開発途上国における医療関連感染症の流行の負担:体系的なレビューとメタ解析
Benedetta Allegranzi1, Sepideh Bagheri Nejad, Christophe Combescure
1First Global Patient Safety Challenge, WHO Patient Safety, Geneva, Switzerland.
Lancet (London, England)
|December 15, 2010
まとめ
医療関連感染症は,発展途上国で頻繁に発生する問題であり,ヨーロッパや米国よりも高い流行率を持っています. 感染制御と監視の改善は極めて重要です.
科学分野:
- 感染症 感染症は感染症です.
- エピデミオロジー エピデミオロジー
- 公衆衛生は公衆衛生である.
背景:
- ヘルスケア関連感染症 (HAI) は,主に患者の安全に影響を与える,重要な世界的な課題です.
- 開発途上国におけるHAIの流行病学に関するデータはほとんどなく,標的型介入を妨げている.
- 世界保健機関 (WHO) は,資源の限られた環境におけるHAI負担をよりよく理解する必要性を強調しています.
研究 の 目的:
- 開発途上国における医療関連感染症の流行病学を体系的に評価する.
- これらの地域におけるHAIの流行,発生,および微生物学的原因を決定する.
- 開発途上国におけるHAI率と先進国で報告されたHAI率を比較する.
主な方法:
- 1995年から2008年の間に発表された研究の電子データベースと参照リストを通じて,包括的な文献検索が行われました.
- 開発途上国の特定の感染部位と病原体を含むHAIの流行または発生に関するデータを提供する研究が選択されました.
- 研究の質を評価し,データを集約して分析し,質の高い研究に焦点を当てました.
主要な成果:
- 合計220件の研究が含まれており,多くの開発途上国からのデータ表現が限られており,54%が質が低いと分類されています.
- 高品質の研究は,ヨーロッパと米国と比較して,HAIの有意に高い流行率 (15.5%) を示しています.
- 成人の集中治療室では,HAI密度 (1000患者日当たり47.9) が米国より少なくとも3倍高いと報告されており,手術現場の感染が最も一般的な病院内感染です.
結論:
- 開発途上国は,医療関連感染症の大きな負担に直面しています.
- これらの地域では,緊急に監視システムを強化し,堅実な感染対策を実施する必要がある.
- 結論は,データにおける重大なギャップと,HAIのリスクを軽減するために医療基準の改善の必要性を強調しています.
関連する概念動画
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01:20Infection
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Managed Care System:
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