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. 2024 Jul 29:12:100412.
doi: 10.1016/j.ijregi.2024.100412. eCollection 2024 Sep.

Infection prevention and control in conflict-affected areas in northeast Syria: A cross-sectional study

Mohamed Alaa Ahmado  1 , Muaaz Alghajar  2 , Amina Olabi  2 , Kristen Meagher  3 , Preeti Patel  3 , Abdulkarim Ekzayez  3   4
Affiliations

Infection prevention and control in conflict-affected areas in northeast Syria: A cross-sectional study

Mohamed Alaa Ahmado et al. IJID Reg. .

Abstract

Objectives: In northeastern Syria (NES), the adherence of health care facilities to infection prevention and control (IPC) standards remains underexplored. This study evaluates the IPC performance of various health facilities against World Health Organization (WHO) benchmarks using the IPC Assessment Framework (IPCAF) and the Hand Hygiene Self-Assessment Framework (HHSAF).

Methods: We conducted a cross-sectional survey of 33 health care facilities, including primary (PHC), secondary (SHC), and tertiary health care centres (THC). Data were collected via on-site evaluations using the IPCAF and HHSAF tools.

Results: A significant 91% of facilities did not meet half of the WHO IPC minimum requirements. Specifically, 57% of PHCs met 26-50% of the standards, while none exceeded 75%. Among SHCs, 71% met 26-50% of the standards, while 44% of THCs fell within this range. Notably, 81.8% of facilities were classified as 'inadequate' per the IPCAF, with none achieving 'intermediate' or 'advanced' levels. The HHSAF results were similarly concerning, with 34.4% deemed 'inadequate' and 65.6% at the 'basic' level. A weak positive correlation (0.137) was found between IPCAF and HHSAF scores.

Conclusions: NES health care facilities demonstrate substantial deficiencies in IPC compliance, with critical gaps in IPC programmes, health care-associated infection surveillance, and training. Urgent interventions are required to enhance IPC practices, leveraging local strengths and fostering international collaborations to improve patient safety and health care quality in the region.

Keywords: Conflict; Hand Hygiene Self-Assessment Framework (HHSAF); Health assessment; Infection Prevention and Control Assessment Framework (IPCAF); Infection prevention and control (IPC); Northeast Syria (NES); Syria.

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Conflict of interest statement

The authors have no competing interests to declare.

Figures

Figure 1
Figure 1
A: The selection sample contained 21.2%; (n1=7) primary health care centres (PHCs), 51.5%; (n2=17) secondary health care centres (SHCs), and 27.3%; (n3=9) tertiary health care centres (THCs) facilities. B: The geographical distribution, Deir-ez-Zor governorate had the highest proportion of the assessed facilities (39.4%; n4=13), followed by Ar-Raqqa (36.4%; n5=12), and lastly Al-Hasakeh and Aleppo (12.1%; n6=4 for each).
Figure 2
Figure 2
The percentage of health facilities that meet the World Health Organization (WHO) Infection Prevention and Control (IPC) minimum requirements according to the type of facility.
Figure 3
Figure 3
The percentage of health facilities classified (inadequate, basic, intermediate, and advanced) for each component of the Infection Prevention and Control Assessment Framework (IPCAF) tool.
Figure 4
Figure 4
The percentage of health facilities classified (inadequate, basic, intermediate, and advanced) for each component of the Hand Hygiene Self-Assessment Framework (HHSAF).
Figure 5
Figure 5
A. Normal Q-Q Plot of Infection Prevention and Control Assessment Framework (IPCAF) Scores. B. Normal Q-Q Plot of Hand Hygiene Self-Assessment Framework (HHSAF) Scores.
See this image and copyright information in PMC

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