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Catheter-associated urinary tract infections in Africa: Systematic review and meta-analysis
Zelalem Asmare1, Mulat Erkihun2, Wagaw Abebe1
1Department of Medical Laboratory Science, College of Health Sciences, Woldia University, Woldia, Ethiopia.
Insights
Catheter-associated urinary tract infections (CAUTIs) are highly prevalent in Africa, affecting 43.28% of patients. Gram-negative bacteria, particularly E. coli, are the primary cause, highlighting the need for improved infection control.
Area of Science:
- Healthcare Epidemiology
- Infectious Diseases
- Public Health in Africa
Background:
- Catheter-associated urinary tract infections (CAUTIs) represent a significant global burden of healthcare-associated infections.
- Limited resources and inconsistent infection control in developing nations exacerbate CAUTI prevalence.
- Existing studies on CAUTI in Africa show variable findings, necessitating a comprehensive review.
Approach:
- A systematic review and meta-analysis was conducted using multiple databases including Medline/PubMed, Google Scholar, Science Direct, and African Journal online.
- Data from twenty studies were extracted and analyzed using STATA 17.0 with a random effects model to estimate pooled prevalence.
- Statistical heterogeneity was assessed using inverse of variance, and Egger's tests were employed to detect publication bias.
Key Points:
- The pooled prevalence of CAUTI in Africa was found to be 43.28%.
- Gram-negative bacteria were responsible for 82.9% of CAUTIs, with Escherichia coli (45.06%) and Klebsiella spp. (24.17%) being the most common pathogens.
- Staphylococcus aureus was the predominant Gram-positive isolate, causing 53.24% of Gram-positive associated CAUTIs.
Conclusions:
- The high prevalence of CAUTI in Africa presents a critical healthcare challenge requiring urgent attention.
- Effective strategies include enhanced health education, robust infection prevention measures, adequate resource allocation, and collaborative efforts.
- Judicious use and timely removal of urinary catheters are essential to reduce infection risk and improve patient safety.
Background:
Catheter-associated urinary tract infections (CAUTIs) account for the majority of device-associated healthcare-acquired infections with significant morbidity and mortality worldwide. In developing countries with limited resources, the burden of CAUTI have substantial burden owing to the lack of well-organized infection prevention and control. Although there are studies in African countries, the magnitude of CAUTI is inconsistent. Therefore this systematic review and meta-analysis aimed to determine the pooled prevalence of CAUTI in Africa and identify the pathogens involved.
Methods:
Systematic review of articles from different databases and search engines such as Medline/PubMed, Google Scholar, Science Direct, and African Journal online were systematically searched to identify potential studies. Data were extracted on Microsoft Excel spreadsheet and analyzed using STATA 17.0. The pooled prevalence of CAUTI was estimated using a random effects model, inverse of variance was used to assess statistical heterogeneity across studies. Egger's tests was performed to identify possible publication bias.
Results:
This systematic review and meta-analysis incorporated twenty studies, revealing a pooled prevalence of CAUTI at 43.28%. Gram-negative bacteria were the leading cause of CAUTI accounts for 82.9%. Escherichia coli (45.06%) was the most frequent gram-negative bacterial isolate involved in CAUTI followed by Klebsiella spp (24.17%). Staphylococcus aureus was the predominant gram-positive bacterial isolate, accounting for 53.24% of gram-positive associated cases in CAUTI.
Conclusion And Recommendations:
In conclusion, the high prevalence of CAUTI in Africa underlines a pressing healthcare challenge. Addressing this issue requires a concerted effort, encompassing health education, infection prevention measures, resource allocation, and collaborative initiatives to enhance patient safety and mitigate the impact of CAUTI on healthcare systems in the region. As prolonged catheterization increases the risk of infection, catheters should only be used for proper indications and removed promptly when no longer needed.
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