BlessWorld Foundation International

Affecting the World Through Health
A Global Health Initiative

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CORONAVIRUS: IMPORTANT FACTS AND UPDATES

Although, the early symptoms of COVID-19 and influenza (flu) infections are similar in that they both cause fever and similar respiratory symptoms, the speed of transmission is an important difference between the two viruses. Influenza typically has a shorter incubation period (the time from infection to appearance of symptoms) than COVID-19, which means that influenza spreads faster than COVID-19. On the other hand, the proportion with severe disease appears to be higher for COVID-19 given that approximately 15% of infected people have severe symptoms and 5% require intensive care in a hospital. Generally, the proportions of severe and critical COVID-19 infections are higher compared to influenza infections.

Currently, the World Health Organization suggests that the risk for contracting coronavirus from someone who isn’t showing any symptoms is quite low. However, experts believe that people infected with coronavirus can possibly transmit it to others even before showing any serious symptoms. According to the CDC, people who have contracted the virus are most contagious when they’re showing symptoms- and that’s when they’re most likely to transmit the virus. CDC maintains that COVID-19 is not limited by race as infection can make anyone sick regardless of their ethnicity. However, the immediate risk of becoming seriously ill from the virus is thought to increase by age- higher in older adults compared to younger adults. Older adults and people of any age with underlying health conditions, such as diabetes, lung disease, or heart disease, have weaker immunity, are more vulnerable and are at greater risk of severe illness from COVID-19.

The overall period of COVID-19 infection varies from person to person and depends on the immune system of the host. Mild symptoms in an otherwise healthy individual may resolve in about a few days. However, recovery in older or unhealthy individuals with underlying health problems, such as respiratory conditions, may take weeks and in severe cases lead to mortality. People who have completed quarantine or have been released from isolation pose no risk of infection to others and should not be stigmatized. Experts emphasize there isn’t a specific course of treatment for corona virus infection, considering that a new strain of virus causes it. Therefore, one must heed the general advice and take the standard precautionary measures as these can help to strengthen the immune system.

It is uncertain how long COVID-19 specifically survives on surfaces but it seems to behave like other coronaviruses- persisting on varying surfaces from some hours up to several days, depending on the material. This duration may be influenced by different conditions and factors such as the type of surface, as well as the temperature and humidity of the environment.  Maintaining proper hygiene and cleanliness remain the best ways to protect one-self. Surfaces thought to be exposed should be wiped thoroughly with household disinfectant to kill the virus and keep the surface clean. Hands must be regularly and constantly cleaned with alcohol-based sanitizers or washed for at least 20 seconds with soap and water. Additionally, it is important to avoid touching the face, eyes, mouth, or nose with unclean hands.

Today, most of the world is on lockdown with borders, airports, companies, schools, churches mosques and stores shut down in order to contain the spread of the virus. Countries such as China, Italy, the United States- representing three continents, have had the highest cases so far. It is advised that people, especially those experiencing symptoms, should wear masks and hand gloves, call their hospital or public health hotlines, stay at home and not go out to public areas, not use public transport, taxis, or ride-sharing services and not attend public events such as religious gatherings, social events, music festivals or sporting matches.

As Always, Stay Safe!

CORONAVIRUS:  SYMPTOMS AND PREVENTION- HOW TO PROTECT MYSELF AND OTHERS

Following exposure to coronavirus, it takes about 14 days for symptoms to develop. This is called the incubation period of the virus, which is the number of days between coming in contact with the infectious agent (exposure to droplets of infected people) and the establishment of an infection. An infection is established when the virus replicates in sufficient amount to overwhelm the host’s immunity and cause symptoms. Symptoms associated with corona virus are somewhat similar to that of other viruses that cause upper respiratory tract infections. They include:

  • Runny nose
  • Sneezing and Wheezing
  • Coughing and Sore throat
  • Headache and Fever
  • Lethargy
  • Shortness of breath and breathing difficulties

Most of the above listed symptoms are identical to some other viral infections making it challenging to reach a diagnosis. Corona virus usually affects the upper respiratory tract and can be mild. However, the infection may become severe and result in more serious conditions such as pneumonia, bronchitis, severe acute respiratory syndrome, kidney failure or death if it affects lower respiratory tract, including lungs and windpipe. The severity of the symptoms is much more in older adults and vulnerable populations with compromised immunity. It is important to seek medical advice if one comes in close contact with anyone diagnosed with COVID-19. More so, people who live in or have recently traveled from areas with ongoing spread of COVID-19 should be isolated for 14days. Since the major reliable and medically protective measure- vaccination, is not yet available for corona virus, it is important to follow a few simple guidelines and measures to prevent infection:

  • Proper and frequent hand washing with soap or any other alcohol-based hand sanitizer- for at least 20 seconds, especially after blowing the nose, coughing,  sneezing, going to the bathroom and before eating or preparing food
  • Covering nose and mouth with tissues when sneezing or coughing, tissues should be immediately disposed properly in a trash can
  • Social distancing and avoiding any form of close contact with infected individuals, typically anybody feeling feverish or exhibiting associated symptoms
  • Cooking foods thoroughly, particularly meat and eggs, before consumption
  • Avoid touching face- eyes, nose, and mouth with unwashed hands
  • Staying and remaining home when sick
  • Keeping oneself protected when in contact with wild or domestic animals, dead or alive
  • Drinking sufficient amounts of fluids daily
  • Getting adequate rest and taking prescribed over-the-counter medicines in case of sore throat or fever

CORONA VIRUS: WHAT IT IS AND HOW IT IS TRANSMITTED

In general, viruses are inactive, microscopic and parasitic infectious agents that cannot reproduce by themselves outside a host cell. However, once they infect a susceptible cell, viruses have the capacity to direct the machinery of the infected cell to reproduce and multiply itself, thereby causing diseases. The whole infectious virus particle is called a virion and it consists of the nucleic acid and an outer shell of protein. Viruses contain either RNA or DNA as their genetic material and their nucleic acid may be single or double-stranded. The simplest virus particles contain only enough RNA or DNA to encode four proteins while the most complex viruses encode about 200 proteins.

Now that we understand what viruses are in general, let us then focus on and discuss the virus of significance at the moment- corona virus. The most recent outbreak is reported to have begun in Wuhan (China) in late 2019, infecting more than 90,000 people and claiming over 4,000 lives. Corona viruses are crown-like shaped infectious agents or a group of agents which can cause diseases in birds and mammals. The virus, which was first identified in the 1960’s, is a common virus that predominantly infects the nose, upper throat and sinuses. While most strains aren’t dangerous, some strains and less common forms such as SARS, MERS, and COVID-19 cause severe symptoms and can be lethal. In humans more specifically, corona viruses cause respiratory tract infections that are characteristically mild, as in some cases of the common cold. Symptoms vary in other species, for example; in chickens, they cause an upper respiratory tract disease, while in cows and pigs they cause diarrhea. Treatment measures for viruses such as vaccines and antiviral drugs to prevent or treat human corona virus infections are yet to be developed.

Coronavirus infection, like all viral infections, begins when the virus gains access into the body of the host organism and attaches itself to the complementary host cell receptor using its spike protein. Following the viral attachment, a protease of the host cell cleaves and activates the attached spike protein. Depending on which protease is available in the host cell, cleavage and activation permits the entry of the virus into the cell through endocytosis or direct fusion of the viral envelop with the host membrane. Once in the host cell, the virus particle is uncoated, and its genome enters the host cell cytoplasm. Then, the viral RNA attaches to the host cell’s ribosome for translation and transcription while the host ribosome begins to replicate and reproduce the viral genome. Establishing an infection, determining tissue tropism, infectivity and species range of the virus all depend on the interaction of the corona virus spike protein with its complementary host cell receptor.

Similar to most flu-like viruses, human to human transmission of corona virus occurs predominantly through respiratory droplets generated by sneezing and coughing. Infection occurs when the virus gains access into the host cell following direct or close contact with these droplets released by already infected people. Infection can also occur through touching everyday objects such as doorknobs that may be harboring these droplets, and then using the infected hands to touch ones face.

The recent anti vaccination campaigns, conspiracy theories and possible links to conditions like autism have caused us to rethink the use of mass vaccination. The questions on everyone minds are: should we continue mass vaccination? Is vaccination a safe public health measure? These questions, in recent times, have become socio political, medical, religious and even ethical. The socio political basis of the argument is due to the fact that some political groups like the liberalists are against forced vaccination due to liberality. Also, there are some conspiracy theories about their use in regional subjugation through the spread of infectious agents. The medical argument of course comes from the potential adverse effects and concerns over potentially harmful agents like thimerosal (a mercury containing compound)that have been phased out in many countries including Canada.

The concerns about the public health safety of vaccination exist because of the potential harm that vaccines can cause. Let us briefly discuss vaccines to understand why this potential harm exists. Vaccination is the administration of vaccines (which contain a microorganisms in a weakened or killed state, or proteins or toxins from the organism) in order to stimulate the immune system to defend against an infectious agent. Generally, the closer the organism or virus resembles the original organism, the more the immune response that would be generated but the more likely it would reverse to the original organism, that is, the more the potency the less safe it is. This risk of reversion is why vaccines are contraindicated in high risk groups such as:

  • Children
  • Elderly
  • Pregnant women
  • Immune-compromised individuals e.g. AIDS patients
  • Individuals under immunosuppressive therapy

Despite these risks, vaccination is recommended for some group of people because they are more likely to be exposed to an infectious agent. These groups include:

  • Health workers and Vetenarians
  • Travellers moving to areas of high endemicity
  • Explorers and researchers moving to wild regions
  • Children going to public schools

Amidst the debate, the answer to the question “should we continue mass vaccination?” remains a RESOUNDING YES! Why? Let us look at these facts

  • Immunization currently prevents 2-3 million deaths every year
  • Over 1.5 million children die annually from diseases that can be prevented by vaccination
  • Since 2000, 2.5 billion children have been vaccinated and the number of polio cases has fallen by more than 99%, dropping to just 22 cases in 2017
  • Measles vaccinations averted an estimated 21.1 million deaths between 2000 and 2017

And regarding vaccine safety? Vaccination is safe. Even with the ethical argument about one person in a million being at risk of serious adverse reaction or toxicity, this is not surprising as no procedure is 100% safe. Consider this…

  • The risk for colonoscopy complications, a routine screening procedure is about 0.35%
  • In Canada, the risk of severe pregnancy complications is about 1.5% and 1.6%(700 to 900 deaths) each year in the US
  • For venepuncture, serious complications are seen in 3.4% of these procedures

Food Safety

22.12.2019

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Food Safety is a public health issue that involves the handling, preparation and storage of foods in ways that prevent or reduce the risk of contamination from external sources. Consumption of contaminated foods results in individuals becoming sick from the food, referred to as food borne illnesses. Food safety is a global and public health concern that encompasses a variety of different areas of everyday life. Food contamination is a part of food safety; there is a lot more to food safety than handling, preparing and storing foods properly decrease the chances of contamination. The choice of what and how to eat is perhaps the most important aspect of food safety. We all have to choose between healthy diets (diets high in fibre, low in saturated and trans-fat) and unhealthy diets (diets high in saturated and trans-fat but low in fibre). Unhealthy diet is associated with chronic diseases like cancers particularly colorectal cancer, diabetes and heart disease. Beyond these health benefits/risks, it is also important to stay away from unsafe sea foods such as the puffer fish delicacy. These types of foods are very common in Asia and cause quite a number of deaths; first timers and people not used to these foods should make sure they are properly cooked. Not every food must be eaten!! I mean, you don’t just pick any mushroom in Scandinavia and eat because you want to eat mushroom. You must check if it has white gills like most poisonous ones or you run the risk of eating the death cap.

On a daily basis, avoiding spoilt foods, unlabelled or improperly labelled foods and disfigured canned foods are good food choices. Due to the nature of the 21st century society, people are switching more to produced and processed food which are often stored in containers like cans, sachets etc. This has led to addition of substances to food which act as preservatives, flavours, sweeteners, stabilizers. These food additives, even though they are added for beneficial reasons, some of them like nitrates used in meat preservation are dangerous to health in this case with a known risk of colon cancer. This is why they are tested and guaranteed by the Joint FAO/WHO Expert Committee on Food Additives (JECFA); then clearly written on the food label. This helps people to make better choices if they want to limit the intake of any substance for any reason.

The case is quite different for food adulteration which involves addition of inferior and harmful substances that mimic the desired substance but with reduced quality. It is important to note that food adulteration is a criminal offence as individuals have the right to expect a certain quality of food they purchase; and food adulteration tramples on this right with impunity. It is mostly due to profit drive but can also be due to increased demand and lack of strong regulatory food laws. Some adulterants and food involved with ways to detect the adulterant are

  • Mustard oil(adulterant is argemone oil): Shake and heat mustard oil with drops of nitric acid for 2 minutes, argemone oil is present if it turns red
  • Salt/sugar (chalk powder): Stir in a spoonful of the salt in a glass of water. If the solution turns white and a residue settles at the bottom, it indicates the presence of chalk.
  • Turmeric powder (adulterant-metanil yellow, chalk powder, lead chromate): Add a teaspoon of turmeric to a glass of warm water. Do not stir it and leave it still for a while. Check after about 20 minutes. If the powder settles down at the bottom of the glass with clear water above, the turmeric is pure.
  • Chilli powder(brick powder): Adulterant settles on addition of water

These imitations pose serious health risk to consumers and must be taken seriously. As many persons are ignorant of them and the fact that people will not usually carry out these tests, it left for the government to enact strong regulatory laws and policies along with strong surveillance systems to stop this menace. Finally, the fuss about genetically modified foods (or bioengineered foods if you like)  deserves mention. Whether GMOs have future harmful effects is unproven but the general consensus is that they are at least safe for now.

If you have ever developed abdominal pain and discomfort with frequent stooling, chances are that you are just part of the 1 in 10 people who have suffered from diarrhoeal diseases, the most common result of food contamination. Diarrhoea is implicated in, and has been reported as a cause of over 200,000 deaths worldwide. About 600 million people fall ill due to food contamination leading to economic losses of over $950 billion. With the involvement of larger group of people- international and intercontinental outbreaks of food poisoning like the fipronil egg contamination case in Eurasia and many other cases, it has become clear that this problem is worldwide public health priority essential to achieve food safety, better nutrition and food security. Although anyone can get affected, vulnerable populations such as the elderly, sick and children especially those under 5 years of age, are more likely to be affected and even die from food borne diseases which result from contaminated food. Also, people living in developing parts of the world like Africa and Asia (especially South East Asia) are more likely to get food borne diseases due to poor food handling, sanitation, waste management and weak food regulatory laws.

Even though these features are risk factors for contamination, they are not direct causes. The major causes of food contamination include:

  • Biological contaminants: These are microorganisms including bacteria, parasites, viruses, fungi and even the novel infectious agents, prions. Notable agents are salmonella (the cause of typhoid fever), E. coli (the cause of diarrhoea), vibrio (the cause of cholera), rota and noro viruses, the prion protein that caused the disastrous disease, kuru.
  • Chemical contaminants: Chemical substances like pesticides, herbicides, food additives and adulterants added throughout the process of food production and processing can result in contamination. Also, contaminants may find their way into food due to other reasons like poor waste management, water and land pollution.
  • Physical contaminants: These are foreign objects like metal, glass, hair, plastic etc that could be found in food due to poor food production, handling and cooking practices.

It is important to stress the importance of food safety which is the absence of hazards in food. Food safety actually involves everyone from producer to consumer, from farm to fork. That is why the WHO in the quest for better food safety education have provided 5 ways of proper food hygiene which include keeping food clean, separating raw and cooked food, cooking thoroughly, keeping food at safe temperatures and using safe water and raw materials. Food safety education should also involve teaching the public to make better food choices and other good food handling practices like proper spacing when storing foods in the refrigerator and following producer directions on containers that should not be put in a microwave. Those involved in food production and processing must be regulated by strong regulatory laws from the government who should be influenced by WHO/FAO codex alimentarius.

Food Insecurity

8.12.2019

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Hunger is an unpleasant feeling reflected by abdominal pain, discomfort, irritability or headaches. These feelings tell our brain that we’re hungry so we can find something to eat. In the case of food insecurity, there is the unavailability or lack of access to food in the face of hunger. Food insecurity is fear of hunger because there is nothing to, something that is more common than we think. Food insecurity is a global problem and needs to be addressed as public health emergency. Although the statistics in the developing nations of Africa, Asia and South America is alarming, the problem of food insecurity is far from being restricted to these regions; there is a lot of food insecurity in North America including US, Canada and other developed nations. About 1 in 7 people have food insecurity in the US; some regions like Milwaukee are even worse with 1 in 4 people living with food insecurity (Nunavut and other parts of northern Canada have more than 40% of people living in food insecurity). There is a direct correlation between food insecurity and protein energy malnutrition with resulting effects like psychosocial problems (depression and anxiety), stunting growth and other developmental problems predominantly seen in children. In addition, food insecurity is a risk factor that sits at the heart of many public health problems such as marginalization, food safety, political Instability and mass migrations, etc.

It is necessary to know the components of food insecurity to understand how it is caused. The four components of food insecurity are:

  • Availability: Sufficient quantities of appropriate food are unavailable from domestic production, commercial imports or food assistance.
  • Access: Adequate income or other resources are unavailable to access appropriate food through home production, buying, exchange, gifts, borrowing or food aid.
  • Utilization: Food eaten is unsafe from contaminants and nutritionally inadequate to meet the needs of the individual
  • Stability: Adequate food is lacking at all times so that access and availability of food is curtailed by acute or recurring emergencies

The most common cause of serious food insecurity is political instability due to conflicts and wars. It is almost impossible to see any war where hunger is not used as a war strategy; Yemen, South Sudan, Syria…These disrupt food availability to as much as 30-50% of the population. Aside conflict, government policies like reduced budget allocation to agriculture, reduced incentives and loans to farmers could increase the likelihood of food insecurity. Also, Poverty which is related to unemployment and low income leads to food insecurity by reducing access to available food. It is more common in developing countries, rural areas and marginalized groups. More so, extreme climate events like global warming and natural disasters such as droughts and floods are also important causes of increasing food crisis and insecurity. One of the oldest examples come from the biblical Egyptian famine story where Joseph saved the Egyptians by storing food in the good times.

With that said, we would expect to address food insecurity by working on the above causes but it’s not that simple. First, natural disasters and conflicts are out of control most times, plus poverty which remains a persistent problem. One of the most important things is to address the stigma around food stamps which leads to low self-esteem, anxiety, depression and shame. Food supports should be available and accessible to people in need; not by increasing production as, sadly, one-third of the world food is wasted. This is why there should be food policies that would facilitate proper food distribution. There are lots of stereotypes about people living in food insecurity; that hunger should have a certain appearance (ragged clothes) but there are well dressed people who do not know where their next meal would come from. Public health programs, education and awareness are needed to correct these unfounded beliefs.

Wildfires are large, uncontrolled and destructive fires that spread quickly over woodland, brush or an area of combustible vegetation, mostly in rural regions. Depending on the kind of vegetation involved, wildfires may also be referred to as forest fires, grassland fires, bush fires, brush fires, urban fires or wildland fires. Wildfires could happen in most parts of the world except places like the Antarctica. Fire is always seen as a good servant and a terrible master; in the case of wildfires, it evolves from being not just a terrible servant but an enraged god causing loads of destruction to life, properties, environment and natural resources.

Wildfires can occur naturally and spontaneously due to factors like lightning and heat- extremely dry heat waves can produce enough heat to spark a wildfire. Dry weather and drought convert green vegetation into dry, flammable fuel; strong winds spread fire quickly over the land and warm temperatures encourage combustion. Additionally, humans also contribute to this disaster either accidentally or deliberately through campfires, careless cigarettes disposal, burning etc. According to the national interagency fire center, human beings cause about sixty one thousand eight hundred and fifty two (61,852) fires yearly.

Wildfires can burn hundreds to millions of acres of land at rapid speeds consuming everything on its path from trees to animals and humans. The largest single fire ever recorded was that of the 2003 Siberian Taiga fires- 27 million Acres of land engulfed in flames and about 47 people died, emissions from the fire equaled the emission cuts promised by the European Union under the Kyoto protocol. The scars caused by this fire are still seen in present day environmental studies on ozone depletion.

Some countries like Canada and Australia have accepted wildfires as an integral component in shaping their forests. Their ecological system has developed symbiosis with the fire which in turn affects the air quality and landscape. Wildfires and industrial activities result in the release of greenhouse gases which increase the level of heat through the depletion of the ozone layer- the heat in turn increases the rate to which the wildfires can occur. This causal sequence explains the increased frequency of fires around the amazon basin as well as the recent California fire outbreaks.

The war on climate change is far from ending if the problems of wildfires are not properly addressed. Wildfires pose immediate and serious public health threats to individuals living around the region and also to everyone on planet earth- there are already increased reports of respiratory diseases among Brazilian children.Wildfire prevention starts from different agencies that cover restrictions but ultimately depends on the behavior of the general public. In order to stop and reduce the rate or frequency of wildfires, regulating bodies need to be vigilant and enact the necessary laws and policies important in tackling this issue. Data of previous fire incidents should be continuously reviewed and compared with the weather forecast to recognize dangerous patterns so as to know how to manage them effectively. People living in fire susceptible areas should be well educated and constantly informed through various means of communication about any slight change in their environment. Programs like firewise, community wildfire protection plan and fire adapted communities are plans that work to protect people, properties and natural resources by emphasizing forest fire readiness and creating fire resistant community designs. These and more regulations will help in preventing and containing wildfires as well as minimizing spreads and damage to the environment.

Health care workers are often at increased risks of infections due to their immediate work environment. The potential risk to their health is an important public health issue that is particularly neglected in many developing countries. The 2006 World Health Report-Working Together for Health reported a severe health workforce crisis In fifty-seven (57) countries- most of them in Africa and Asia. In Nigeria for example, during the 2014 Ebola outbreak, Dr Stella Adadevoh and some other health care workers lost her lives while trying to prevent Ebola spread from Port Harcourt to Lagos and other parts of the country- sadly without receiving a national honour or credit for their efforts and bravery. It is a costly price for health workers to lose their lives in the course of their service but unfortunately, the list of healthcare workers that have lost their lives in a similar fashion is unending. There are various kinds of hazards to which health workers are exposed-they include, Biological hazards which is a group of hazards including infectious agents like Ebola mentioned above, HBV, HIV etc. Other forms of hazards can be physical hazards, chemical hazards and psychosocial hazards.

Biological hazards such as infectious agents pose serious risk to the lives of every health care personnel. These workers may be exposed through inhalation, contact with bodily fluids and more importantly, needle stick injuries. In fact, the WHO global burden of disease from sharps injuries to health-care workers showed that 37% of the hepatitis B among health workers was the result of occupational exposure. Sometimes, these are due to either mistakes from the health worker or poor disposal of wastes.

Health workers are also affected by physical hazards including fire and radiation as well as work related violence just like industrial workers. Fire hazards have been reduced due to widespread public health measures but there are still risks of harmful radiation exposure as radiation is a part of diagnostic medicine. Work related violence is a common problem in developing countries- studies have shown that over 90% health workers especially nurses, have been abused physically or verbally.

Chemical hazards from toxic substances used in routine medical practice mostly result in injury unlike biological hazards that can lead to death. Also, allergy from latex gloves is an important form of chemical hazard. Similar to biological hazards, they can also be due to mistakes from the health worker and poor disposal of wastes. Finally, there are psychosocial hazards that affect the mental health of health workers. These are mostly due to very long work time leading to physical and emotional exhaustion, low pay in developing countries and stress induced illnesses such as hypertension. These emotional hazards inflict invisible wounds that reduce the efficiency and efficacy of health workers. This is then reflected in the poor quality of care and health systems experienced by the public at large.

The WHO and other international health organisations continue to advocate for better occupational health through practices like use of post exposure prophylaxis, vaccination of health workers, increase in wages and trainings to prevent occupational hazards and its consequences in the health care system.

According to World Health Organization (WHO), healthcare associated infections (HCAIs)constitute a significant public health burden with about 15% of hospitalized patients affected- leading to an increase in morbidity, mortality and healthcare costs. Also known as nosocomial infections, healthcare associated infections are regarded as infections that occur within 48 hours of hospital admission, 3 days of discharge or 30 days of an operation. HCAIs pose serious problems because the organisms implicated are usually drug resistant, the most common ones being methicillin resistant staphylococcus aureus (MRSA) and multi-drug resistant gram negative bacteria.

Given to the presence of several risk factors, intensive care unit (ICU) patients are by far the most affected group by nosocomial infections. The risk factors associated with HCAIs include:

  1. Health status: Since most patients are exposed to similar conditions, the current health status and immunity of a patient determines the risk of infection of particular patients. Some vulnerable and immune-compromised patients may be malnourished or elderly.
  2. Invasive procedures: Some hospital procedures, especially surgery, involves the use of materials like catheters, lines and drains which when left for a long time can serve as a nidus for infection
  3. Treatment: Some treatment modalities can pose risk to infection e.g. blood transfusion, hemo-dialysis and immunosuppressive treatments
  4. Poor and unhygienic hospital practices: Poor sanitation and improper disposal of hazardous healthcare wastes can expose patients to infectious pathogens. Also, healthcare workers could play a role as vectors of infectious agents when they fail to take standard precautions.

Perhaps, the most important historical guide on addressing HCAIs was by the Hungarian physician- Ignaz Semmelweiz, who demonstrated that hand washing drastically reduced the incidence of puerperal fever in childbearing women. Even though his teachings were not accepted by physicians at that time, it laid the foundation for antisepsis. Till today, regular and proper hand washing remains the single most important measure in infection control. Proper hand washing should involve the use of alcohol disinfectants or medicated soap after removal of jewellery like watches, rings and should not be replaced with gloving. Hospitals should provide more wash sinks and easier to use disinfectants like sprays to encourage regular hand washing. To improve hygiene in general, healthcare facilities should provide enough personal protective materials such as overalls, gloves and nose masks which must not be reused. Also, healthcare workers must endeavour to engage in regular daily cleaning of stethoscopes with alcohol and observing complete aseptic procedure in invasive procedures to reduce the risk of infection.

In addition, it is pertinent that the healthcare system ensures enlightenment of caregivers and students alike on the importance of standard precautions of everyday practice in reduction of nosocomial infections. Also, there must be proper disposal of hazardous healthcare wastes which can harbour dangerous infectious organisms that are drug resistant. The related problem of antimicrobial resistance can then be reduced by good antimicrobial stewardship.