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- Thomas, HS, et al.
(författare)
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- 2019
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swepub:Mat__t
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- Drake, TM, et al.
(författare)
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Surgical site infection after gastrointestinal surgery in children: an international, multicentre, prospective cohort study
- 2020
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Ingår i: BMJ global health. - : BMJ. - 2059-7908. ; 5:12
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Tidskriftsartikel (refereegranskat)abstract
- Surgical site infection (SSI) is one of the most common healthcare-associated infections (HAIs). However, there is a lack of data available about SSI in children worldwide, especially from low-income and middle-income countries. This study aimed to estimate the incidence of SSI in children and associations between SSI and morbidity across human development settings.MethodsA multicentre, international, prospective, validated cohort study of children aged under 16 years undergoing clean-contaminated, contaminated or dirty gastrointestinal surgery. Any hospital in the world providing paediatric surgery was eligible to contribute data between January and July 2016. The primary outcome was the incidence of SSI by 30 days. Relationships between explanatory variables and SSI were examined using multilevel logistic regression. Countries were stratified into high development, middle development and low development groups using the United Nations Human Development Index (HDI).ResultsOf 1159 children across 181 hospitals in 51 countries, 523 (45·1%) children were from high HDI, 397 (34·2%) from middle HDI and 239 (20·6%) from low HDI countries. The 30-day SSI rate was 6.3% (33/523) in high HDI, 12·8% (51/397) in middle HDI and 24·7% (59/239) in low HDI countries. SSI was associated with higher incidence of 30-day mortality, intervention, organ-space infection and other HAIs, with the highest rates seen in low HDI countries. Median length of stay in patients who had an SSI was longer (7.0 days), compared with 3.0 days in patients who did not have an SSI. Use of laparoscopy was associated with significantly lower SSI rates, even after accounting for HDI.ConclusionThe odds of SSI in children is nearly four times greater in low HDI compared with high HDI countries. Policies to reduce SSI should be prioritised as part of the wider global agenda.
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| 5. |
- El Tahir, B. A., et al.
(författare)
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Changes in soil properties following conversion of Acacia senegal plantation to other land management systems in North Kordofan State, Sudan
- 2009
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Ingår i: Journal of Arid Environments. - : Elsevier BV. - 1095-922X .- 0140-1963. ; 73:4-5, s. 499-505
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Tidskriftsartikel (refereegranskat)abstract
- Changes in soil texture, bulk density, pH, concentrations and stocks of OC, N, P and K before and after conversion of a 6-year-old Acacia senegal plantation to other land management systems (LMS) were investigated, after three cropping seasons, in the drylands of western Sudan. LMS included pure and intercropped sorghum (PS), roselle (PR) and grasses (PC) with A. senegal at high and low-tree densities (HD 433 and LD 266 trees ha(-1)). Significant changes included increase in coarse sand and a decrease in fine sand under pure and intercropped systems at LD: decrease in clay contents in PS and PR: an increase in clay ratio in all pure crops and HD + R; a decrease in aggregated mean concentrations of OC, N and P under all LMS by 42%, 68% and 45%, respectively; increase in soil pH under all LMS: a depletion of aggregated mean stocks of OC, N, P and K in all LMS by 38%, 30%, 52% 13%, respectively. The study established that wholesale tree clearance constitutes a major cause of soil degradation, and tree inputs and cycling of nutrients are of major importance to soil fertility in the study area. (C) 2008 Elsevier Ltd. All rights reserved.
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