South Africa lacks a national database to track hospital-acquired infections (HAIs), leaving a critical gap in patient safety and infection control. Health experts warn that the absence of systematic surveillance allows preventable infections and deaths to go unnoticed, particularly among vulnerable groups such as newborns and mothers.
A 2024 study, The Burden of Hospital-Acquired Infections (HAI) in Sub-Saharan Africa, revealed that 12.9% of patients admitted to hospitals in the region contract HAIs - many of them deadly. Globally, HAIs remain a leading cause of morbidity, often resulting from conditions patients did not have upon admission.
Neonatal Units Bear The Brunt
The issue is especially severe in neonatal wards. Professor Angela Dramowski, head of the general paediatrics unit at Stellenbosch University, highlighted that 70% of pre-term babies who died at Chris Hani Baragwanath Academic Hospital had laboratory-confirmed infections.
She stressed that data on HAIs are patchy and drawn mainly from research in tertiary hospitals. Dramowski said SA does not have a single national database on neonatal and maternity admissions and outcomes. She added that such a system would be ideal to track mortality and morbidity trends.”
The BabyGerms study, one of the few to provide laboratory-based data on neonatal infections, offered insights but lacks the national reach to comprehensively monitor trends.
Hospital-Acquired Infections Data Is “Inadequate”
Professor Vindana Chibabhai, who leads the Centre for Healthcare-Associated Infections at the NICD, warned that deaths due to infections are often misclassified. She said most are listed as caused by prematurity, but infection is frequently the actual cause.
Lab-based surveillance, she added, is a powerful tool for identifying pathogens, tracking resistance, and detecting outbreaks early. However, even the best lab data captures only about 40% of the infection burden.
Lack Of Transparency Hinders Response
Experts argue that transparent reporting could be transformative. Chibabhai said sharing infection data helps identify problem areas. It’s not about blame, she said, it’s about solutions.
When infection and antibiotic-resistance data are openly shared, hospital management is more likely to act. Resources, staff, and equipment can be directed where they are most needed.
Antimicrobial Resistance Adds Urgency
Both Dramowski and Chibabhai stress the urgency of a coordinated national response. Without surveillance, HAIs and antimicrobial resistance (AMR) could soon eclipse other infectious causes of death in the country.
Dramowski said public awareness, political will, and national advocacy are urgently needed.
Until South Africa establishes a national system to monitor and report HAIs, experts warn the country remains at risk of hidden hospital epidemics - silent killers that go unseen, uncounted, and unaddressed.
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