London School of Hygiene & Tropical Medicine

While the importance of cleanliness and infection prevention in hospitals is well known in high-income countries, many African hospitals suffer from overcrowding and shortages of basic supplies such as running water or clean linen. However, there is virtually no data on the number of hospital-acquired infections in the region.

In the largest ever study of hospital-acquired bacteraemia (bloodstream infections caused by invasive bacteria), which was funded by the Wellcome Trust, researchers at the KEMRI-Wellcome Trust Research Programme examined more than 33,000 paediatric admissions to the Kilifi District Hospital in Kenya between 2002 and 2009. They found that hospital-acquired bacteraemia infections occurred in six out of every 1,000 paediatric in-patient admissions and more than half (53%) of these cases died – accounting for almost one in 20 deaths in hospital. The study was published in The Lancet.

Dr Alex Aiken, a Wellcome Trust Research Training Fellow at the London School of Hygiene and Tropical Medicine and first author of the study, said the research provides a starting point for future research and also for immediate efforts to reduce the burden of disease.

"Hospital-acquired bacteraemia infections are a serious problem for children in African hospitals, but now that we can recognise the problem, we can begin to take action," he said. "Many of the infections occurred in easily identifiable, high-risk patient groups like children with malnutrition, which should allow us to make targeted interventions. Simple measures like improved hand hygiene can have a large impact on hospital-acquired infections."

Commenting on the results, Professor Aggrey Wasunna of the University of Nairobi, said: "This is a wake up call for all of those involved in the hospital care of children, especially in the resource constrained regions. We know that these infections do occur, but they are often not given the priority they deserve partly because they can be difficult to detect. The paediatric ward in Kilifi is well resourced and therefore levels of hospital acquired infections are likely, if anything, to be lower than what may be found in many such hospitals across the region."

Aiken, AM. Risk and causes of paediatric hospital-acquired bacteraemia in Kilifi District Hospital, Kenya: a prospective cohort study. The Lancet; 30 November 2011