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PAHEF’s support of healthcare-associated infection control and prevention efforts provides the foundation and the pathway for much needed sustainable efforts in Bolivia

geral 1From November 14 to 17, the Pan American Health and Education Foundation (PAHEF) sponsored and participated in the VIII Pan-American Congress on Healthcare-Associated Infections and I Bolivian Congress on Healthcare-Associated Infections, which were simultaneously held in Santa Cruz de la Sierra, Bolivia. PAHEF’s support of the Congresses, which were hosted by the Bolivian Association of Hospital Epidemiology and Control of Healthcare-Associated Infections (Asociación Boliviana de Epidemiología Hospitalaria y Control de Infecciones Asociadas a Servicios de Salud), was made possible through a grant from a fund created by the generosity of the People of Taiwan. This support was a natural extension of PAHEF’s previous efforts and has further helped establish it as a recognized leader in this field in Latin America and the Caribbean.


Since 2004, PAHEF has been involved in infection control and prevention efforts. In Bolivia, PAHEF’s support has been pivotal in initiating various activities related to this important topic, including:

  • Implementation of the Infection Control in Hospitals project in seven hospitals in La Paz and El Alto to establish infection control and prevention programs. The nurses who were trained through the project remain employed in that capacity in their respective hospitals or have gone into teaching. One of the nurses who was trained is now the Director of the Nursing Program at the University of San Andres in La Paz and has established a one-year training program in infection control and prevention for students who wish to receive additional training in infection control and prevention and for established nurses who wish to extend their nursing education and gain specific expertise in this field. She has requested approval of Bolivia’s Ministry of Health (MOH) for this initiative so that nurses who receive the additional education are awarded a diploma in infection control and prevention and epidemiology, giving them recognition and professional opportunities to advance in this important effort.
  • Improvement of the National Reference Laboratory in Clinical Microbiology (Laboratorio Nacional de Referencia de Microbiología Clínica) by updating and creating identification and susceptibility testing standards for pathogens involved in health care-associated infections as well as by creating monographs for updating microbiology laboratory procedures. The laboratory medicine (microbiology) technical manuals created by the National Institute of Health Laboratories (Instituto Nacional de Laboratorios de Salud, INLASA) under the auspices of this project have been adopted by all Bolivian clinical laboratories as part of standard operating procedures in clinical microbiology.
  • Creation of a successful computerized registry system for the analysis and reporting of hospital pathogens to produce an accurate epidemiologic map for Bolivia. Currently, the central registry at INLASA in La Paz is handling a volume of information on hospital pathogens that is about 10 times larger than before the project was initiated. Additionally, the information gathered has enhanced the creation of valid epidemiological profiles for the hospital pathogens and their antimicrobial susceptibility patterns, which is crucial to any effort to institute prudent antimicrobial prescribing and use.
  • Provision of updated monographs on the management of healthcare-associated infections (HCAIs) for clinicians with an emphasis on judicious antimicrobial utilization. Most recently, Bolivia’s MOH is working to develop and implement a hospital accreditation program as a result of these studies, which includes infection control and prevention as a key component and is fully-supported by the Minister of Health at the time of the conference, Dr. Nila Heredia.
  • Creation of a reference textbook on infection control and prevention. The two-volume reference book that was published last year in Bolivia was distributed in CD-ROM format to all the Congress participants. An additional 1,500 copies has been distributed to all the hospitals in Bolivia. Several participants inquired about permission for reproduction for use and dissemination in their respective countries. Presently, 500 printed copies and 2,500 electronic copies have been disseminated in Bolivia, in Ecuador (May 2011 MOH conference on infection control), and in other Latin American countries.
  • Development and adoption of definitions of HCAIs, methods of surveillance, and other systems of infection control and prevention. These definitions, methods, and systems have been incorporated by the Pan American Health Organization (PAHO) in a document that outlines the creation of a national infection control and prevention program. Bolivia’s MOH is currently reviewing this document and approval is expected sometime in early 2012.

Additionally, as a result of the PAHEF-sponsored programs on infection control and prevention in Bolivia, the Bolivian Association of Hospital Epidemiology and Control of HCAIs was created. As a registered International Federation of Infection Control (IFIC) member and Bolivian IFIC Chapter, its members include nurses, microbiologists, epidemiologists, public health physicians, infectious disease physicians, and other physicians interested in this field. The founding members were all involved in the PAHEF projects.

In recognition of Bolivia’s efforts to develop a national HCAIs control and prevention program and to create further incentives for training and education in these fields in Bolivia, as a result of PAHEF’s support, the IFIC granted the Bolivian Association of Hospital Epidemiology and Control of HCAIs the opportunity to host the VIII Pan-American Congress on Healthcare-Associated Infections.

The Congress also had the support and involvement of Bolivia’s MOH. The Minister of Health was involved throughout the planning and coordination of the Congress. She accepted the organizers’ invitation to open the Congress, but unfortunately, unanticipated circumstances prevented Dr. Heredia’s attendance. The National Health Director, Dr. Jhonny Vedia Rodriguez, represented the ministry in her absence.

The congresses were a great success. Total attendance exceeded 500, double the anticipated number of 250. Over 530 individuals, including 39 invited guest professors who lectured and held practical workshops, participated in the Congress. One hundred twenty participants came from various Latin American countries. Additionally, guest speakers represented 16 different countries in North, Central, and South America and Europe. Feedback from national and international attendees and from the invited guest speakers was uniformly positive.

The attendees praised the number and breadth of the covered subjects, the high quality of the scientific presentations, and the excellent venue facilities. Four half-day pre-Congress courses in hospital epidemiology, nosocomial outbreaks management, and sterilization techniques and antimicrobial management in HCAIs were offered. Twelve plenary sessions as well as 12 concurrent symposia with 60 lectures, question and answer sessions, and roundtable discussions were held. Forty oral and poster sessions were also held.

Bolivia’s National Health Director presented a special award, jointly bestowed by the Government of Bolivia and the Bolivian Association of Hospital Epidemiology and Control of HCAIs, to Edward L. Kadunc, PAHEF president, representing PAHEF. The award recognized PAHEF’s support to Bolivia and its impact in formulating the norms to be employed in the national infection control and prevention program, as well as PAHEF’s leadership and sustained commitment to the efforts to improve infection control and prevention practices throughout the Latin America and the Caribbean Region. Ms. Pilar Torres, PAHEF Director of Programs accepted the Award, after a comprehensive video message from Mr. Kadunc to the Congress had been presented and well received.

Dr. Luis Jauregui, a member of the PAHEF Board of Directors, was also honored with an award, which recognized his sustained and critical individual efforts on behalf of the PAHEF board since 2004. Additionally, Dr. Jauregui was equally honored as the Keynote Speaker at the opening of the Congress. Representatives from the IFIC, PAHO’s Bolivian and Washington, DC offices, the United Nations Children's Fund (UNICEF), the Bolivian Academy of Sciences, the Bolivian College of Physicians, the Bolivian Association of Nurses, the Bolivian Association of Odontology, and the Bolivian Association of Microbiology and Biochemistry, as well as the Governor of the Department of Santa Cruz were present for receipt of these honors.

A Sample of Recent PAHEF Projects in the Region