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Implementation status of infection prevention and control and healthcare-associated infection surveillance in Zambian public hospitals: a WHO IPCAF tool assessment

Article scientifique 2026 Anglais

Résumé

Abstract Background: Healthcare-associated infections (HAIs) remain a major global public health challenge, with a disproportionately higher burden in low- and middle-income countries (LMICs), including Zambia, where infection prevention and control (IPC) systems face resource and capacity constraints. Effective IPC programs are essential for reducing HAIs, limiting the emergence and spread of antimicrobial resistance (AMR), and improving patient safety. This study assessed the implementation status of IPC programs in Zambian hospitals. Materials and methods: A descriptive multicenter cross-sectional survey was conducted from June 1–30, 2025, in 18 public hospitals across Zambia. The World Health Organization Infection Prevention and Control Assessment Framework (IPCAF) tool was used to evaluate IPC implementation across eight core components. Descriptive statistics and Welch’s independent-samples t-test were used to compare IPC implementation levels across hospitals. Results: The overall mean IPC score was 558 out of 800, indicating an intermediate level of implementation. Half of the hospitals (50%, n = 9) achieved advanced implementation, 39% (n = 7) intermediate, and 11% (n = 2) basic levels. Tertiary hospitals performed better than secondary hospitals (mean score 622 vs 507). The highest-scoring components were IPC programs (86%) and guidelines (88%), while the lowest were workload, staffing, and bed occupancy (60%) and IPC education and training (63%). Despite established IPC committees and guidelines, gaps remained in staff training, HAI and AMR surveillance, and infrastructure. Conclusion: Most Zambian hospitals have achieved intermediate to advanced IPC implementation. However, sustained investment in workforce capacity, surveillance systems, and infrastructure is required to strengthen IPC practices and support national AMR containment efforts.

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Mudenda, S., Chizimu, J., Njung'e, J., Mutila, M., Daka, V., Hangoma, J., Mweso, O., Mufwambi, W., Hakayuwa, C., Mwaba, M., Mutwale, I., Champo, M., Lubanga, A., Sakalimbwe, L., Mugenyi, N., Musonda, L., Muhimba, Z., Lukwesa, C., Chibi, M., Gardner, P., Mwadetsa, S., Kasanga, M., Mupila, Z., Kamboyi, H., Fwoloshi, S., Wesangula, E., Muma, J., Sinyange, N., Chilengi, R. (2026). Implementation status of infection prevention and control and healthcare-associated infection surveillance in Zambian public hospitals: a WHO IPCAF tool assessment. https://doi.org/10.1017/ash.2026.10855

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Auteur(s)

Steward Mudenda Joseph Yamweka Chizimu Joseph Njung'e Malambo Mutila Victor Daka Jimmy Mapenzi Hangoma Oliver Mweso Webrod Mufwambi Clyde Moono Hakayuwa Martha Mwaba Ilunga Mutwale Morreah Champo Adriano Focus Lubanga Loveness Sakalimbwe Nathan Mugenyi Linda Musonda Zoran Muhimba Chileshe Lukwesa Mpela Chibi Priscilla Nkonde Gardner Sandra Diana Mwadetsa Maisa Kasanga Zachariah Mupila Harvey Kamboyi Sombo Fwoloshi Evelyn Wesangula John Bwalya Muma Nyambe Sinyange Roma Chilengi

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