THE deaths of several babies at Port of Spain General Hospital (PoSGH) in April was linked to poor infection prevention and control, said the PAHO report that Health Minister Terrence Deyalsingh laid in the House of Representatives on Friday.
The report rated the precautionary measures in the hospital’s Neonatal Intensive Care Unit (NICU) at just 29 per cent.
The report said the deaths of the seven babies were “possibly related to the increase in cases of sepsis,” referring to bacterial infections.
Based on available information, while admitting to a low sample size, the report blamed an increase in NICU mortality of newborns or neonates.
“Regarding the variables gestational age and birth weight, both show the vulnerability and clinical complexity of the neonates.
“Of note, 17 out of 20 (85 per cent) fatal neonates were very or extremely pre-term and had extremely low or very low weight at birth.” Extremely pre-term meant less than 28 weeks of gestation and very pre-term meant 28-31 weeks of gestation. Full-term babies are born at 40 weeks.
Extremely low birth weight meant under 1,000 grammes (2.2 pounds) and very low birth weight meant less than 1,500 grammes (3.3 pounds).
The report listed five aspects of infection prevention control (IPC) at PoSGH which were respectively rated at 29-80 per cent. Among these, neonatology was rated lowest, at 29 per cent. The PAHO recommendations included breast-feeding within 24 hours of birth, better hand hygiene, active screening of bacteria cultures during outbreaks, better nurse-patient ratios, policies and procedures for cleaning and for high-level disinfection and external performance evaluation of the laboratory.
Deyalsingh told the House, “I once again take this opportunity to extend my deepest condolences to the affected families.”
He quoted the report’s executive summary: “A significant strength identified in PoSGH is the presence of a dedicated IPC programme and a knowledgeable microbiology laboratory team capable of identifying pathogens. The commitment from both hospital administration and national authorities to enhance IPC measures was clearly evident and commendable.”
He said the report said TT’s National Action Plan on Antimicrobial Resistance for 2023-2027 aligned with the WHO Global Action Plan.
“The Ministry of Health and the North West Regional Health Authority (the RHA under whose aegis the hospital falls) having gone through the report, inclusive of the findings and recommendations, note that many of the recommendations contained within the report were already integral parts of the national and regional standard operating procedure.
“We are of the view, however, that there are certain findings that require urgent clarification.”
Deyalsingh said since getting the report on June 21, his ministry had actively communicated and collaborated with PAHO via its country office. “This is to ensure that PAHO has the opportunity to address and resolve these concerns promptly as the report anticipates the submission of additional data and inf
