ArticleInfection2026
Hand hygiene infrastructure and point-of-care resource availability in public hospitals in Sierra Leone: a national multicentre cross-sectional study.
Article in Infection, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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.
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.
Who cites it
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
19 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionThis study explores hospital hand hygiene (HH) infrastructure and point-of-care (POC) resource availability in Sierra Leone's public hospitals.
methodsA multicentre cross-sectional survey was conducted in 19 public hospitals between February to March 2025. Using the World Health Organization (WHO) Ward Infrastructure Survey tool (WIS), 155 wards were assessed. Outcomes included ward-level availability of water, soap, alcohol-based handrub (ABHR), towels, posters, and audits, plus POC indicators such as sink/dispenser density and bedside ABHR access. Analyses were descriptive, with hospital comparisons and modified Poisson regression for selected binary outcomes. Sensitivity analyses used strict and lenient definitions and best-/worst-case assumptions to assess missing data impact. Denominators vary by indicator due to item‑level missingness and skip‑logic inherent to the WHO‑WIS tool.
resultsIn total, 109 wards with complete hospital-level data were analysed. Ward-level availability was uneven: running water available in 61/105 (58.1%) of wards, soap at all sinks in 64/103 (62.1%), and disposable towels at all sinks in 15/103 (14.6%); 73.4% relied on hand-operated taps. ABHR was reported in 87/107 (81.3%) of wards under strict criteria (lenient criteria = 98.1%), while HH audits and posters were common (> 60%). POC readiness was very low: only 73/1,762 (4.1%) beds had ABHR within reach, 14/145 (9.7%) sinks had the full triad (water, soap, and towels), and median sink density was 0.67 per 10 beds (1/15 beds), below WHO recommendations. Tertiary hospitals had higher adjusted ward-level ABHR availability than secondary (PR = 1.26, p = 0.043). Sensitivity analyses supported the robustness of findings, with prevalence ratios for ABHR (1.22-1.28), running water (0.93-1.02), and soap (1.25-1.30) aligning with adjusted estimates.
conclusionThis first national multicentre survey of hospital HH infrastructure found major systemic gaps, especially in bedside access to essential HH facilities. Despite ward-level ABHR availability, shortages of water, soap, towel, and limited POC access fell below standards. Strengthening HH in similar settings requires investment in basic infrastructure/supplies, strategic resource placement, audits, and behavioural reinforcement.
Indexed as
Identifiers
42848183What OpenQuestion holds
Registered trials
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.