Simulation models for transmission of healthcare-associated infection : a systematic review

Nguyen, Le Khanh Ngan and Megiddo, Itamar and Howick, Susan (2019) Simulation models for transmission of healthcare-associated infection : a systematic review. American Journal of Infection Control. ISSN 0196-6553 (In Press)

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    Healthcare associated infections (HAIs) pose a serious risk for patients and providers as they cause increased morbidity and mortality, prolonged length of stay in healthcare facilities, increased prevalence of multi-drug resistant organisms and psychological and financial burdens to patients, their families and the healthcare system. The risk of HAIs is universal and pervades every healthcare facility, setting and system globally. In Europe, the prevalence of HAIs was estimated at 5.5% (1) and about 2.6 million new patients having HAIs have been identified annually (2). These infections accounted for an estimated 33,000 attributable deaths and 900,000 disability-adjusted life-years (3). In the US, the estimated prevalence of HAIs in hospitals was between 2.9% and 3.5% in 2015 (4). The burden is even higher in low- and middle-income countries (LMICs). A systematic review and meta-analysis reported that the pooled prevalence of overall HAIs in Southeast Asia, where most countries are middle-income, was 9.1% (5). The reported prevalence in Africa varies significantly: in Ghana, prevalence ranged between 3.5% and 14.4% in acute care hospitals, and in tertiary hospitals in South Africa and Ethiopia it was 7.67% and 19.4%, respectively (6-8). Data on the impact of HAIs at the national level in LMICs, especially African countries, is scanty and fragmented, generating difficulty in assessing the true scale of the problems of HAIs. The actual figure is assumed to be higher due to the lack of a functioning HAI surveillance system in these countries (9).