National Trends in Healthcare-Associated Infections and Evaluation of Infection Prevention and Control Policies in Uzbekistan (2015-2024).

Background/Objectives: Healthcare-associated infections (HAIs) disproportionately burden low- and middle-income countries, but no such description has been published for Uzbekistan. We describe national trends in reported HAIs over 2015-2024 with their regional and clinical distribution and review the country's infection prevention and control (IPC) regulations against the eight World Health Organization (WHO) Core Components. Methods: We analysed the complete national series of reported HAI cases for 2015-2024 (ten annual counts; 817 cases in 2024, disaggregated by region and HAI type), with official population denominators. Trend was assessed by the Mann-Kendall test, log-linear average annual percentage change (AAPC) and the Theil-Sen slope estimator, with 2020 treated separately as pandemic-affected. The five binding national IPC instruments in force were reviewed against each Core Component using five pre-specified criteria. Results: Reported incidence fell from 3.95 to 2.16 per 100,000 population (45.3%; Mann-Kendall p = 0.007; Theil-Sen slope -0.186 per 100,000 per year, 95% confidence interval (CI) -0.293 to -0.110). The fall in 2020 was isolated (1.00), with an underlying decline of about 6% per year otherwise (AAPC -6.36%, 95% CI -8.34 to -4.33). Tashkent city accounted for 31.7% of cases and had the highest incidence (8.19 per 100,000) and bed density; Jizzakh (3.55) and Navoi (3.44) had elevated incidence at close to average bed density. Surgical site infections were the most frequently reported HAI type (44.1%). Of the eight Core Components, one met all five criteria, six met some and one none; verification was the most frequent shortfall, absent for seven of eight. Conclusions: This is the first decade-long description of reported HAIs in Uzbekistan. Incidence declined substantially, but passive case-finding and the 2020 disruption mean the data cannot separate a fall in occurrence from a fall in detection. Standardised case definitions and facility-level denominators are the first priority among the eight corrective actions proposed.