Nosocomial infections in developing countries: cost effective control and prevention.

OBJECTIVES To review the efficient and cost-effective preventive, control and surveillance measures that could be employed against nosocomial infections in developing countries. DATA SOURCES Literature search on compact disk-read only memory (CD-ROM), Medline and Internet, using the key words: nosocomial infection, prevention and control, use of antibiotics and use of computers. Some articles were manually reviewed. STUDY SELECTION Relevant studies or articles on nosocomial infections in developing and developed countries were included in the review. DATA EXTRACTION From individual studies or articles. DATA SYNTHESIS Information on nosocomial infections from developing and developed countries with some emphasis on Kenya is synchronized under the headings; introduction, historical background of nosocomial infections. Current situation of nosocomial infections and predisposing factors, nosocomial infections and antimicrobial resistance, consequences of nosocomial infections, hospital infection control programme and use of computers in nosocomial infection surveillance, and the cost benefit of infection prevention and control programme. CONCLUSION Nosocomial infections may be contained more effectively by having an infection prevention and control programme. Computer-assisted epidemiological surveillance appears to be the most important aspect of monitoring infection control programmes, and to identify changes in risk factors that can increase the infection rate. Even minimally, effective infection control programmes are cost-effective. For the war against nosocomial infections to be won, the whole exercise should be handled as a global project with significant inputs from developing countries.