A multimodal infection control and patient safety intervention to reduce surgical site infections in Africa: a multicentre, before–after, cohort study

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A multimodal infection control and patient safety intervention to reduce surgical site infections in Africa: a multicentre, before–after, cohort study Benedetta Allegranzi, MD, Alexander M Aiken, PhD, Nejla Zeynep Kubilay, MD, Peter Nthumba, MD, Jack Barasa, MD, Gabriel Okumu, MD, Robert Mugarura, MD, Alexander Elobu, MD, Josephat Jombwe, MD, Mayaba Maimbo, MD, Joseph Musowoya, MD, Angèle Gayet- Ageron, MD, Prof Sean M Berenholtz, MD The Lancet Infectious Diseases Volume 18, Issue 5, Pages 507-515 (May 2018) DOI: 10.1016/S1473-3099(18)30107-5 Copyright © 2018 World Health Organization. Published by Elsevier Ltd/Inc/BV. All rights reserved. Terms and Conditions

Figure 1 Characteristics of the four participating hospitals and activities implemented during the intervention Due to unforeseen local difficulties, one site (Zimbabwe) was unable to recruit adequate numbers of patients and was not included in the analysis. SSI=surgical site infection. SUSP=Surgical Unit-based Safety Programme. CUSP=Comprehensive Unit-based Safety Programme. *Support materials related to the technical SSI preventive measures are available at http://www.who.int/infection-prevention/countries/surgical/en/ (see appendix). †Materials from the CUSP study used in this project are available at https://www.ahrq.gov/professionals/quality-patient-safety/hais/tools/surgery/index.html. The Lancet Infectious Diseases 2018 18, 507-515DOI: (10.1016/S1473-3099(18)30107-5) Copyright © 2018 World Health Organization. Published by Elsevier Ltd/Inc/BV. All rights reserved. Terms and Conditions

Figure 2 Unadjusted SSI cumulative incidence overall and by site at baseline and follow-up in four sites Error bars show 95% CIs. SSI=surgical site infection. The Lancet Infectious Diseases 2018 18, 507-515DOI: (10.1016/S1473-3099(18)30107-5) Copyright © 2018 World Health Organization. Published by Elsevier Ltd/Inc/BV. All rights reserved. Terms and Conditions