Evidence map›Paper›PMID 31970501›Full record

ArticleEnvironmental monitoring and assessment2020

Application of tools to monitor environmental conditions, identify exposures, and inform decision-making to improve infection prevention and control practices in Malawian maternity wards.

Hemali Harish Oza, Michael Benjamin Fisher, Lydia Abebe, Ryan Cronk, Ryan McCord, Frances Reuland, Nikki Behnke, Holystone Kafanikhale, Innocent Mofolo, Irving Hoffman and 1 more

Abstract read
PubMed Publisher
In one paragraph

Article in Environmental monitoring and assessment, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
0.6field-weighted citation impact, top 35% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed, 6 citations in OpenAlex.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors at 3 institutions in 4 countries.

Hemali Harish OzaThe Water Institute, Gillings School of Global Public Health, University of North Carolina at Chapel Hill (UNC-CH), Chapel Hill, NC, USA. hemali.harish.oza@emory.edu.ORCID https://orcid.org/0000-0002-5432-3919
Michael Benjamin FisherThe Water Institute, Gillings School of Global Public Health, University of North Carolina at Chapel Hill (UNC-CH), Chapel Hill, NC, USA. mischaf2@email.unc.edu.
Lydia AbebeThe Water Institute, Gillings School of Global Public Health, University of North Carolina at Chapel Hill (UNC-CH), Chapel Hill, NC, USA.
Ryan CronkThe Water Institute, Gillings School of Global Public Health, University of North Carolina at Chapel Hill (UNC-CH), Chapel Hill, NC, USA.
Ryan McCordThe Water Institute, Gillings School of Global Public Health, University of North Carolina at Chapel Hill (UNC-CH), Chapel Hill, NC, USA.
Frances ReulandThe Water Institute, Gillings School of Global Public Health, University of North Carolina at Chapel Hill (UNC-CH), Chapel Hill, NC, USA.
Nikki BehnkeThe Water Institute, Gillings School of Global Public Health, University of North Carolina at Chapel Hill (UNC-CH), Chapel Hill, NC, USA.
Holystone KafanikhaleMalawi Ministry of Health and Population, Lilongwe, Malawi.
Innocent MofoloUNC Project-Malawi, Lilongwe, Malawi.
Irving HoffmanUNC Project-Malawi, Lilongwe, Malawi.
Jamie BartramThe Water Institute, Gillings School of Global Public Health, University of North Carolina at Chapel Hill (UNC-CH), Chapel Hill, NC, USA. jbartram@email.unc.edu.
University of North Carolina at Chapel Hill · USUniversity of North Carolina Health Care · USMinistry of Health · MW

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Healthcare-acquired infections (HAIs) contribute to maternal and neonatal morbidity and mortality, especially in low- and middle-income countries (LMICs). Deficient environmental health (EH) conditions and infection prevention and control (IPC) practices in healthcare facilities (HCFs) contribute to the spread of HAIs, but microbial sampling of sources of contamination is rarely conducted nor reported in low-resource settings. The purpose of this study was to assess EH conditions and IPC practices in Malawian HCFs and evaluate how EH deficiencies contribute to pathogen exposures and HAIs, and to provide recommendations to inform improvements in EH conditions using a mixed-methods approach. Thirty-one maternity wards in government-run HCFs were surveyed in the three regions of Malawi. Questionnaires were administered in parallel with structured observations of EH conditions and IPC practices and microbial testing of water sources and facility surfaces. Results indicated significant associations between IPC practices and microbial contamination. Facilities where separate wards were not available for mothers and newborns with infections and where linens were not used for patients during healthcare services were more likely to have delivery tables with surface contamination (relative risk = 2.23; 1.49, 3.34). E. coli was detected in water samples from seven (23%) HCFs. Our results suggest that Malawian maternity wards could reduce microbial contamination, and potentially reduce the occurrence of HAIs, by improving EH conditions and IPC practices. HCF staff can use the simple, low-cost EH monitoring methods used in this study to incorporate microbial monitoring of EH conditions and IPC practices in HCFs in low-resource settings.

Indexed as

Escherichia coliHospitals, MaternityInfection ControlInfectionsDecontaminationEnvironmental MonitoringFemaleHumansInfant, NewbornMalawiPregnancyATP fluorescenceCleaningClinicHospitalHygieneSanitation

Identifiers

PMID31970501
OpenAlexW3002306010

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.