Journal Article

Rates of Hospital-Acquired Respiratory Illness in Bangladeshi Tertiary Care Hospitals: Results from a Low-Cost Pilot Surveillance Strategy

Emily S. Gurley, Rashid Uz Zaman, Rebeca Sultana, Michael Bell, Alicia M. Fry, Arjun Srinivasan, Mahmudur Rahman, M. Waliur Rahman, M. Jahangir Hossain and Stephen P. Luby

in Clinical Infectious Diseases

Published on behalf of Infectious Diseases Society of America

Volume 50, issue 8, pages 1084-1090
Published in print April 2010 | ISSN: 1058-4838
Published online April 2010 | e-ISSN: 1537-6591 | DOI: http://dx.doi.org/10.1086/651265
Rates of Hospital-Acquired Respiratory Illness in Bangladeshi Tertiary Care Hospitals: Results from a Low-Cost Pilot Surveillance Strategy

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  • Infectious Diseases
  • Immunology
  • Public Health and Epidemiology
  • Microbiology

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Background. Patients hospitalized in resource-poor health care settings are at increased risk for hospital-acquired respiratory infections due to inadequate infrastructure.

Methods. From 1 April 2007 through 31 March 2008, we used a low-cost surveillance strategy to identify new onset of respiratory symptoms in patients hospitalized for >172 h and in health care workers in medicine and pediatric wards at 3 public tertiary care hospitals in Bangladesh.

Results. During 46,273 patient-days of observation, we recorded 136 episodes of hospital-acquired respiratory disease, representing 1.7% of all patient hospital admissions; rates by ward ranged from 0.8 to 15.8 cases per 1000 patient-days at risk. We identified 22 clusters of respiratory disease, 3 of which included both patients and health care workers. Of 226 of heath care workers who worked on our surveillance wards, 61 (27%) experienced a respiratory illness during the study period. The cost of surveillance was US$43 per month per ward plus 30 min per day in data collection.

Conclusions. Patients on these study wards frequently experienced hospital-acquired respiratory infections, including 1 in every 20 patients hospitalized for >72 h on 1 ward. The surveillance method was useful in calculating rates of hospital-acquired respiratory illness and could be used to enhance capacity to quickly detect outbreaks of respiratory disease in health care facilities where systems for outbreak detection are currently limited and to test interventions to reduce transmission of respiratory pathogens in resource-poor settings.

Journal Article.  3894 words.  Illustrated.

Subjects: Infectious Diseases ; Immunology ; Public Health and Epidemiology ; Microbiology

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