Direct cost implications of managing surgical site infections in low-income rural settings- Irrua, Nigeria

Morgan, Eghosa; Onuminya, John Enekele; Osime, Clement Odigie; Ehioghae, Osaze; Ayantayo, Temitayo; Usuah, John; Poluyi, Edward

doi:10.21608/pajn.2024.288237.1126

Direct cost implications of managing surgical site infections in low-income rural settings- Irrua, Nigeria

Document Type : Original Articles

Authors

¹ Department of Surgery, Ambrose Alli University

² Department of Orthopaedic surgery, Ambrose Alli University, Ekpoma

³ Department of Surgery, University of Benin

⁴ Department of Surgery, Babcock University

⁵ Department of surgery, RNZ Neurosciences, Lagos, Nigeria.

⁶ Lagos University Teaching Hospital, Lagos Nigeria

10.21608/pajn.2024.288237.1126

Abstract

Background
Surgical site infections (SSIs) represent one of the most common nosocomial infections. They cause increased morbidity and devastating economic impact the cost of care has on patients, and it involves the loss of billions of dollars globally.
The exact direct cost of managing SSIs in our resource-constrained settings has been elusive, and there is a lack of data on this subject.

Objective
Our objective was to determine the direct cost of managing SSIs in a rural Nigeria neurosurgical setting.

Methodology
We conducted a 12-month prospective hospital-based randomised case-control study of patients who had clean cranial and spine surgeries excluding implant surgeries. The experimental group had intrawound vancomycin powder before wound closure, and the control group received no intrawound vancomycin. Patients with evidence of SSIs were determined using clinical, and laboratory evidence of SSIs. SSIs' direct cost implication was calculated. This was quantified in local currency (Naira and Kobo) and standardised to the United States dollars to allow for international comparison.
Results
Forty–two patients were enrolled on this study. 76 % of these patients were males, and the prevalence of SSIs in the control group was 33.3% with a p-value less than 0.05, while none was seen in the experimental group. Staphylococcus aureus was the most common isolated organism, and the average cost of managing SSIs was N496, 812.50±234, 317.85(US$1,104.03 ± US$520. 71)
Conclusion
This study showed that the financial implications of managing SSIs are huge, and far exceeded the yearly income of average Nigerians.

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