The National Conference on Infection Control (NCIC) Organized by the Nigerian Society for Infection Control (NSIC) Held at Ostra Hotel, Ikeja, Lagos on 15th to 16th August 2019

Preamble:
The Nigerian Society for Infection Control (NSIC) is a multidisciplinary platform for infection prevention and control (IPC) practitioners and stakeholders in Nigeria, with a mission to ensuring safe patient care and improving occupational and public health through the implementation of evidence-based infection prevention and control practices. The society held her 5th National Conference on Infection Control at Ostra Hotel Ikeja, on 15th -16th August 2019.

Cognizant of the high burden of healthcare-associated infections; an increasing spate of infectious disease outbreaks in Nigeria; the emergence and increasing burden of antimicrobial resistance (AMR) in Nigeria and globally, the theme of the 2019 National Conference was ´More Active and Focused Infection Prevention and Control in Healthcare Delivery’. Sub-themes included; Antimicrobial Resistance and Stewardship; Neonatal Infections; Water Sanitation and Hygiene (WASH) and Surgical Site Infections.

In attendance were different healthcare professionals including but not limited to Clinical Microbiologists, Nurses, Public Health Physicians, Infectious Disease Physicians, Surgeons, Pharmacists, Veterinarians, Environmentalists, Research scientists and Medical Laboratory Scientists. Keynote address and research papers were presented by subject matter experts drawn from academia, the public health sector, and non-governmental organizations.

Observations:
The conference observed and noted as follows;

Recent Progress in IPC :
• The conference acknowledged the role and activities of government, healthcare management, and healthcare workers in infection prevention and control (IPC) at all levels of healthcare delivery. In particular, the Nigerian Centre for Disease Control (NCDC) was acknowledged for developing a national action plan on antimicrobial resistance, the establishment of national IPC unit/ desk and in providing IPC equipment and supplies to healthcare facilities during outbreaks in the country.

• The establishment of a bio-safety level 3 (BSL3) facility in Lagos State, facilitated by the Lagos State Government with the support of the Government of Canada, with bio-security and bio-banking capacity.

• The establishment of the National Antimicrobial Stewardship Working Group by the Clinical Microbiology and Infectious Diseases Society of Nigeria (CLIMIDSON), and the initiative of some healthcare facilities across the country in setting up and antimicrobial stewardship programs.

• The development and operationalization of infection prevention and control training curricula and diploma program by the University of Lagos. Several healthcare workers have been trained through this platform.

• The recognition of the importance of IPC in hospitals by the National Health Act of 2014 (NHA 2014)

Gaps and Challenges in Infection Prevention and Control:
• Dearth of IPC supplies and consumables in healthcare facilities across the country – including regular clean water supply, personal protective equipment (PPE), etc.

• IPC programs are weak or non-existent in most healthcare facilities in the country which has compromised patient safety and quality of care and increased occupational hazards, as evident by the deaths of healthcare workers and others in recent Lassa fever outbreaks across the country.

• Low IPC capacity among healthcare workers, characterized by limited training opportunities, non-standardized training program and lack of dedicated IPC career path.

• Lack of political and administrative support for IPC activities, particularly the absence of budgetary provisions by governments and hospital management despite the recurrent outbreaks of communicable diseases recorded in the country, and the provisions on IPC by NHA 2014.

• Weak surveillance system for healthcare-associated infections and antimicrobial resistance in healthcare facilities across the country.

• Concerns about infectious hazards’ management due to dearth of facilities for bio-safety, biosecurity, and bio-banking in the country.

• Lack of policies to standardize, regulate and institutionalize IPC practices at national and health care facilities levels.

• Lack of integration IPC practices into the One Health Approach in the country.

• High rates of inappropriate prescribing of antibiotics and poor knowledge of the magnitude of antibiotic-resistant infections in the country

Recommendations:

• Recognition of IPC as a distinct discipline and adoption of standardized curriculum and career path for IPC practitioners by the ministry of health.

• Setting up and strengthening IPC programs at national, state and health facility levels with governance structures, policies, and dedicated funding.

• Establishment of a surveillance system for healthcare-associated infections and antimicrobial use/resistance in health facilities

• Setting up and entrenching antimicrobial stewardship programs in hospitals with appropriate guidelines and procedures

• Strengthen multi-sectoral collaboration using the one “One Health Approach” for IPC implementation ( to include human health, animal health and environment ) for a strong national commitment to infectious hazard management in the country through capacity building in bio-security and bio-banking, including the establishment of more bio-safety level 3 and 4 laboratories in the country.

• Enforcement of the provisions of the NHA 2014 as they pertain to IPC in health care facilities

Appreciations:
Our special appreciation and thanks go to the Special Guest of Honour, Her Excellency, the First Lady of Lagos State, Dr. (Mrs.) Ibijoke Sanwo-Olu; Guest of Honour, Prof. Akin Abayomi; Dr. Onwe Ogah Emeka, Keynote Speaker: Prof. Akin Osibogun; Chairman of the event Prof. Wole Atoyebi; Permanent Secretary Lagos State Ministry of Health, Dr. Titilayo Goncalves; Infection Control African Network (ICAN) President Prof. Folasade Ogunsola and Director-General Nigerian Centre for Disease Control (NCDC) Dr. Chikwe Ihekweazu for their presence and support for the conference.

The 6th National Conference in 2020 will also hold in Lagos.

Dr. Abimbola Sowande
Chair, NSIC