Safe infant feeding in healthcare facilities: Assessment of infection prevention and control conditions and behaviors in India, Malawi, and Tanzania.

Autor:	Caruso BA; Hubert Department of Global Health, Emory University School of Public Health, Atlanta, Georgia, United States of America., Paniagua U; Department of Epidemiology, Emory University School of Public Health, Atlanta, Georgia, United States of America., Hoffman I; Institute for Global Health and Infectious Diseases, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, North Carolina, United States of America., Manji K; Department of Pediatrics and Child Health, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania., Saidi F; University of North Carolina Project Malawi, Lilongwe, Malawi., Sudfeld CR; Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, United States of America., Vernekar SS; Jawaharlal Nehru Medical College, KLE Academy of Higher Education and Research (Deemed-to-be-University), Belgaum, Karnataka, India., Bakari M; Department of Pediatrics and Child Health, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania., Duggan CP; Center for Nutrition, Boston Children's Hospital, Boston, Massachusetts, United States of America.; Division of Nutrition, Harvard Medical School, Boston, Massachusetts, United States of America., Kibogoyo GC; Department of Pediatrics and Child Health, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania., Kisenge R; Department of Pediatrics and Child Health, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania., Somji S; Department of Pediatrics and Child Health, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania., Kafansiyanji E; University of North Carolina Project Malawi, Lilongwe, Malawi., Mvalo T; University of North Carolina Project Malawi, Lilongwe, Malawi.; Department of Pediatrics, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, North Carolina, United States of America., Nyirenda N; University of North Carolina Project Malawi, Lilongwe, Malawi., Phiri M; University of North Carolina Project Malawi, Lilongwe, Malawi., Bellad R; Jawaharlal Nehru Medical College, KLE Academy of Higher Education and Research (Deemed-to-be-University), Belgaum, Karnataka, India., Dhaded S; Jawaharlal Nehru Medical College, KLE Academy of Higher Education and Research (Deemed-to-be-University), Belgaum, Karnataka, India., K A C; Bapuji Child Health Institute & Research Centre, Davangere, Karnataka, India., Koppad B; Jawaharlal Nehru Medical College, KLE Academy of Higher Education and Research (Deemed-to-be-University), Belgaum, Karnataka, India., Nabapure S; SS Institute of Medical Sciences & Research Centre, Davangere, Karnataka, India., Nanda S; Shri Jagannath Medical College and Hospital, Puri, Odisha, India., Singh B; Shri Jagannath Medical College and Hospital, Puri, Odisha, India., Yogeshkumar S; Jawaharlal Nehru Medical College, KLE Academy of Higher Education and Research (Deemed-to-be-University), Belgaum, Karnataka, India., Fleming K; Ariadne Labs, Harvard T.H. Chan School of Public Health / Brigham and Women's Hospital, Boston, Massachusetts, United States of America., North K; Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts, United States of America., Tuller DE; Ariadne Labs, Harvard T.H. Chan School of Public Health / Brigham and Women's Hospital, Boston, Massachusetts, United States of America., Semrau KEA; Ariadne Labs, Harvard T.H. Chan School of Public Health / Brigham and Women's Hospital, Boston, Massachusetts, United States of America.; Department of Medicine, Harvard Medical School, Boston, Massachusetts, United States of America., Vesel L; Ariadne Labs, Harvard T.H. Chan School of Public Health / Brigham and Women's Hospital, Boston, Massachusetts, United States of America., Young MF; Hubert Department of Global Health, Emory University School of Public Health, Atlanta, Georgia, United States of America.
Jazyk:	angličtina
Zdroj:	PLOS global public health [PLOS Glob Public Health] 2023 Jun 08; Vol. 3 (6), pp. e0001843. Date of Electronic Publication: 2023 Jun 08 (Print Publication: 2023).
DOI:	10.1371/journal.pgph.0001843
Abstrakt:	Infants need to receive care in environments that limit their exposure to pathogens. Inadequate water, sanitation, and hygiene (WASH) environments and suboptimal infection prevention and control practices in healthcare settings contribute to the burden of healthcare-associated infections, which are particularly high in low-income settings. Specific research is needed to understand infant feeding preparation in healthcare settings, a task involving multiple behaviors that can introduce pathogens and negatively impact health. To understand feeding preparation practices and potential risks, and to inform strategies for improvement, we assessed facility WASH environments and observed infant feeding preparation practices across 12 facilities in India, Malawi, and Tanzania serving newborn infants. Research was embedded within the Low Birthweight Infant Feeding Exploration (LIFE) observational cohort study, which documented feeding practices and growth patterns to inform feeding interventions. We assessed WASH-related environments and feeding policies of all 12 facilities involved in the LIFE study. Additionally, we used a guidance-informed tool to carry out 27 feeding preparation observations across 9 facilities, enabling assessment of 270 total behaviors. All facilities had 'improved' water and sanitation services. Only 50% had written procedures for preparing expressed breastmilk; 50% had written procedures for cleaning, drying, and storage of infant feeding implements; and 33% had written procedures for preparing infant formula. Among 270 behaviors assessed across the 27 feeding preparation observations, 46 (17.0%) practices were carried out sub-optimally, including preparers not handwashing prior to preparation, and cleaning, drying, and storing of feeding implements in ways that do not effectively prevent contamination. While further research is needed to improve assessment tools and to identify specific microbial risks of the suboptimal behaviors identified, the evidence generated is sufficient to justify investment in developing guidance and programing to strengthen infant feeding preparation practices to ensure optimal newborn health. Competing Interests: The authors have read the journal’s policy and have the following competing interests: BAC, KM, KEAS, KF, LV, DET, and CRS report funding from the Bill & Melinda Gates Foundation outside the submitted work. BAC reports funding from the National Institutes of Health outside the submitted work. CPD reports editorial duties with American Society for Nutrition and royalties from People’s Medical Publishing House (PMPH USA, Ltd.) outside the submitted work. CPD reports royalties from Wolters Kluwer Health (UpToDate, Inc.) outside the submitted work. This does not alter our adherence to PLOS policies on sharing data and materials. There are no patents, products in development or marketed products associated with this research to declare. (Copyright: © 2023 Caruso et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)
Databáze:	MEDLINE
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