Routine sterile glove and instrument change at the time of abdominal wound closure to prevent surgical site infection (ChEETAh): a model-based cost-effectiveness analysis of a pragmatic, cluster-randomised trial in seven low-income and middle-income countries
Authors: Mwayi Kachapila, Raymond Oppong, Adesoji O. Ademuyiwa, Aneel Bhangu, Risikat Dauda, Dhruva N. Ghosh, Sivesh K Kamarajah, Ismail Lawani, Antonio Ramos-De la Medina, Mark Monahan, Dion G. Morton, Omar Omar, Maria Picciochi, Stephen Tabiri, Tracy E. Roberts, Peter Brocklehurst, Sohini Chakrabortee, James Glasbey, Pollyanna Hardy, Ewen Harrison, Rachel Lillywhite, Laura Magill, Dmitri Nepogodiev, Joana Simoes, Donna Smith, Bryar Kadir, Thomas Pinkney, Felicity Brant, Elizabeth Li, Emmy Runigamugabo, Michael Bahrami-Hessari, Edward Bywater, Laura Martinez, Sosthene Habumuremyi, Faustin Ntirenganya, Emmanuel Williams, Maria Fourtounas, Bokossa K. Covalic Melic, Dhruva N. Ghosh, Atul Suroy, Didier Ahogni, Aristide Ahounou, K. Alassan Boukari, Oswald Gbehade, Thierry K Hessou, Sinama Nindopa, M.J. Bienvenue Nontonwanou, Nafissatou Orou Guessou, Arouna Sambo, Sorekou Victoire Tchati, Affisatou Tchogo, Semevo Romaric Tobome, Parfait Yanto, Isidore Gandaho, Armel Hadonou, Simplice Hinvo, Montcho Adrien Hodonou, Sambo Bio Tamou, Souliath Lawani, Francis Moise Dossou, Antoine Gaou, Roland Goudou, Marie-Claire Kouroumta, Ismail Lawani, Enrif Malade, Anne stredy Mkoh Dikao, Joel Nzuwa Nsilu, Pencome Ogouyemi, Marcelin Akpla, Nathan Bisimwa Mitima, Blaise Kovohouande, Stephane Laurent Loupeda, Mamonde Victorin Agbangla, Sena Emmanuel Hedefoun, Thierry Mavoha, Juvenal Ngaguene, Janvier Rugendabanga, Rish Romaric Soton, Martin Totin, Mouhamed Agbadebo, Hubert Dewamon, Irene Akpo, Martin Djeto, Aissatou Hada, Monsede Hollo, Albert Houndji, Anasthasie Houndote, Sylvestre Hounsa, Expedit Kpatchassou, Hugues Yome, Mohamed Moussa Alidou, Eric Jerry Bara, B.T. Bonheur Dossou Yovo, Robert Guinnou, Souleymane Hamadou, H.Pauline Kola, Nabil Moussa, Boniface Cakpo, Lolyta Etchisse, Emery Hatangimana, Moise Muhindo, Katia Sanni, Agossou Barthelemy Yevide, Hermann Agossou, Fiston Basirwa Musengo, Hulrich Behanzin, Djifid Morel Seto, Bill Armstrong Alia, Arnaud Alitonou, Y.Edith Mehounou, Lucien Agbanda, Julien Attinon, Nounagnon Rene Hounsou, Marcel Gbassi, Aniakwo Adagrah, Bin Baaba Alhaji Alhassan, Mabel Pokuah Amoako-Boateng, Anthony Baffour Appiah, Alvin Asante-Asamani, Benedict Boakye, Samuel A Debrah, Rahman Adebisi Ganiyu, Donald Enti, Patience Koggoh, Richard Kpankpari, Isanella Naa M. Opandoh, Meshach Agyemang Manu, Maison Patrick Opoku Manu, Samuel Mensah, Martin Tangnaa Morna, Michael Nortey, John Nkrumah, Emmanuel Owusu Ofori, Elizaberth Mercy Quartson, Ato Oppong Acquah, Leslie Issa Adam-Zakariah, Esther Asabre, Ruby Acheampong Boateng, Barbara Koomson, Ataa Kusiwaa, Emmanuel Yaw Twerefour, James Ankomah, Frank Assah-Adjei, Anthony Appiah Boakye, Godfred Fosu, Godwin Serbeh, Kofi Yeboah Gyan, Isaac Omane Nyarko, Zelda Robertson, Dorcas O Acheampong, Jane Acquaye, Michael Adinku, Kwabena Agbedinu, Anita Eseenam Agbeko, Emmanuel Gyimah Amankwa, Michael Amoah, George Amoah, Juliana Appiah, Joshua Arthur, Alex Ayim, Emmanuel Kafui Ayodeji, Jonathan Boakye-Yiadom, Edward Amoah Boateng, Charles Dally, Anthony Davor, Christian Kofi Gyasi-Sarpong, Naabo Nuhu Noel Hamidu, Iddrisu Haruna, Naa Kwarley, Agbenya Kobla Lovi, Boateng Nimako, Bertina Beauty Nyadu, Dominic Opoku, Anita Osabutey, Robert Sagoe, Samuel Tuffour, Yaa Tufour, Francis Akwaw Yamoah, Abiboye Cheduko Yefieye, Joseph Yorke, Kwame Gyambibi Addo, Enoch Appiah Akosa, Percy Boakye, Christian Larbi Coompson, Brian Gyamfi, Bismark Effah Kontor, Christian Kyeremeh, Ruth Manu, Elijah Mensah, Friko Ibrahim Solae, Gideon Kwasi Toffah, Raphael Adu-Brobbey, Christian Larbi Coompson, Abdul-Hamid Labaran, Junior Atta Owusu, Vivian Adobea, Amos Bennin, Fred Dankwah, Stanley Doe, Ruth Sarfo Kantanka, Ephraim Kobby, Hanson Larnyor, Prince Yeboah Owusu, Clement Ayum Sie-Broni, Marshall Zume, Francis Atindaana Abantanga, Darling Ramatu Abdulai, Daniel Kwesi Acquah, Emmanuel Ayingayure, Imoro Osman, Sheba Kunfah, Gbana Limann, Shamudeen Ahhassan Mohammed, Sheriff Mohammed, Yakubu Musah, Bernard Ofori, Emmanuel Abem Owusu, Abdul-Hafiz Saba, Anwar Sadat Seidu, Mustapha Yakubu, Edwin Mwintiereh Ta-ang Yenli, Kavita Bhatti, Jyoti Dhiman, Karan Dhir, Monika Hans, Parvez D Haque, Esther Daniel Mark Jesudason, Latha Madankumar, Rohin Mittal, Ida Nagomy, Soosan Prasad, Amos Dasari, Priya Jacob, Elizabeth Kurien, Arpit Mathew, Danita Prakash, Anju Susan, Rose Varghese, Reyes Cervantes Ortiz, Gonzalo Hernandez Gonzalez, Rosa Hernandez Krauss, Luis Hernández Miguelena, Marco Hurtado Romero, Isaac Baltazar Gomez, Celina Cuellar Aguirre, Alejandro Cuevas Avendaño, Luis Dominguez Sansores, Hector Ortiz Mejia, Laura Urdapilleta Gomez del Campo, Irani Durán Sánchez, Diana Gonzalez Vazquez, Maria Martínez Lara, Laura Martinez Perez Maldonado, Alejandra Nayen Sainz de la Fuente, Antonio Ramos De la Medina, Victoria Adeleye, Oluwafunmilayo Adeniyi, Opeyemi Akinajo, David Akinboyewa, Iyabo Alasi, Felix Alakaloko, Oluwole Atoyebi, Olanrewaju Balogun, Orimisan Belie, Christopher Bode, Andrew Ekwesianya, Olumide Elebute, Francis Ezenwankwo, Adedeji Fatuga, George Ihediwa, Adesola Jimoh, Jubril Kuku, Oluwaseun Ladipo-Ajayi, Ayomide Makanjuola, Olayanju Mokwenyei, Samuel Nwokocha, Olubunmi Ogein, Rufus Ojewola, Abraham Oladimeji, Thomas Olajide, Oluwaseun Oluseye, Justina Seyi-Olajide, Adaiah Soibi-Harry, Aloy Ugwu, Emmanuel Williams, Lukman Abdur-Rahman, Nurudeen Adeleke, Muideen Adesola, Rafiat Afolabi, Sulaiman Agodirin, Isiaka Aremu, Jibril Bello, Saheed Lawal, Abdulwahab Lawal, Hadijat Raji, Olayinka Sayomi, Asimiyu Shittu, Regina Acquah, Charles Banka, Derick Esssien, Romeo Hussey, Yakubu Mustapha, Kojo Nunoo-Ghartey, Grace Yeboah, Luke A Aniakwo, Margarey N M Adjei, Yvonne Adofo-Asamoah, Meshach M Agyapong, Thomas Agyen, Baba A B Alhassan, Mabel P Amoako-Boateng, Anthony Baffour Appiah, Josephine Ashong, Joseph K Awindaogo, Benjamin B Brimpong, Makafui S C J K Dayie, Donald Enti, Wendy W Ghansah, Jude E Gyamfi, Patience Koggoh, Richard Kpankpari, Vincent Kudoh, Philip Mensah, Isabella N Morkor Opandoh, Martin T Morna, Michael Nortey, Emelia Odame, Emmanuel O Ofori, Sandra Quaicoo, Elizabert M Quartson, Cynthia Teye-Topey, Makafui Yigah, Safia Yussif, Esther Adjei-Acquah, Vera O Agyekum-Gyimah, Eric Agyemang, Arko AkotoAmpaw, Forster Amponsah-Manu, Temitope E Arkorful, Moses A Dokurugu, Nanabanyin Essel, Aja Ijeoma, Emmanuel L Obiri, Richard Ofosu-Akromah, Karen N D Quarchey, Leslie Adam-Zakariah, Aaron B Andoh, Esther Asabre, Ruby A Boateng, Barbara Koomson, Atta Kusiwaa, Adeline Naah, Ato Oppon-Acquah, Benjamin A Oppong, Emma A Agbowada, Ameley Akosua, Ralph Armah, Christopher Asare, Lawrence K B Awere-Kyere, Amanda Bruce-Adjei, Nana Ama Christian, Delali A Gakpetor, Korankye K Kennedy, Jacqueline Mends-Odro, Ambe Obbeng, Doris Ofosuhene, Dorcas Osei-Poku, Zelda Robertson, Maria Chávez Jonathan M Chejfec Ciociano, Carlos J Zuloaga Fernández del Valle, Hafsa I Ahmed Gowhar Aziz, Marijose De Cristo Gonzalez Calvillo, David Giovanny I Morales Iriarte, Luz del Carmen M Namur, Antonio Ramos De la Medina, Bilkisu K Lawal Aisha Mustapha, Athanasie Mukasine Jean N Utumatwishima, Iddrisu I A Abdul-Aziz, Gilbert A G Anasara, David K D Ogudi, Jonathan I K Quansah, Nivesh Agrawal Uttkarsh Kumar, Imtiyaz Mantoo Asif Mehraj, Sonia Mathai Pragyanmai Nayak, Kriscia V Ascencio Díaz, Victor J Avalos Herrera, Francisco J Barbosa Camacho, Irma V Brancaccio Pérez, Miguel A Calderón Llamas, Guillermo A Cervantes Cardona, Luis R Cifuentes Andrade, Ana O Cortés Flores, Edgar J Cortes Torres, Tania A Cueto Valadez, Andrea E Cueto Valadez, Jose A Flores Cardoza, Luis A García González, Jaime L González Bojorquez, Fanny Y González Ponce, Cristhian S Guerrero Ramírez, José A Guzmán Barba, Bertha G Guzmán Ramírez, Mario J Guzmán Ruvalcaba, Daniel A Hérnandez Alva, Silvia A Ibarra Camargo, Juan C Ibarrola Peña, Zayra M Lara Pérez, Mel P Mellado Tellez, Roberto C Miranda Ackerman, Luis R Pacheco Vallejo, Víctor H Pérez Bocanegra, Jose V Pérez Navarro, Francisco J Plascencia Posada, María A Quirarte Hernández, Luis R Ramirez Gonzalez, Emilio A Reyes Elizalde, Evelia V Romo Ascencio, Carlos B Ruiz Velasco, José A Sánchez Martínez, José I Sandoval Pulido, Alejandro G Serrano García, Luis O Suárez Carreón, Juan J Tijerina Ávila, Jesus O Vega Gastelum, Melissa L Vicencio Ramirez, Maria F Zarate Casas, Jesus Antonion Aguilar Mata, Miguel Antonio Calderon Vanegas, Rocio Guadalupe Cano Arias, Brenda Vanessa Enriquez Barajas, Laura Olivia Montano Angeles, Angelo Fernando Mortola Lomeli, Jose Esteban Orozco Navarro, Laura Gabriela Pena Baolboa, Ana Camille G Dominguez, Jesus Flavio M Morales, Jose Alberto A Pesquera, Laura Martinez Perez Maldonado, Roland Kevin Cethorth Fonseca, Edgard Efren Lozada Hernandez, Jairo Arturo Rodriguez Ramirez, Mitzi R Becerra Moscoso, Sharon A N Duniya, Gbadebo T C Adeleye, Tajudeen I B Bakare, Alexander A Ohemu, Divine Umuhoza Sosthene Habumuremyi, Gabriel Ntwari Celestin Seneza, Jean de Dieu Haragirimana, Allen J C Ingabire, Okechukwu Hyginus Ekwunife, Dorcas O Acheampong, Anita Eseenam Agbeko, Frank E Gyamfi, Bertina B Nyadu, Nii A Adu-Aryee, Joachim K Amoako, Nicholas T Aperkor, Wilfred K Asman, Godsway S Attepor, Antoinette A Bediako-Bowan, George D Brown, Victor K Etwire, Benjamin S Fenu, Philemon K Kumassah, Linda A Larbi-Siaw, David O Olatola, Sandra E Tsatsu, Charles G Barimah, Guy C Boateng, Ponala W Kwabena, Seidu M Kwarteng, Prosper T Luri, Ruth Sarfo Kantanka, Prince Yeboah Owusu, Daniel K Acquah, Shamsudeen M Adams, Mohammed S Alhassan, Samuel A Asirifi, Mathias K Dery, Bernard A Ofori, Napoleon Bellua Sam, Anwar S Seidu, Emmanuel Kojo Acquah, Christian L Coompson, Addo K Gyambibi, Bismark E Kontor, Dharma R Poonia, Kirti K Rathod, Mahaveer S Rodha, Subhash C Soni, Vaibhav K Varsheney, Jeevan R Vishnoi, Deepak K Garnaik, Manoj J Lokavarapu, Rajkumar K Seenivasagam, Jeffery A Kalyanapu, Arun K Gautham, Deepak S Singh, Eunice S Abraham, Chinta S Gold, Jeremiah N Joseph, Elizabeth N Kurien, Arpit J Mathew, Amy E Mathew, Danita D Prakash, Monika A Hans, Parvez D Haque, Vivin Daniel Sam, Ravinder Singh Thind, Sreejith K Veetil, Esther R Daniel, Smitha E Jacob, Mark R Jesudason, Vasanth Mark Samuel, Moonish V Sivakumar, Sundeep S Saluja, Ashok K Attri, Murlidhar V Pai, P S Prabhu, Sundeep P T, Philip V Alexander, Vijay A Ismavel, Carolin V Solomi, Rahul A Alpheus, Ashish Victor Choudhrie, Rashmi Jacob Gunny, Muneer A Malik, Nitin J Peters, Nisar A Chowdri, Rayees A Dar, Fazl Q Parray, Zamir A Shah, Rauf A Wani, S Alvarez Villaseñor, Aldo Bernal Hernández, Elyoenai Bonilla Ahumada, Guadalupe Castillo Cardiel, Gabino Cervantes Guevara, Enrique Cervantes Perez, Esteban Cueva Martinez, Paulina Domínguez Barradas, Isaac Esparza Estrada, Paola Flores Becerril, Clotilde Fuentes Orozco, Benjamín García Reyna, Eduardo Gómez Sánchez, Eduardo González Espinoza, Alejandro González Ojeda, Martin Islas Torres, Jorge Jiménez Tornero, Roberto Mares País, Damián Mora Santana, Gilberto Morgan Villela, Rodrigo Nájar Hinojosa, Cesar Nuño Escobar, Itzel Ochoa Rodríguez, Oscar Olvera Flores, Angelica Ortega Barreiro, Jacqueline Osuna Rubio, Cornelio Ruelas Bravo, Guillermo Sanchez Villaseñor, Carlos Colunga Tinajero, Fernanda Diaz Samano, Gerardo Gallardo Banuelos, Francisco Ibanez Ortiz, Maryzela Lazo Ramirez, Gerardo Lopez Arroyo, Jaime Orozco Perez, Damaris Orozco Ramirez, Jesus Pizarro Lozano, Guillermo Yanowsky Reyes, Monica N Castillo, Dorihela H Mellado, Katya Bozada-Gutierrez, Ana Florencia Casado-Zarate, Roberto Delano-Alonso, Jose Herrera-Esquivel, Mucio Moreno-Portillo, Mario Trejo-Avila, Bruno Crocco Quiros, Gabriela Ambriz-González, Ishtar Cabrera-Lozano, Ana B Calderón-Alvarado, Francisco J León-Frutos, Erick E Villanueva-Martínez, Mohammed S Aliyu, Abigail Olajumoke Balogun, Abantanga Atindaana Francis, Kehinde Michael Duromola, Stephen G Gana, Mukoro Duke George, Lambert Onahi Iji, Aminat O Jimoh, Afolabi K Koledade, Ahmad T Lawal, Stanley Emeka Nwabuoku, Oluseyi O Ogunsua, Ifeanyi Fidelis Okafor, Ethos Ike Okorie, Ibrahim A Saidu, Tunde T Sholadoye, Abdulhafiz A Abdulkarim, Lawal Barau Abdullahi, Musliu Adetola Tolani, Aliyu Muhammad Tukur, Ahmad Shehu Umar, Aminatu M Umar, Salisu Abeku Yusuf, Khadija A Ado, Nura U Aliyu, Lofty-John Chukwuemeka Anyanwu, Sulaiman M Daneji, Mahmoud Kawu Magashi, Mohammad A Mohammad, Abubakar Bala Muhammad, Saminu S Muhammad, Bello Abodunde Muideen, Calistus U Nwachukwu, Suleiman B Sallau, Abdulrahman A Sheshe, Idris Usman Takai, Garzali I Umar, Joel A Adze, Lydia R Airede, Stephen B Bature, Moses C Galadima, Babatunde K Hamza, Stephen A Kache, Williams Y Kagomi, Ifeanyi A Kene, Jerry G Makama, Amina A Mohammed-Durosinlorun, Mathew C Taingson, Tunde A Odunafolabi, Chukwuma E Okereke, Oluwafemi O Oladele, Oluwaseun H Olaleye, Oyetunde O Olubayo, Olukayode P Abiola, Henry O Abiyere, Idowu O Adebara, Adebayo A Adeniyi, Olumide E Adewara, Olabisi T Adeyemo, Ademola A Adeyeye, Abimbola L Ariyibi, Babatunde S Awoyinka, Olumide M Ayankunle, Olakunle F Babalola, Oluseyi O Banjo, Peter A Egharevba, Oluwafemi S Fatudimu, John A Obateru, Oluremi J Odesanya, Owolabi D Ojo, Abiodun I Okunlola, Cecilia K Okunlola, Adewale T Olajide, Tesleem O Orewole, Adedayo I Salawu, Moruf A Abdulsalam, Aderinsola T Adelaja, Olalekan T Ajai, Kazeem M Atobatele, Oludayo Oluwaseyi Bakare, Omolara M Faboya, Zainab O Imam, Francisca C Nwaenyi, Ayokunle A Ogunyemi, Mobolaji A Oludara, Olufunmilade A Omisanjo, Chinonso U Onyeka, Olabode A Oshodi, Yusuf A Oshodi, Omotade S Salami, Omolara M Williams, Victoria Ibukunoluwa Adeyeye, Moses Vincent Agbulu, Opeyemi Rebecca Akinajo, David O Akinboyewa, Felix M Alakaloko, Iyabo O Alasi, Oluwole A Atoyebi, Olanrewaju S Balogun, Christopher O Bode, Maryam Oluwatobi Busari, Nnamdi Jonathan Duru, Glory Bassey Edet, Olumide A Elebute, Francis Chinonso Ezenwankwo, Adedeji L Fatuga, George C Ihediwa, Emmanuel Sylvester Inyang, Adesola I Jimoh, Jubril Oladayo Kuku, Oluwaseun A Ladipo-Ajayi, Abdulrazzaq O Lawal, Christian Chigoze Makwe, Chinelo Victoria Mgbemena, Samuel U Nwokocha, Moses Adebisi Ogunjimi, Ephraim Okwudiri Ohazurike, Rufus W Ojewola, Moyosoluwa Eunice Badedale, Chike J Okeke, Adeyemi A Okunowo, Abraham T Oladimeji, Thomas O Olajide, Oluwaseun O Oluseye, Adeola Ayoola Orowale, Adedapo Olumide Osinowo, Christianah Bidemi Oyegbola, Justina O Seyi-Olajide, Adaiah P Soibi-Harry, Manuella Talla Timo, Aloy Okechukwu Ugwu, Emmanuel Ojo Williams, Innocent O Duruewuru, Ochonma A Egwuonwu, James J Emeka, Victor Ifeanyichukwu Modekwe, Chimdiebele Daisy Nwosu, Sylvester O Obiechina, Ahuizechukwu E Obiesie, Celestine I Okafor, Theophilus O Okonoboh, Odili A Okoye, Onyekachi A Onu, Chukwudubem C Onyejiaka, Chisom Faith Uche, Joseph O Ugboajah, Jideofor Okechukwu Ugwu, Akeem A Adeleke, Akinfolarin C Adepiti, Adewale A Aderounmu, Abdulhafiz O Adesunkanmi, Adewale O Adisa, Samuel C Ajekwu, Olusegun K Ajenifuja, Olusegun I Alatise, Tajudeen A Badmus, Tajudeen O Mohammed, Abdulkadir A Salako, Oludayo A Sowande, Ademola O Talabi, Funmilola O Wuraola, Paul Aderemi Adegoke, Ideyonbe Samuel Eseile, Olakayode Olaolu Ogundoyin, Dare Isaac Olulana, Collins C Adumah, Adewale O Ajagbe, Olugbenga P Akintunde, Opeyemi Q Asafa, Amogu K Eziyi, Adeniyi O Fasanu, Olufemi O Ojewuyi, Abiodun R Ojewuyi, Abisola E Oyedele, Oluwaseun A Taiwo, Habiba I Abdullahi, Nathaniel D Adewole, Teddy E Agida, Eunice E Ailunia, Godwin O Akaba, Kehinde G Bawa, John Y Chinda, Esther B Daluk, Sefiu B Eniola, Augusta O Ezenwa, Stephen E Garba, Philip M Mshelbwala, Ngozi O Ndukwe, Idoko P Ogolekwu, Olabisi O Osagie, Samuel A Sani, Nancy O Tabuanu, Aminu M Umar, Peter I Agbonrofo, Alexander I Arekhandia, Morrison E Edena, Raymond A Eghonghon, Joel E Enaholo, Stanley N Ideh, Oseihie I Iribhogbe, Omorodion O Irowa, Maradona E Isikhuemen, Oluwatomi R Odutola, Kester O Okoduwa, Scott O Omorogbe, Osasumwen T Osagie, Rukiyat A Abdus-Salam, Sikiru Adekola Adebayo, Oluwasanmi A Ajagbe, Akinlabi E Ajao, Omobolaji O Ayandipo, Kelvin I Egbuchulem, Hyginus O Ekwuazi, Oluwasegun C Idowu, David O Irabor, Taiwo A Lawal, Olatunji O Lawal, Olakayode O Ogundoyin, Akinsola T Sanusi, Augustine O Takure, Lukman Olajide Abdur-Rahman, Mary Oluwadamilola Adebisi, Nurudeen Abiola Adeleke, Rafiat Tinuola Afolabi, Isiaka Ishola Aremu, Jibril Oyekunle Bello, Saheed Abolade Lawal, Hadijat Olaide Raji, Patrick O Igwe, Ikechukwu Enyinnaya Iweha, Raphael E John, Philemon E Okoro, Vaduneme Kingsley Oriji, Ibiene T Oweredaba, Jean Paul Majyabere, Jean Aimable Habiyakare, Marie Gloriose Nabada, Jean pierre Masengesho, Jean Paul Niyomuremyi, Jean Claude Uwimana, Hope Lydia Maniraguha, Christian Jean Urimubabo, Jean Yves Shyirakera, Mary Augusta Adams, Chikwendu Jeffrey Ede, Mpho Nosipho Mathe, Ncamsile Anthea Nhlabathi, Hlengiwe Samkelisiwe Nxumalo, Mmule Evelyn Sethoana, Jane Acquaye, Juliana Appiah, Joshua Arthur, Jonathan Boakye-Yiadom, Samira Abdulai, Nelson Agboadoh, Erica Akoto, Kwaku Boakye-Yiadom, Florence Dedey, Josephine Nsaful, Theodore Wordui, Fatao Abubakari, Johnson Akunyam, Cletus Ballu, Kennedy Ngaaso, Vivian Adobea, Amos Bennin, Stanley Doe, Ephraim Kobby, Collins Kyeremeh, Edwin Osei, Frank Owusu, Clement Sie-Broni, Marshall Zume, Saba Abdul-Hafiz, Munira Amadu, Martin Awe, Millicent Azanlerigu, Yenli Edwin, Gbana Limann, Aloysius Maalekuu, Hawa Malechi, Sheriff Mohammed, Ibrahim Mohammed, Kareem Mumuni, Shekira Yahaya, Jaabir Alhassan, Percy Boakye, Ametepe Jeffery-Felix, Ruth Manu, Elijah Mensah, Gifty Naah, Carmen Noufuentes, Abraham Sakyi, Ramkaran Chaudhary, Sanjeev Misra, Puneet Pareek, Manish Pathak, Naveen Sharma, Nivedita Sharma, Farhanul Huda, Neha Mishra, Rohit Ranjan, Shanky Singh, Pratik Solanki, Raunak Verma, Enono Yhoshu, Suzan John, Ananta Kutma, Sanish Philips, Alice Hepzibah, Grace Mary, Chetana Chetana, Amos Dasari, Prashant Dummala, Jurgen Jacob, Priya Mary, Oliver Samuel, Ashwin Sukumar, Niyah Syam, Rose Varghese, Alisha Bhatt, William Bhatti, Tapasya Dhar, Ankush Goyal, Sunita Goyal, Deepak Jain, Rita Jain, Savleen Kaur, Karan Kumar, Anil Luther, Amit Mahajan, Kavita Mandrelle, Vishal Michael, Partho Mukherjee, Reuben Rajappa, Prashant Singh, Atul Suroy, Rahul Williams, Sreekar D, Pushplatha Kumari, Rohin Mittal, Soosan Prasad, Bharat Shankar, Srujan Sharma, Suraj Surendran, Anita Thomas, Paul Trinity, Sudheer Kanchodu, K Leshiini, Ishan Bansal, Sanjay Gupta, Monika Gureh, Simran Kapoor, Manisha Aggarwal, Vinoth Kanna, Harmanjot Kaur, Ashwani Kumar, Simrandeep Singh, Gurtaj Singh, Viju John, Mohammed Adnan, Pardeep Kumar, Abhishek S, Vikram Sehrawat, Deepak Singla, Gaurav Thami, Vijay Kumar, Stanley Mathew, Naseem Akhtar, Arun Chaturvedi, Sameer Gupta, Vijay Kumar, Puneet Prakash, Shiv Rajan, Mohit Singh, Abhilasha Tripathi, Josy Thomas, Pradeep Zechariah, Moloti Kichu, Susan Joseph, Neha Pundir, Ram Samujh, Robindera Kour, Najmus Saqib, Subrat Raul, Komal Rautela, Rajeev Sharma, Nishu Singh, Rakesh Vakil, Priyanka Chowdhury, Sona Chowdhury, Bipradas Roy, Aisha Abdullahi, Maimuna Abubakar, Mudi Awaisu, Fadimatu Bakari, Mohammed Bashir, Ahmad Bello, Muhammad Daniyan, Justina Gimba, Isaac Gundu, Nasir Oyelowo, Ibrahim Sufyan, Hajara Umaru-Sule, Mohammed Usman, Anisah Yahya, Alfa Yakubu, Muzzammil Abdullahi, Abdulmajeed Soladoye, Abubakar Yahaya, Lubabatu Abdulrasheed, Bashiru Aminu, Firdaws Bello-Tukur, Damai Chinyio, Samaila Joshua, Jamila Lawal, Caleb Mohammed, Deborah Nuwam, Danjuma Sale, Abdulrasheed Sani, Salome Tabara, Emmanuel Usam, Josiah Yakubu, Folasade Adegoke, Oluwasuyi Ige, Adewumi Bakare, Olukemi Akande, Noble Anyanwu, Grace Eke, Yemisi Oyewole, Esther Abunimye, Adebunmi Adeoluwa, Adedotun Adesiyakan, Michael Amao, Christiana Ashley-Osuzoka, Christianah Gbenga-Oke, Ayomide Makanjuola, Olabisi Olanrewaju, Olawunmi Olayioye, Stephen Olutola, Kenneth Onyekachi, Emili Osariemen, Benedetto Osunwusi, Emmanuel Owie, Chukwuemeka Okoro, Kenneth Ugwuanyi, Chuka Ugwunne, Olalekan Olasehinde, Abidemi Akinloye, Ayodeji Akinniyi, Joseph Ejimogu, Amos Okedare, Omolara Omotola, Francis Sanwo, Kehinde Awodele, Oseremen Aisuodionoe-Shadrach, Janet Alfred, Terkaa Atim, Ndubuisi Mbajiekwe, amson Olori, Salisu Suleiman, Helen Sunday, Genesis Ida, David Oruade, Osarenkhoe Osemwegie, Gboyega Ajibola, Peter Elemile, Adegbolahan Fakoya, Oluwabukade Ojediran, Naomi Olagunju, Robiat Bello, Abdulwahab Lawal, Adeolu Ojajuni, Sabur Oyewale, Olayinka Sayomi, Asimiyu Shittu, Victor Abhulimen, Nnyonno Okoi, Japhet Mizero, Immaculee Mutimamwiza, Francoise Nirere, Irenee Niyongombwa, Anastase Byaruhanga, Rongin Dukuzimana, Marcel Uwizeye, Mathias Ruhosha, joselyne Igiraneza, Faustine Ingabire, Aloys Karekezi, Christophe Mpirimbanyi, Lydia Mukamazera, Clemence Mukangabo, Alphonsine Imanishimwe, Salathiel Kanyarukiko, Francine Mukaneza, Deborah Mukantibaziyaremye, Aphrodis Munyaneza, Gibert Ndegamiye, Pierrine Nyirangeri, Ronald Tubasiime, Moses Dusabe, Emelyne Izabiriza, Christophe Mpirimbanyi, Josiane Mutuyimana, Olivier Mwenedata, Elisee Rwagahirima, Job Zirikana, Isaie Sibomana, Desire Rubanguka, Josine Umuhoza, Roda Uwayezu, Leoncie Uzikwambara, Aime Dieudonne, Elysee Kabanda, Salomee Mbonimpaye, Christine Mukakomite, Piolette Muroruhirwe, Herbert Butana, Moise Dusabeyezu, Mediatrice Batangana, Georges Bucyibaruta, Sosthene Habumuremyi, Alphonsine Imanishimwe, Violette Mukanyange, Emmanuel Munyaneza, Emmanuel Mutabazi, Espoir Mwungura, Isaie Ncogoza, Faustin Ntirenganya, Jeannette Nyirahabimana, Dancilla Nyirasebura, Anaclet Dusabimana, Sam Kanyesigye, Robert Munyaneza, Maria Fourtounas, Gabriella Hyman, Rachel Moore, Nnosa Sentholang, Paul Wondoh, Zain Ally, Aimee Domingo, Philip Munda, Chido Nyatsambo, Victor Ojo, Rudo Pswarayi, Jonathan Cook, David Jayne, Soeren Laurberg, Julia Brown, Neil Smart, Simon Cousens
Journal: The Lancet Global Health (2024)

<h2>Summary</h2><h3>Background</h3> Surgical site infection (SSI) is a major burden on patients and health systems. This study assessed the cost-effectiveness of routine change of sterile gloves and instruments before abdominal wall closure to prevent SSI. <h3>Methods</h3> A decision-analytic model was built to estimate average costs and outcomes of changing gloves and instruments before abdominal wall closure compared with current practice. Clinical data were obtained from the ChEETAh trial, a multicentre, cluster-randomised trial in seven low-income and middle-income countries (LMICs), and costs were obtained from a study (KIWI) that assessed costs associated with SSIs in LMICs. Outcomes were measured as the percentage of surgeries resulting in SSIs. Costs were measured from a health-care provider perspective and were reported in 2021 US$. The economic analysis used a partially split single-country costing approach, with pooled outcomes data from all seven countries in the ChEETAh trial, and data for resource use and unit costs from India (KIWI); secondary analyses used resource use and costs from Mexico and Ghana (KIWI). <h3>Findings</h3> In the base case, the average cost of the intervention was $259∙92 compared with $261∙10 for current practice (cost difference –$1∙18, 95% CI –4∙08 to 1∙33). In the intervention group, an estimated 17∙6% of patients had an SSI compared with 19∙7% of patients in the current practice group (absolute risk reduction 2∙10%, 95% CI 2∙07–2∙84). At all cost-effectiveness thresholds assumed ($0 to $14 000), the intervention had a higher likelihood of being cost-effective compared with current practice, indicating that the intervention was cost-effective. Similar results were obtained when the analysis using data from India was repeated using resource use and unit cost data from Mexico and Ghana. <h3>Interpretation</h3> Routine sterile glove and instrument change before abdominal wall closure is effective and the costs are similar to those for current practice. Routine change of gloves and instruments before abdominal wall closure should be rolled out in LMICs. <h3>Funding</h3> National Institute for Health and Care Research (NIHR) Clinician Scientist Award, NIHR Global Health Research Unit Grant, and Mölnlycke Healthcare.