Prevalence of Hospital-Acquired Infections in Low- and Middle-Income Countries: Systematic Review and Meta-Analysis

The burden of hospital-acquired infections (HAIs) is particularly substantial in low- and middle-income countries (LMICs). However, a comprehensive understanding of their prevalence in these regions is lacking. This systematic review aimed to evaluate the prevalence of HAIs in LMICs. Major databases, including Scopus, PubMed, and Web of Science, were thoroughly searched for published studies between January 1, 2000, and July 15, 2024. The PRISMA guidelines were followed. The pooled prevalence of HAIs was estimated using a random-effects model and a 95% confidence interval. The literature search identified 87 studies reporting HAI prevalence in LMICs. The overall prevalence of HAIs across LMICs was 22% (95% CI = [17, 28]). The South-East Asian Region presented the highest prevalence at 37% (95% CI = [13, 62]). In terms of income level, low-income countries had the highest prevalence at 37% (95% CI = [23, 52]). Surgical site infections had the highest prevalence among infection types at 27% (95% CI = [23, 31]). This systematic review underscores the high prevalence of HAIs in most LMICs, emphasizing the need to facilitate the development of targeted prevention and control strategies to mitigate the impact of this critical public health issue, especially in resource-limited settings.