Systematic review and meta-analysis of the prevalence and types of health care associated infections in Nigeria.

BACKGROUND

HealthCare-Associated Infections (HCAIs) are those infections that patients acquire while receiving treatment for other health conditions within the health facility. There is a paucity of data on HCAIs in Nigeria.

OBJECTIVES

To evaluate the prevalence and types of as well as the common organisms causing HCAIs in Nigeria.

MATERIALS AND METHODS

A systematic review, with meta-analysis was conducted, and the results were presented in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. PubMed, AJOL, Google Scholar and Cochrane electronic databases were searched in April 2024. Studies describing prevalence of HCAIs in Nigeria were included. Data extraction was done using pre-specified data extraction form. We performed a meta-analysis on prevalence of HCAIs and subgroup analysis on types of HCAIs in Nigeria using the random-effects model. A risk of bias tool from Hoy and colleagues was used to assess risk of bias.

RESULTS

Out of 1899 articles searched, we included 16 studies involving 86772 participants. The pooled prevalence of HCAIs in Nigeria was 15.75% (95% CI 14.39, 17.11) and the commonest type was urinary tract infections (32.54%; 95% CI 29.44-35.64) followed by surgical site infections (22.17%; 95% CI 19.96-24.38) and skin and soft tissue infection (16.43%; 95% CI 9.42-23.43). The commonest organisms reported were Proteus species and Staphylococcus aureus, followed closely by Escherichia coli, Klebsiella and Pseudomonas. One study reported on multidrug resistance. The commonest associated risk factors were surgery, Human Immunodeficiency Virus infection, prior use of antibiotics and endotracheal intubation.

CONCLUSIONS

The findings of this research unveil a significant prevalence of HCAIs in Nigeria, standing at 15.75%. Urinary tract infections, surgical site infections, and skin and soft tissue infections were the most prevalent. Proteus species and Staphylococcus aureus were identified as the predominant organisms. This review indicates a scarcity of data concerning the risk factors for HCAIs and associated multidrug-resistant infections. Included studies mainly used isolation of microbial organisms to define HCAIs. These gaps underscore the need for further research in these critical areas within the country's healthcare settings.

TRIAL REGISTRATION

This systematic review was registered in PROSPERO (CRD42023439338).

© 2025. The Author(s).