Controlling infectious disease outbreaks in low-income and middle-income countries

Infection Prevention and Safety in Low and Middle Income Countries (C Bardossy, Section Editor)
Part of the following topical collections:
  1. Topical Collection on Infection Prevention and Safety in Low and Middle Income Countries


When an infectious disease outbreak is detected or suspected, a healthcare facility’s infection control personnel should be notified and an outbreak control team formed that is pertinent to the size and severity of the outbreak and healthcare facility. Management of an infectious disease outbreak in a middle- or low-income country is challenging. Cost-effective recommendations that are easy to carry out and that have been stratified according to the type of infection and prevention and control intervention used are provided in this paper and constitute basic practices.


infectious disease outbreak healthcare facility infection control middle-income countries low-income countries 


Compliance with Ethical Standards

Conflict of Interest

Juan Pablo Caeiro declares that he has no competing interests. María I. Garzón declare that she has no competing interests.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

References and Recommended Reading

  1. 1.
    From panic and neglect to investing in health security: financing pandemic preparedness at a national level. International working group on financing preparedness 2017.
  2. 2.
    Nordmann P, Poirel L. The difficult-to-control spread of carbapenemase producers among Enterobacteriaceae worldwide. Clin Microbiol Infect. 2014;20(9):821–30.CrossRefPubMedGoogle Scholar
  3. 3.
    WHO Ebola Response Team. After Ebola in West Africa--Unpredictable Risks, Preventable Epidemics. N Engl J Med. 2016;375(6):587–96.CrossRefGoogle Scholar
  4. 4.
    Vonberg RP, Weitzel-Kage D, Behnke M, Gastmeier P. Worldwide Outbreak Database: the largest collection of nosocomial outbreaks. Infection. 2011;39(1):29–34.CrossRefPubMedGoogle Scholar
  5. 5.
    Raka L. Prevention and control of hospital-related infections in low and middle income countries. Open Infect Dis J. 2010;4:125–31.CrossRefGoogle Scholar
  6. 6.
    World Health Organization. WHO guidelines on hand hygiene in health care. First global patient safety challenge: clean care is safer care. Geneva: World Health Organization; 2009.Google Scholar
  7. 7.
    Paul R, Das NK, Dutta R, Bandyopadhyay R, Banerjee AK. Bacterial contamination of the hands of doctors: a study in the medicine and dermatology wards. Indian J Dermatol Venereol Leprol. 2011;77(3):307–13.CrossRefPubMedGoogle Scholar
  8. 8.
    Munoz-Price LS, Birnbach DJ, Lubarsky DA, et al. Decreasing operating room environmental pathogen contamination through improved cleaning practice. Infect Control Hosp Epidemiol. 2012;33(9):897–904.CrossRefPubMedGoogle Scholar
  9. 9.
    Townsend J, Greenland K, Curtis V. Costs of diarrhea and acute respiratory infection attributable to not handwashing: the cases of India and China. Trop Med Int Health. 2017;22(1):74–81.CrossRefPubMedGoogle Scholar
  10. 10.
    Holmen IC, Niyokwizerwa D, Nyiranzayisaba B, Singer T, Safdar N. Challenges to sustainability of hand hygiene at a rural hospital in Rwanda. Am J Infect Control. 2017;45(8):855–9.CrossRefPubMedGoogle Scholar
  11. 11.
    Mitchell BG, Dancer SJ, Anderson M, Dehn E. Risk of organism acquisition from prior room occupants: a systematic review and meta-analysis. J Hosp infect. 2015;91(3):211–7Google Scholar
  12. 12.
    Dancer SJ. Hospital cleaning in the 21st century. Eur J Clin Microbiol Infect Dis. 2011;30(12):1473–148.CrossRefPubMedGoogle Scholar
  13. 13.
    Doll M, Stevens M, Bearman G. Environmental Cleaning and Disinfection of Patient Areas. International Journal of Infectious Diseases.
  14. 14.
    Reidy P, Fletcher T, Shieber C, Shallcross J, Towler H, Ping M, et al. Personal protective equipment solution for UK military medical personnel working in an Ebola virus disease treatment unit in Sierra Leone. J Hosp Infect. 2017;96(1):42–8.CrossRefPubMedPubMedCentralGoogle Scholar
  15. 15.
    Magiorakos AP, Burns K, Rodríguez Baño J, Borg M, Daikos G, Dumpis U, et al. Infection prevention and control measures and tools for the prevention of entry of carbapenem-resistant Enterobacteriaceae into healthcare settings: guidance from the European Centre for Disease Prevention and Control. Antimicrob Resist Infect Control. 2017;6:113.CrossRefPubMedPubMedCentralGoogle Scholar
  16. 16.
    Lefebvre A, Gbaguidi-Haore H, Bertrand X, Thouverez M, Talon D. Impact of barrier precautions and antibiotic consumption on the incidence rate of acquired cases of infection or colonization with Acinetobacter baumannii: a 10-year multi-department study. Am J Infect Control. 2011;39(10):891–4.CrossRefPubMedGoogle Scholar
  17. 17.
    Dramowski A, Whitelaw A, Cotton MF. Burden, spectrum, and impact of healthcare-associated infection at a South African children's hospital. J Hosp Infect. 2016;94(4):364–72.CrossRefPubMedGoogle Scholar
  18. 18.
    Freedberg DE, Salmasian H, Cohen B, Abrams JA, Larson EL. Receipt of antibiotics in hospitalized patients and risk for Clostridium difficile infection in subsequent patients who occupy the same bed. JAMA Intern Med. 2016;176(12):1801–8.CrossRefPubMedPubMedCentralGoogle Scholar
  19. 19.
    Doll M, Masroor N, Major Y, Fleming M, Doern C, Cooper K, et al. Carbapenem-resistant Enterobacteriaceae at a low prevalence tertiary care center: Patient-level risk factors and implications for an infection prevention strategy. Am J Infect Control. 2017;45(11):1286–8.CrossRefPubMedGoogle Scholar
  20. 20.
    Pulcini C, Botelho-Nevers E, Dyar OJ, Harbarth S. The impact of infectious disease specialists on antibiotic prescribing in hospitals. Clin Microbiol Infect. 2014;20(10):963–72.CrossRefPubMedGoogle Scholar
  21. 21.
    Kim YA, Park YS, Youk T, Lee H, Lee K. Correlation of Aminoglycoside Consumption and Amikacin- or Gentamicin-Resistant Pseudomonas aeruginosa in Long-Term Nationwide Analysis: Is Antibiotic Cycling an Effective Policy for Reducing Antimicrobial Resistance? Ann Lab Med. 2018;38(2):176–8.CrossRefPubMedGoogle Scholar
  22. 22.
    Barlam TF, Cosgrove SE, Abbo LM, MacDougall C, Schuetz AN, Septimus EJ, et al. Implementing an Antibiotic Stewardship Program: Guidelines by the Infectious Diseases Society of America and the Society for Healthcare Epidemiology of America. Clin Infect Dis. 2016;62(10):1197–12.CrossRefPubMedGoogle Scholar
  23. 23.
    De Serres G, Skowronski DM, Ward BJ, Gardam M, Lemieux C, Yassi A, et al. Influenza Vaccination of Healthcare Workers: Critical Analysis of the Evidence for Patient Benefit Underpinning Policies of Enforcement. PLoS One. 2017;12(1):e0163586.CrossRefPubMedPubMedCentralGoogle Scholar
  24. 24.
    Kim DK, Riley LE, Harriman KH, Hunter P, Bridges CB. Advisory Committee on Immunization Practices. Recommended Immunization Schedule for Adults Aged 19 Years or Older, United States. Ann Intern Med. 2017;166(3):209–19.CrossRefPubMedGoogle Scholar
  25. 25.
    Wong H, Eso K, Ip A, Jones J, Kwon Y, Powelson S, et al. Use of ward closure to control outbreaks among hospitalized patients in acute care settings: a systematic review. Syst Rev. 2015;4:152.CrossRefPubMedPubMedCentralGoogle Scholar
  26. 26.
    Sapkota B, Gupta GK, Mainali D. Impact of intervention on healthcare waste management practices in a tertiary care governmental hospital of Nepal. BMC Public Health. 2014;14:1005.CrossRefPubMedPubMedCentralGoogle Scholar
  27. 27.
    Al-Surimi K, Khalifa M, Bahkali S, El-Metwally A, Househ M. The potential of social media and internet-based data in preventing and fighting infectious diseases: from internet to twitter. Adv Exp Med Biol. 2017;972:131–9.CrossRefPubMedGoogle Scholar
  28. 28.
    Christaki E. New technologies in predicting, preventing and controlling emerging infectious diseases. Virulence. 2015;6(6):558–65.CrossRefPubMedPubMedCentralGoogle Scholar
  29. 29.
    Moss R, Hickson RI, McVernon J, et al. Model-informed risk assessment and decision making for an emerging infectious disease in the Asia-Pacific region. PLoS Negl Trop Dis. 2016;10(9):e0005018.CrossRefPubMedPubMedCentralGoogle Scholar
  30. 30.
    Radonovich, et al. The Respiratory Protection Effectiveness Clinical Trial (ResPECT): a cluster randomized comparison of respirator and medical mask effectiveness against respiratory infections in healthcare personnel. BMC Infect Dis. 2016;16:243.CrossRefPubMedPubMedCentralGoogle Scholar
  31. 31.
    Foote MMK, Styles TS, Quinn CL. Assessment of Hospital Emergency Department Response to Potentially Infectious Diseases Using Unannounced Mystery Patient Drills - New York City, 2016. MMWR Morb Mortal Wkly Rep. 2017;66(36):945–9.CrossRefPubMedPubMedCentralGoogle Scholar
  32. 32.
    Banach DB, Johnston BL, Al-Zubeidi D, Bartlett AH, et al. Outbreak Response and Incident Management: SHEA Guidance and Resources for Healthcare Epidemiologists in United States Acute-Care Hospitals. Infect Control Hosp Epidemiol. 2017;30:1–27.Google Scholar
  33. 33.
    Peak CM, Childs LM, Grad YH, Buckee CO. Comparing nonpharmaceutical interventions for containing emerging epidemics. Proc Natl Acad Sci U S A. 2017;114(15):4023–8.CrossRefPubMedPubMedCentralGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Hospital Privado UniversitarioCórdobaArgentina

Personalised recommendations