Adaptation of guidelines for musculoskeletal infections to local conditions characterised by limited resources \r
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The Center for Musculoskeletal Surgery at Charité – Universitätsmedizin Berlin and the specialist orthopaedic hospitals of the Hessing Foundation in Augsburg, all in Germany, as well as five hospitals in Cameroon are drawing up new guidelines for the treatment of postoperative infections of the musculoskeletal system and evaluating their use. The guidelines are being adapted to the conditions of the health system in Cameroon.\r
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Charité has been working with two hospitals in Cameroon as part of hospital partnerships since 2017. With this project, the cooperation there is being expanded to further hospitals, and the specialist orthopaedic hospitals of the Hessing Foundation are joining the cooperation as a German partner.\r
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Background\r
Surgical wound infections are common in low-income and middle-income countries. They represent a high cost for health systems, prolong hospital stays and may cause functional impairment or lead to a permanent disability. It is estimated that up to a third of patients in sub-Saharan Africa that undergo surgery on the musculoskeletal system are affected by such infections. Increasing antibiotic resistance is exacerbating the problem. Against this backdrop, treatment guidelines adapted to local conditions are very important.\r
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Activities\r
•\tCollection and assessment of data on musculoskeletal infections (including analysis of the typical pathogens, antibiotic resistance, risk factors), establishment of a biobank of clinically relevant resistant pathogens and testing of the benefits of bacteriophage therapy \r
•\tEvaluation of the availability and affordability of antibiotics in Cameroon\r
•\tAdaptation and publication of guidelines for the treatment of musculoskeletal infections, taking into account the limited resources and antimicrobial resistance patterns locally\r
•\tTraining of doctors, nurses and students at the partner hospitals and the university hospital on implementing the guidelines and improving orthopaedic surgery \r
•\tDevelopment of research capacities and improvement of the medical and laboratory equipment in the partner hospitals\r
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Impact\r
The quality of orthopaedic surgery will be improved for more than 40 per cent of the population in Cameroon’s West Region by optimising the prevention, diagnosis and treatment of postoperative infections of the musculoskeletal system with the help of the guidelines. The approach may serve as an example of good practice for other hospitals in low-income and medium-income countries.\r