Table 4 Multimodal interventions
From: Effect of interventions on surgical site infections in Sub-Saharan Africa: a systematic review
S no | Authors, country, year | Study type | Type of surgery | Study populations | Hospital setting | Study group size | Intervention | Outcome (SSI)% | Source of SSI definition | ||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
Control /pre-intervention | Treatment/ post-intervention | Comparator | Type/ treatment /study group/ | Follow-up duration | Control group /before Interventions | Treatment group/ After interventions | |||||||
1 | Allegranzi et al., Kenya, Uganda, Zambia, 2018 [35] | Before and After cohort | Elective & Emergency | Surgical patients | Tertiary & mission hospitals | 1604 | 1827 | Baseline | Multimodal interventions (preoperative bath, hair removal, skin and hand antiseptics, SAP, OR discipline | 30 day | 8 | 3.8 | CDC |
2 | Abubakar et al.. Nigeria, 2019 [29] | pre-post intervention | Elective & Emergency | Women undergoing obs. & gyn. surgery | Tertiary hospital | 226 | 238 | Pre-intervention | Antibiotic stewardship intervention (SAP protocol, education, audit, and feedback) | Hospitalization period | 4 | 3.4 | CDC |
3 | Gentilotti et al., Tanzania, 2020 [30] | Before and After Intervention | Elective & Emergency | Pregnant women underwent CS | Regional hospital | 467 | 573 | Pre-intervention | Education on AMR, training on IPC, SAP, Hand hygiene, OR discipline, multidiscipline team | 30 day | 48.2 | 16.6 | CDC |
4 | Ngonzi et al.. Uganda, 2021 [33] | pre-post intervention | Elective & Emergency | Pregnant women underwent CS | Referral and teaching hospital in Gyn. Dept | 200 | 248 | Pre-intervention | Quality improvement interventions (education, audit, and feedback on WHO SSC, pre-operative antibiotics) | During hospitalization | 14.5 | 10.5 | Clinical charts |
5 | Alidina et al. Tanzania 2021 [31] | pre-post intervention | Elective & Emergency | CS & major surgeries | Health center, district & regional Hos | 1539 | 1626 | Pre-intervention and control facilities | Training and infrastructure support | 30 day | 7.3 | 4.5 | Not indicated |
6 | Forrester et al., Ethiopia, 2021 [32] | pre-post intervention | Elective & Emergency | Surgical patients | Teaching regional, and district hospital | 374 | 1839 | Pre-intervention | Quality improvement SSC use, gauze count, antibiotic use, sterile field, and skin antisepsis) | 30 day | 7.4 | 5.8 | CDC |
7 | Starr et al., Ethiopia, 2023 [36] | Cohort | Elective & Emergency | General surgery for > 18 age | Referral & district hospital | 1575 | 1789 | Before the quality improvement program | Quality improvement program (SSC use, surgical instrument safety, OR safety, SAP, hygiene, appropriate PPE) | 30 day | 23.2 | 17.4 | CDC |
8 | Ernest et al., Tanzania, 2021 [37] | Pre/ /post cross-sectional | Emergency | Pregnant women underwent CS | Comprehensive emergence & obstetric center | 136 | 143 | Pre-intervention | Multicomponent safe surgery intervention (training for HCW on IP bundles, WHO SSC, Hygiene, SAP) | 7 day | 13.9 | 0.7 | CDC |