Leveraging Syndromic Surveillance of Surgical Site Infections to Improve Infection Prevention and Control in Tanzania: A Quasi Experimental Study
Abstract:
Surveillance of surgical site infection (SSI) is key for improving Infection Prevention and Control (IPC). In Tanzania, it is unclear how primary health facilities (PHFs) that perform syndromic surveillance of SSI differ from those that do not. This quasi-experimental study, conducted from September to November 2024, evaluated how PHFs implementing syndromic surveillance differ in IPC adherence from those that do not. The quantitative sample included 905 surgical patients from surveillance conducting PHFs and 600 from non-conducting facilities. Results demonstrated that facilities practicing syndromic surveillance achieved significantly higher IPC adherence scores, with a mean of 400.1 (SD 138.9) compared to 263.1 (SD 99.88) in the control group. This marked difference of 137 points proved statistically significant (SE 54.12; CI 23.29–250.71; unpaired t = 2.5313; P < 0.0209). For the qualitative, researchers interviewed 49 Quality Improvement Team (QIT) members to triangulate the quantitative data. These sessions were transcribed verbatim on the same day and analyzed using NVivo version 20.2, utilizing a hybrid deductive and inductive coding approach. Reported via consolidated criteria for reporting qualitative research, the analysis generated four core themes. Participants reported that syndromic surveillance is a highly valuable tool for identifying operational gaps, understanding the true infection burden, and actively strengthening facility wide IPC measures. Ultimately, these findings provide suggestive evidence that syndromic surveillance directly aids in reducing surgical site infections. Because establishing surveillance systems improves care quality, the authors recommend that all healthcare facilities should monitor for healthcare-associated infections, including SSIs, to protect patient safety.References:
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