Epidemiology and Outcome of Sepsis in Adults and Children in a Rural, Sub-Sahara African Setting.

Africa Rwanda epidemiology malaria outcome sepsis

Journal

Critical care explorations
ISSN: 2639-8028
Titre abrégé: Crit Care Explor
Pays: United States
ID NLM: 101746347

Informations de publication

Date de publication:
Dec 2021
Historique:
entrez: 23 12 2021
pubmed: 24 12 2021
medline: 24 12 2021
Statut: epublish

Résumé

To identify the epidemiology and outcome of adults and children with and without sepsis in a rural sub-Sahara African setting. A priori planned substudy of a prospective, before-and-after trial. Rural, sub-Sahara African hospital. One-thousand four-hundred twelve patients (adults, None. Demographic, clinical, laboratory data, danger signs, and the presence of sepsis (defined as a quick Sequential Organ Failure Assessment score count ≥ 2) at admission were extracted. Sepsis was observed in 69 adults (14.1%) and 248 children (26.9%). Sepsis patients differed from subjects without sepsis in several demographic and clinical aspects. Malaria was the most frequent type of infection in adults (66.7%) and children (63.7%) with sepsis, followed by suspected bacterial and parasitic infections other than malaria. Adults with sepsis more frequently developed respiratory failure (8.7% vs 2.1%; In addition to suspected bacterial, viral, and fungal infections, malaria and other parasitic infections are common and important causes of sepsis in adults and children admitted to a rural hospital in sub-Sahara Africa. The in-hospital mortality associated with sepsis is substantial, primarily in adults.

Identifiants

pubmed: 34939034
doi: 10.1097/CCE.0000000000000592
pmc: PMC8687731
doi:

Types de publication

Journal Article

Langues

eng

Pagination

e0592

Informations de copyright

Copyright © 2021 The Authors. Published by Wolters Kluwer Health, Inc. on behalf of the Society of Critical Care Medicine.

Déclaration de conflit d'intérêts

Dr. Mer received funding from Pfizer and Sanofi Aventis. Drs. Patterson’s and Dünser’s institutions received funding from the Hellman Foundation; they received support for article research from the Society of Critical Care Medicine through the Surviving Sepsis Campaign. Dr. Patterson’s institution received funding from the European Society of Intensive Care Medicine; he received funding from the American Board of Anesthesiology, the Accreditation Council for Graduate Medical Education, and Contagion Solutions, LCC. Dr. Farmer received funding from REES, VinMec International Healthcare, and Avera eCARE; he disclosed that he is a member of REES Architecture, Ambient Clinical Analytics, Arche Healthcare, VinMec International Healthcare, Avera eCARE, and the president of BOD Trajectory Group. Dr. Dünser’s institution received funding from the Life Priority Fund and the King Baudouin Foundation; he received support for article research from the European society of Intensive Care Medicine. The remaining authors have disclosed that they do not have any potential conflicts of interest.

Références

Intensive Care Med. 2020 Aug;46(8):1552-1562
pubmed: 32572531
N Engl J Med. 2011 Jun 30;364(26):2483-95
pubmed: 21615299
JAMA. 2016 Feb 23;315(8):801-10
pubmed: 26903338
PLoS One. 2009 Nov 11;4(11):e7782
pubmed: 19907656
Crit Care. 2018 Mar 9;22(1):64
pubmed: 29523184
Lancet HIV. 2019 Dec;6(12):e831-e859
pubmed: 31439534
Lancet. 2020 Jan 18;395(10219):200-211
pubmed: 31954465
Intensive Care Med. 2017 Mar;43(3):304-377
pubmed: 28101605
Clin Infect Dis. 2019 Jan 7;68(2):266-272
pubmed: 29868873
Intensive Care Med. 1996 Jul;22(7):707-10
pubmed: 8844239
JAMA. 2016 Feb 23;315(8):762-74
pubmed: 26903335
Crit Care. 2019 Jun 11;23(1):212
pubmed: 31186062
JAMA. 2017 Oct 3;318(13):1233-1240
pubmed: 28973227
Trans R Soc Trop Med Hyg. 2009 May;103(5):476-84
pubmed: 19243803
J Crit Care. 2018 Jun;45:184-196
pubmed: 29571116
Crit Care Med. 2013 Apr;41(4):972-81
pubmed: 23324951
Malar J. 2013 May 01;12:146
pubmed: 23634654
Crit Care Med. 2006 Feb;34(2):344-53
pubmed: 16424713
Crit Care Explor. 2020 Jun 11;2(6):e0123
pubmed: 32695992
Anaesthesia. 2017 Feb;72(2):181-189
pubmed: 27868190
JAMA. 2018 Jun 5;319(21):2202-2211
pubmed: 29800114
Intensive Care Med. 2017 Nov;43(11):1683-1685
pubmed: 27816986
JCI Insight. 2019 Apr 23;5:
pubmed: 31013257
PLoS One. 2019 Oct 9;14(10):e0223457
pubmed: 31596907
PLoS One. 2017 Jan 23;12(1):e0170267
pubmed: 28114415
Intensive Care Med. 2018 Sep;44(9):1436-1446
pubmed: 29955924
JAMA. 2020 Apr 21;323(15):1478-1487
pubmed: 32207816

Auteurs

Arthur Kwizera (A)

Department of Anaesthesia and Critical Care, Makerere University College of Health Sciences, Kampala, Uganda.

Olivier Urayeneza (O)

Gitwe Hospital and Gitwe School of Medicine, Gitwe, Rwanda.
Department of Surgery, California Medical Center, Los Angeles, CA.

Pierre Mujyarugamba (P)

Gitwe Hospital and Gitwe School of Medicine, Gitwe, Rwanda.

Inipavudu Baelani (I)

Great Lakes Free University, Goma, Democratic Republic of Congo.

Jens Meier (J)

Department of Anesthesiology and Intensive Care Medicine, Kepler University Hospital and Johannes Kepler University Linz, Linz, Austria.

Mervyn Mer (M)

Department of Medicine, Divisions of Critical Care and Pulmonology, Charlotte Maxeke Johannesburg Academic Hospital and Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.

Ndidiamaka Musa (N)

Seattle Children's Hospital, University of Washington, Seattle, WA.

Niranjan Kissoon (N)

BC Children's Hospital, University of British Columbia, Vancouver, BC, Canada.

Andrew J Patterson (AJ)

Department of Anesthesiology, Emory University, Atlanta, GA.

Joseph C Farmer (JC)

Department of Critical Care Medicine, Mayo Clinic, Phoenix, AZ.

Martin W Dünser (MW)

Department of Anesthesiology and Intensive Care Medicine, Kepler University Hospital and Johannes Kepler University Linz, Linz, Austria.

Classifications MeSH