Assessment of Nosocomial Infection Surveillance Systems in Tertiary Hospitals in Lagos State

Functional nosocomial infection surveillance systems are essential for detecting healthcare-associated infection outbreaks, monitoring trends, and driving prevention measures. This evaluative cross-sectional study assessed the operationality and effectiveness of nosocomial infection surveillance systems at three tertiary hospitals in Lagos State, Lagos Island General Hospital, Lagos University Teaching Hospital, and Gbagada General Hospital, in the South West geopolitical zone of Nigeria. A validated surveillance system assessment tool incorporating WHO core components of infection prevention and control programs was administered. Key informant interviews were conducted with infection control nurses, medical microbiologists, and hospital administration staff. Case definition implementation, data collection frequency, reporting pathways, and surveillance feedback loops were evaluated. Formal healthcare-associated infection surveillance systems were functional in only one of three assessed facilities. Prospective case identification was not practiced in any facility, with passive retrospective review being the only surveillance modality. Infection control committees had not convened in the preceding six months in two facilities. Surveillance data were not used for clinical decision-making in any facility reviewed. The study identifies critical structural and functional deficits in nosocomial infection surveillance in Lagos tertiary hospitals and recommends adoption of standardized case definitions, prospective active surveillance, and mandatory monthly infection control committee meetings reporting directly to hospital boards. Keywords: nosocomial infection, surveillance system, Lagos, infection control, healthcare-associated infection.