Transactions of the Royal Society of Tropical Medicine and Hygiene
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Trans. R. Soc. Trop. Med. Hyg. · Aug 2009
Infection control education: impact on ventilator-associated pneumonia rates in a public sector intensive care unit in Pakistan.
We describe efforts towards introducing infection control (IC) practices and establishment of antimicrobial resistance (AMR) surveillance in a public sector hospital in Pakistan. The study was conducted in an eight-bed intensive care unit. IC principles, introduced through interactive sessions, were used as an intervention and their impact was observed by conducting surveillance for ventilator-associated pneumonia (VAP) before and after the intervention. ⋯ All Acinetobacter spp. and 72% P. aeruginosa were multidrug resistant. The mean stay of the nosocomially infected patients was significantly higher than for the uninfected group (6.5 vs. 2.1 days, P<0.001). Our study suggests IC education needs to be supplemented by a hospital system that facilitates IC practices and development of surveillance programmes.
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Trans. R. Soc. Trop. Med. Hyg. · Aug 2009
Use of an early warning score and ability to walk predicts mortality in medical patients admitted to hospitals in Tanzania.
Early warning scores (EWS) are widely used in developed health-care systems to identify patients who would benefit from intensified observation or therapy. They are aggregated scales that represent the derangement of simple physiological measurements: blood pressure, pulse, respiratory rate, etc. In more resource-limited settings, where simple methods for triage are required, the validity of EWS is not known. ⋯ Ability to walk unaided into the consultation was similarly helpful in identifying patients at low risk of death (NPV 97%). There was a positive correlation between EWS and risk of mortality. Uncomplicated patient measurements may be a useful triage tool in adult patients attending clinics in sub-Saharan hospitals.