Additional costs of healthcare-associated infections (HAI) in three hospitals in the City of Bobo Dioulasso, Burkina Faso, 2022: A nested cohort case-control study

Abstract

The economic and human impact of healthcare-associated infections (HAIs) remains poorly documented in Sub-Saharan African countries. This study aimed to assess the human and economic costs of HAIs in the main hospitals of Bobo Dioulasso. A nested cohort case-control study with matched cases of HAIs and controls (1:1) by age, sex, reason for hospitalization, and ward. The study was conducted in three wards of the Sourô Sanou University Hospital and in the postoperative wards of the Do and Dafra district hospitals. Paired groups with and without HAIs were compared based on mortality, medical expenses, length of hospital stay, and duration of illness. The Wilcoxon test and the McNemar test were used to test hypotheses between groups. The statistical significance level was 5% for all analyses. A total of 118 patients with HAIs and 118 without HAIs (236 patients) were included. HAIs were associated with a 4.4-day increase in hospital stay (8.4 vs 4.0 days; p=0.000), a 7.7-day increase in duration of illness (19.2 vs 11.5 days; p=0.000). In-hospital mortality rate was 18.6% in patients with HAIs and 7.6% in patients without HAIs (p=0.02). HAIs resulted in an additional medical cost estimated at US$ 60.6 (p=0.000), representing a 33.0 % increase in health expenditure. This is mainly due to additional drug costs (US$ 55.6). Treatment of HAIs were more expensive in the intensive care unit (US$ 295.2) than in other wards (US$ 155.6), p=0.017. These findings show that HAIs increased the burden of the disease. The quantified financial burden will be useful to policymakers in allocating resources to reduce HAIs.

Keywords: Additional cost, healthcare-associated infections, hospitals Burkina Faso.