Components of Existing National Surgical Site Infection Surveillance Programs Based on a Case Series of Low- and Middle-Income Countries: Building Blocks for Success and Opportunities for Improvement

Joseph D. Forrester, Abebe Bekele, Andrei Marius Stefan, Tshokey Tshokey, Allison E. Berndtson, Robel T. Beyene, Jesse Chou, Robert G. Sawyer, Julie Y. Valenzuela, Jennifer Rickard

Research output: Contribution to journalReview articlepeer-review

Abstract

Background: Surgical site infection (SSI) surveillance programs are recommended to be included in national infection prevention and control (IPC) programs, yet few exist in low- or middle-income countries (LMICs). Our goal was to identify components of surveillance in existing programs that could be replicated elsewhere and note opportunities for improvement to build awareness for other countries in the process of developing their own national surgical site infection surveillance (nSSIS) programs. Methods: We administered a survey built upon the U.S. Centers for Disease Control and Prevention's framework for surveillance system evaluation to systematically deconstruct logistical infrastructure of existing nSSIS programs in LMICs. Qualitative analyses of survey responses by thematic elements were used to identify successful surveillance system components and recognize opportunities for improvement. Results: Three respondents representing countries in Europe and Central Asia, sub-Saharan Africa, and South Asia designated as upper middle-income, lower middle-income, and low-income responded. Notable strengths described by respondents included use of local paper documentation, staggered data entry, and limited data entry fields. Opportunities for improvement included outpatient data capture, broader coverage of healthcare centers within a nation, improved audit processes, defining the denominator of number of surgical procedures, and presence of an easily accessible, free SSI surveillance training program for healthcare workers. Conclusions: Outpatient post-surgery surveillance, national coverage of healthcare facilities, and training on how to take local SSI surveillance data and integrate it within a broader nSSIS program at the national level remain areas of opportunities for countries looking to implement a nSSIS program.

Original languageEnglish (US)
Pages (from-to)112-118
Number of pages7
JournalSurgical infections
Volume24
Issue number2
DOIs
StatePublished - Mar 1 2023

Bibliographical note

Funding Information:
Dr. Forrester received Surgical Infection Society Junior Faculty Award and has received unrestricted research funding from Varian ( https://clinicaltrials.gov/ct2/show/NCT04482582 ) and Pacira ( https://clinicaltrials.gov/ct2/show/NCT05330611 ) for investigator-initiated trials. These do not lead to conflicts of interest for this work product. No other authors have disclosures or conflicts of interest to report.

Publisher Copyright:
© Copyright 2023, Mary Ann Liebert, Inc., publishers 2023.

Keywords

  • developing world
  • infection surveillance
  • surgical infections
  • surgical quality

Fingerprint

Dive into the research topics of 'Components of Existing National Surgical Site Infection Surveillance Programs Based on a Case Series of Low- and Middle-Income Countries: Building Blocks for Success and Opportunities for Improvement'. Together they form a unique fingerprint.

Cite this