ID	Reference	Data collection period	Country	Sample size	HCAIprevalence	Statistical method
1	Yadi, S.N. (2012)[7] ε	2012 - 1 month	AlgeriaOH	239	0.121	No Regression β Matching
2	Afle et al (2018).[33]ε	2017 - 1.3 months	BeninUTH/OH	139	0.144	Regressionλ Matching
3	Bukasa, J. C., Kabamba, A. M., Mwamba, A. G. K., Ilunga, F. I., & Mukendi, A. K. (2018). [45] $	2016-2017 -7 months	Congo-DROH	2841	0.175	No Regression No MatchingφConvenienceNo Determinants
4	Kuissi et al. (2017). (46]$	2014-2015 - 6 months	GabonUTH	51	0.118	No Regression β No Matching
5	Tchoua, R., Vemba, A., Koun1ba, C. T., & Nsafu, D.N. (1999).[47]ε N. {1999).[47] '	1994-1995 - 13 months	GabonUTH	216	0.092	No Regression β Matching
6	Samou, F. H. S.(2005). [42]$	2003-2004 - 12 months	MaliUTH	300	0.067	No Regressionβ Matching
7	Togo et al (2010).[12]$	2007 -6 months	MaliUTH	460	0.096	No Regressionβ No Matching
8	Suso, H. S. (2012). [t s]$	2010-2011 - 6 months	MoroccoUTH	347	0.144	No Regressionβ No Matching
9	Nd i r, A. (2015).[48]•	2012-2013- 24 months	Senegal UTH/OH	2,172	15.0%	Regression A Matching Retrospective
10	Dramowski et al (20 16).[I lJ s	2014-2015 - 12 months	South UTH Africa	l,347	24.1%	Regression A Match ing
1 1	Fourie,T., Schellack, N., Bronkhorst, E., Coetzee,J., & Godman,B. (2018). [49) '	2013-2014- 12 months	South UTH Africa	39	92.3%	Regression/ Index A Match ing Retrospective
12	Bouafia et al (2013).[50] '	2009 - I month	Tunisia UTH	428	l7.1%	No Regression ' Matching
13	Oheneh-Yeboah, M. (2007). [14]'	2002-2005 -48 months	Ghana UTH	248	87%	No Regression No Matching φ

Key

Statistical Methods: ^λHigh quality study (31%).^β Medium quality study (54%). ^φLow quality study (15%) Facility/ICU Type: ^UTH Advanced Facility/Teaching Hospital (70%). ^OH Other (15%). ^UTH/OH Both (15%). Economic Impact: $ Monetary (54%).^ε;LOS Estimate (46%).
Table 1: Overview of selected articles

ID	Reference	Determinants	Country	Cost $/LOS	Pathogens
1f	Yadi, S. N.(2012)(7]'	Antibiotics exposure ,LOS in ICU, Respiratory status	Algeria 0H	LOS (0.6d]	Enterobacteria(30%),Aeromonadaceae(14.3%), Pseudomonadaceae & vibrillonaceae (9%) β
2	Aile et al (2018).(33]'	Invasive procedures ,surface sterilisation & hygiene, technical quality of services	Benm. UTHOH	LOS (5d]	Staphylococcus aur.(33%) Escherichia coli (22%) & Pseudomonas aeruginosa (22%) Acinetobacter spp (11%) λ
3f	Bukasa et al(20 18) (45jS	No Detenninants	Congo-DR 0H	10.2	No pathogens listed φ
4f	Kuissi et al.(2017).(46jS	C-Section, premature membrane rupture, breast/formula feeding, LOS, preterm birth,underlying maternal infection	Gabon UTH	19.78	Candida albicans(25%),Escherichia coli (22.2%), Klebsiella pneumoniae (13.9%),Klebsiella oxytoca (11.1%) β
5	Tchoua et al (1999)(47]'	Underlying conditions	Gabon UTH	LOS (30d)	No pathogens listed β
6	Samou, F. H. S.(2005).(42]s	Catheter/other implants,Diabetes & other comorbidities; Age>50;Length of operation and department	MaliUTH	55.98	Escherichia Coli(21%),Staphylococcus Auréus (16%), Pseudomonas Aeruginosa (11%),Enterococcus spp (8%). Β
ID	Reference	Determinants	Country	Cost $/LOS	Pathogens
7	Togo et al(2010).[12] $	underlying conditions, overcrowding of beds, department	Mali UTH	114.8	Escherichia coli(39.29%),Klebsiella pneumoniae (14.26%),Proteus mirabilis (14.26%),Pseudomonas aeruginosa (10.72%) β
8	Suso, H. S.(2012).[15]$	Laparoscopy & other invasive procedures, malnutrition, immune response, age (very young or >65), Diabetes, obesity and other co-morbidities	Morocco UTH	3,252.18	Escherichia coli(31,80%),Klebsiella pneumoniae (22,70%) & Acinetobacter baumanii(18,10%) Staphylococcus Aureus (4.5%) β
9f	Ndir, A.(2015).[48]$	neonates, implants,sickle cell, HIV	Senegal UTH/OH	149.14	Extended Spectrum β Lactamase related λ
10f	Dramowski et al (2016).[11]$	HIV association/infection, transfer in, PICU LOS & malnutrition, indwelling devices and comorbidities	South UTH Africa	1,248.68	Klebsiella pneumoniae &Staphylococcus Aureus & several viruses (adeno,influenza, syncytial & boca) λ
11	Fourie et al (2018).[49]ε	malignancy,diabetes mellitus, renal insufficiency, HIV infection and neutropenia	South UTH Africa	LOS [17.2d]	Extended Spectrum βLactamase related λ
12	Bouafia et al(2013).[50]ε	Age 40+; gender - m, LOS in hospital, invasive procedures; clinical service/department -	Tunisia UTH	LOS [2d]	No pathogens listed β
13	Oheneh-Yeboah,M.(2007).[14] ε	Male,age and peri-operative procedures	Ghana UTH	LOS [8.9d]	No pathogens listed φ

Table 2: HCAI determinants, pathogens and Costs (2018 $)

Tables at a glance

Figures at a glance