Effectiveness and acceptability of ventilation modifications in healthcare facilities, Liberia 2022–2023
Abstract Objective: To evaluate the effectiveness and acceptability of ventilation interventions in naturally ventilated hospitals in Liberia. Design: Difference-in-differences analysis of pre- and post-air changes per hour of intervention and control spaces. Setting: Hospitals in Bong and Mon...
Saved in:
| Main Authors: | , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Cambridge University Press
2025-01-01
|
| Series: | Antimicrobial Stewardship & Healthcare Epidemiology |
| Online Access: | https://www.cambridge.org/core/product/identifier/S2732494X25100776/type/journal_article |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1849229190106185728 |
|---|---|
| author | Ronan F. Arthur Ashley Styczynski Krithika Srinivasan Amos Tandanpolie Philip Bemah Ethan Bell Jason R. Andrews Tom Baer Jorge L. Salinas |
| author_facet | Ronan F. Arthur Ashley Styczynski Krithika Srinivasan Amos Tandanpolie Philip Bemah Ethan Bell Jason R. Andrews Tom Baer Jorge L. Salinas |
| author_sort | Ronan F. Arthur |
| collection | DOAJ |
| description |
Abstract
Objective:
To evaluate the effectiveness and acceptability of ventilation interventions in naturally ventilated hospitals in Liberia.
Design:
Difference-in-differences analysis of pre- and post-air changes per hour of intervention and control spaces.
Setting:
Hospitals in Bong and Montserrado Counties, Liberia.
Participants:
Seventy patient care spaces were evaluated at baseline. Six spaces underwent physical intervention modifications, while 2 spaces were assessed for indirect effects and 2 others used as controls. Healthcare workers were interviewed to assess ventilation knowledge and acceptability.
Interventions:
Ventilation interventions included the installation of window screens, louvered doors and windows, and wind turbines.
Methods:
We measured carbon dioxide levels with portable meters and documented persons per room to estimate per-person ventilation rates in both L/s/person for the initial assessment and air changes per hour (ACH) in the intervention. Measurements were taken in patient care spaces in 7 hospitals in Liberia. Healthcare worker acceptability was evaluated via structured interviews.
Results:
Two-thirds (46/70) of patient care spaces were below the WHO-recommended ventilation threshold of 60 L/s/person. Six spaces underwent ventilation interventions, including placement of window screens (3), wind turbines (2), and louvered doors and windows (1), with 2 additional spaces being indirectly affected by these interventions and 2 more spaces serving as controls. Ventilation improved by an average of 2 ACH in the spaces with wind turbines and louvered doors and windows. Overall acceptability of the interventions was high.
Conclusions:
Implementing interventions to improve ventilation in naturally ventilated healthcare facilities is efficacious, feasible, and acceptable, though longer-term evaluations should assess sustainability.
|
| format | Article |
| id | doaj-art-be4c7ac5da274f87b25d7b682aa0e2ba |
| institution | Kabale University |
| issn | 2732-494X |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Cambridge University Press |
| record_format | Article |
| series | Antimicrobial Stewardship & Healthcare Epidemiology |
| spelling | doaj-art-be4c7ac5da274f87b25d7b682aa0e2ba2025-08-22T05:32:07ZengCambridge University PressAntimicrobial Stewardship & Healthcare Epidemiology2732-494X2025-01-01510.1017/ash.2025.10077Effectiveness and acceptability of ventilation modifications in healthcare facilities, Liberia 2022–2023Ronan F. Arthur0https://orcid.org/0000-0001-8513-8348Ashley Styczynski1https://orcid.org/0000-0002-4682-8087Krithika Srinivasan2Amos Tandanpolie3Philip Bemah4Ethan Bell5Jason R. Andrews6Tom Baer7Jorge L. Salinas8School of Medicine, Stanford University, Palo Alto, CA, USASchool of Medicine, Stanford University, Palo Alto, CA, USADepartment of Infectious Diseases, Infection Control, and Employee Health, MD Anderson Cancer Center, Houston, TX, USAPartnership for Research on Vaccines and Infectious Diseases in Liberia, LiberiaNational Public Health Institute of Liberia, Monrovia, LiberiaSchool of Medicine, Stanford University, Palo Alto, CA, USASchool of Medicine, Stanford University, Palo Alto, CA, USAStanford Photonics Research Center, Stanford University, Palo Alto, CA, USASchool of Medicine, Stanford University, Palo Alto, CA, USA Abstract Objective: To evaluate the effectiveness and acceptability of ventilation interventions in naturally ventilated hospitals in Liberia. Design: Difference-in-differences analysis of pre- and post-air changes per hour of intervention and control spaces. Setting: Hospitals in Bong and Montserrado Counties, Liberia. Participants: Seventy patient care spaces were evaluated at baseline. Six spaces underwent physical intervention modifications, while 2 spaces were assessed for indirect effects and 2 others used as controls. Healthcare workers were interviewed to assess ventilation knowledge and acceptability. Interventions: Ventilation interventions included the installation of window screens, louvered doors and windows, and wind turbines. Methods: We measured carbon dioxide levels with portable meters and documented persons per room to estimate per-person ventilation rates in both L/s/person for the initial assessment and air changes per hour (ACH) in the intervention. Measurements were taken in patient care spaces in 7 hospitals in Liberia. Healthcare worker acceptability was evaluated via structured interviews. Results: Two-thirds (46/70) of patient care spaces were below the WHO-recommended ventilation threshold of 60 L/s/person. Six spaces underwent ventilation interventions, including placement of window screens (3), wind turbines (2), and louvered doors and windows (1), with 2 additional spaces being indirectly affected by these interventions and 2 more spaces serving as controls. Ventilation improved by an average of 2 ACH in the spaces with wind turbines and louvered doors and windows. Overall acceptability of the interventions was high. Conclusions: Implementing interventions to improve ventilation in naturally ventilated healthcare facilities is efficacious, feasible, and acceptable, though longer-term evaluations should assess sustainability. https://www.cambridge.org/core/product/identifier/S2732494X25100776/type/journal_article |
| spellingShingle | Ronan F. Arthur Ashley Styczynski Krithika Srinivasan Amos Tandanpolie Philip Bemah Ethan Bell Jason R. Andrews Tom Baer Jorge L. Salinas Effectiveness and acceptability of ventilation modifications in healthcare facilities, Liberia 2022–2023 Antimicrobial Stewardship & Healthcare Epidemiology |
| title | Effectiveness and acceptability of ventilation modifications in healthcare facilities, Liberia 2022–2023 |
| title_full | Effectiveness and acceptability of ventilation modifications in healthcare facilities, Liberia 2022–2023 |
| title_fullStr | Effectiveness and acceptability of ventilation modifications in healthcare facilities, Liberia 2022–2023 |
| title_full_unstemmed | Effectiveness and acceptability of ventilation modifications in healthcare facilities, Liberia 2022–2023 |
| title_short | Effectiveness and acceptability of ventilation modifications in healthcare facilities, Liberia 2022–2023 |
| title_sort | effectiveness and acceptability of ventilation modifications in healthcare facilities liberia 2022 2023 |
| url | https://www.cambridge.org/core/product/identifier/S2732494X25100776/type/journal_article |
| work_keys_str_mv | AT ronanfarthur effectivenessandacceptabilityofventilationmodificationsinhealthcarefacilitiesliberia20222023 AT ashleystyczynski effectivenessandacceptabilityofventilationmodificationsinhealthcarefacilitiesliberia20222023 AT krithikasrinivasan effectivenessandacceptabilityofventilationmodificationsinhealthcarefacilitiesliberia20222023 AT amostandanpolie effectivenessandacceptabilityofventilationmodificationsinhealthcarefacilitiesliberia20222023 AT philipbemah effectivenessandacceptabilityofventilationmodificationsinhealthcarefacilitiesliberia20222023 AT ethanbell effectivenessandacceptabilityofventilationmodificationsinhealthcarefacilitiesliberia20222023 AT jasonrandrews effectivenessandacceptabilityofventilationmodificationsinhealthcarefacilitiesliberia20222023 AT tombaer effectivenessandacceptabilityofventilationmodificationsinhealthcarefacilitiesliberia20222023 AT jorgelsalinas effectivenessandacceptabilityofventilationmodificationsinhealthcarefacilitiesliberia20222023 |