East African Journal of Health and Biomedical Sciences

Global Healthcare-Associated Bloodstream Infection among Inpatients: A Systematic Review and Meta-Analysis

2025-02-04T06:37:44+00:00

Background: Healthcare-associated or nosocomial infections are among the most common infections and potential threats to patients and remain a significant problem for healthcare workers. Similarly, healthcare-associated bloodstream infections are the most common healthcare-associated infection. Therefore, this review aimed to determine the global and regional prevalence of healthcare-associated bloodstream infection among inpatients.

Methods: This systematic review and meta-analysis followed the PRISMA guidelines. Studies were retrieved from databases and other search engines such as PubMed, Scopus, Web of Science, Google Scholar, and MedNar using Boolean operators, MeSH terms, and relevant keywords. Data was extracted using an Excel form created by the authors. Data analysis was performed using comprehensive meta-analysis software version 4 with random effects. The quality of articles was assessed using the Joanna Briggs Institute Critical Appraisal Tool. Heterogeneity was evaluated using the I² statistic. Publication bias was evaluated using funnel plots. Sensitivity analysis was conducted to examine the impact of extreme values on overall estimates.

Results: A total of 1681 studies were searched from the included electronic databases and other search engines. Finally, 36 articles conducted on 937,412 inpatients were included in the current study. The findings from the current review revealed that the global prevalence of bloodstream infection was 1.2% (95% CI: 0.8%, 1.70%). Based on the World Health Organization’s region and survey period, the highest prevalence of healthcare-associated bloodstream infection reported between 2019 and 2023 was 4.2% (95% CI: 1.2%, 13.4%) and in the African region (3.5%: 95% CI: 1.1%, 10.6%).

Conclusions: This review found that at least one in 100 patients is infected with a healthcare-associated bloodstream infection. The prevalence varies in different regions of the world, with the highest prevalence reported in the African region. The findings from the current review indicate the need to implement effective infection prevention and control to prevent healthcare-associated bloodstream infections.

Barriers to Implementation of Nursing Rounds among Nurses Working in Public Hospitals in Harar, Eastern Ethiopia: A Qualitative Descriptive Study

2025-03-05T03:15:51+00:00

Background: Nursing rounds are scheduled patient visits conducted by hospital nurses to assess patients' needs, comfort, and safety, enhancing their well-being. Understanding the barriers affecting the implementation is vital for improving patient care, nurse satisfaction, and overall healthcare quality, yet information is scarce regarding this practice. Therefore, this study explores barriers to implementing nursing rounds among nurses at public hospitals in Harar, Eastern Ethiopia.

Methods: A qualitative descriptive study was conducted among six nursing staff, two head nurses, and two nurse directors working in two public hospitals in Harar from July 1 to 30, 2023. In-depth interviews were conducted with purposively selected respondents using a semi-structured interview guide. The interviews were tape-recorded. Each transcript was thoroughly read and re-read before being exported to Archive for Technology, Lifetime of Attention & Social Sciences version 7 (ATLAS.ti.7) software for coding. Verbatim transcriptions were complemented with field notes and initial codes were generated. Reflexive thematic analysis was conducted in alignment with the primary research question.

Results: This study identified the barriers to implementing nursing rounds and categorized them into organizational, behavioral, and technical themes. Organizational barriers encompass a lack of human and material resources, workloads and time constraints, lack of administrative support, and strict protocols. Behavioral barriers involve a lack of commitment, lack of knowledge, language barriers, and a perception that nursing rounds are ineffective. Technical barriers include the absence of guidelines and lack of training.

Conclusion: This study found multilevel barriers hindering the implementation of nursing rounds. These barriers included organizational, behavioral, and technical. Increasing staffing levels, ensuring sufficient resources, improving administrative support, providing training programs on nursing rounds, and establishing and enforcing protocols and monitoring systems can enhance the implementation of nursing rounds.

Factors associated with Length of Hospital Stay among Under-Five Children Admitted with Severe Acute Malnutrition in St. Paul’s Hospital Millennium Medical College, Addis Ababa, Ethiopia

2025-04-04T15:34:22+00:00

Background: Prolonged hospitalization among children with severe acute malnutrition remains a significant challenge in Ethiopia. While most of these children receive hospital treatment, a substantial proportion experience extended hospital stays. However, there is a paucity of research on the determinants of prolonged hospitalization in this context. Therefore, this study aimed to determine the average length of hospital stay and its determinants among children who recovered from SAM at St. Paul’s Hospital Millennium Medical College (SPHMMC), Addis Ababa, Ethiopia.

Methods: An institution-based cross-sectional study was among 466 under-five children admitted to St. Paul’s Hospital Millennium Medical College from 2012 to 2019. A retrospective document review was carried out using a standardized data extraction tool. A multiple linear regression model was employed to identify factors associated with length of stay. A Backward stepwise variable selection was employed to determine the final model. The coefficient of determination (R2) was used to assess the model's adequacy, and residual analysis verified the fundamental assumptions of the model.

Results: This study included 466 children aged between 1 and 59 months. The average duration of stay for children in this study was 19.27 +11.67 days. The main determinants of length of hospital stay were hemoglobin level (β=-0.62, p=6.5E-03), tuberculosis (β=9.05, p=6.1E-09), hospital-acquired infections (β=7.96, p=5.5E-07), meningitis (β=8.38, p=5.4E-03), rickets (β=2.58, p=3.9E-02), hyponatremia (β=9.14, p=4.8E-02) and no impaired level of consciousness (β=-5.04, p=2.4E-02). The coefficient of determination (R2) was found to be 26%.

Conclusion: The typical length of hospital stays for children with SAM fell within the suggested range established by Sphere. However, many children, particularly those with comorbidities including tuberculosis, meningitis, nosocomial infections, and rickets, ended up spending a prolonged time in the hospital. Therefore, promptly treating comorbidities could decrease the duration of hospital stays for children with SAM.

In-hospital Mortality and its Associated Factors among People with Acute Heart Failure Presented to Emergency Department at Haramaya University Hiwot Fana Comprehensive Specialized Hospital, Harar Eastern Ethiopia

2025-06-24T07:40:58+00:00

Background: Acute heart failure is a sudden and severe condition in which the heart is unable to pump blood efficiently to meet the body's demands. This results in a rapid accumulation of fluid in the lungs and/or other parts of the
body, leading to symptoms such as shortness of breath, fatigue, fluid retention, and swelling in the legs or abdomen.
Despite its high burden, there are paucity of data in study setting. Therefore, this study aimed to assess in-hospital
mortality and its associated factors among people with acute heart failure presented to emergency department at Hiwot
Fana Comprehensive Specialized Hospital, Harar Eastern Ethiopia.
Methods: An institution-based cross-sectional study with a retrospective chart review was conducted among 256
patients diagnosed with acute heart failure between January 2020 and January 2022. Data were retrieved and extracted
from April to May 2022. Data were extracted using a checklist, and analyzed using Statistical Package for Social
Science 23. Multivariable binary logistic regression was employed to identify factors associated with in-hospital mortality. Adjusted odds ratios with corresponding 95% confidence intervals were calculated to show the strength of the
associations. Factors with p-value < 0.05 were declared statistically significant.
Results: Of the 256 study participants, 64.9% (95% CI: 59.0%–70.7%) had acute decompensated heart failure, and
the majority (86.3%) were classified as New York Heart Association class IV. Major precipitating factors were identified in 70% of the cases, with pneumonia being the most common (53.1%). Comorbid conditions were present in
53.1% of the participants. In-hospital mortality was 13.6% (95% CI: 12.91% – 14.28%). Multivariable analysis
showed that initial triage scores >7 (AOR=3.25; 95% CI: 1.08-9.78), low diastolic blood pressure (AOR= 5.81; 95%
CI: 1.79 – 18.91), and low left ventricular ejection fraction (AOR= 3.53; 95% CI: 1.31 – 9.53) were factors associated
with in-hospital mortality.
Conclusion: This study highlights the significant concern of in-hospital mortality of acute heart failure. It further
reveals that acute decompensated heart failure accounts for the majority of acute heart failure cases, with pneumonia
emerging as the leading precipitating factor. Key associated factors of in-hospital mortality include a high initial triage
score, low diastolic blood pressure, and reduced left ventricular ejection fraction. Enhanced monitoring and tailored
care plans for patients with low diastolic blood pressure or reduced ejection fraction should be in place to prevent
deterioration.
Keywords: Acute Heart Failure, Clinical profiles, Emergency Medicine Department, Hiwot Fana Comprehensive Specialized Hospital, In-hospital Mortality