2  |  Page 3  |  Page 4  |  Page 5  |  Page 6  |  Page 7  |  Page 8  |  Page 9  |  Page 10  |  Page 11  |  Page 12  |  Page 13  |  Page 14  |  Page 15  |  Page 16  |  Page 17  |  Page 18  |  Page 19  |  Page 20  |  Page 21  |  Page 22  |  Page 23  |  Page 24  |  Page 25  |  Page 26  |  Page 27  |  Page 28  |  Page 29  |  Page 30  |  Page 31  |  Page 32  |  Page 33  |  Page 34  |  Page 35  |  Page 36  |  Page 37  |  Page 38  |  Page 39  |  Page 40  |  Page 41  |  Page 42  |  Page 43  |  Page 44  |  Page 45  |  Page 46  |  Page 47  |  Page 48  |  Page 49  |  Page 50  |  Page 51  |  Page 52  |  Page 53  |  Page 54  |  Page 55  |  Page 56  |  Page 57  |  Page 58  |  Page 59  |  Page 60  |  Page 61  |  Page 62  |  Page 63  |  Page 64  |  Page 65  |  Page 66  |  Page 67  |  Page 68  |  Page 69  |  Page 70  |  Page 71  |  Page 72  |  Page 73  |  Page 74  |  Page 75  |  Page 76  |  Page 77  |  Page 78  |  Page 79  |  Page 80  |  Page 81  |  Page 82  |  Page 83  |  Page 84  |  Page 85  |  Page 86  |  Page 87  |  Page 88  |  Page 89  |  Page 90  |  Page 91  |  Page 92  |  Page 93  |  Page 94  |  Page 95  |  Page 96  |  Page 97  |  Page 98  |  Page 99  |  Page 100  |  Page 101  |  Page 102  |  Page 103  |  Page 104  |  Page 105  |  Page 106  |  Page 107  |  Page 108  |  Page 109  |  Page 110  |  Page 111  |  Page 112  |  Page 113  |  Page 114  |  Page 115  |  Page 116  |  Page 117  |  Page 118  |  Page 119  |  Page 120  |  Page 121  |  Page 122  |  Page 123  |  Page 124  |  Page 125  |  Page 126  |  Page 127  |  Page 128  |  Page 129  |  Page 130  |  Page 131  |  Page 132