Availability of critical care resources to treat patients with severe sepsis or septic shock in Africa: a self-reported, continent-wide survey of anaesthesia providers

Baelani, Inipavudu; Jochberger, Stefan; Laimer, Thomas; Otieno, Dave; Kabutu, Jane; Wilson, Iain; Baker, Tim; Dünser, Martin W.

doi:10.1186/cc9410

Cited by 208 publications

(222 citation statements)

References 28 publications

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“…For example, it has been reported that approximately 37% hospitals in African and Sub-Saharan African countries have no access to lactate measurement (77). As a result, the diagnosis of septic shock involving lactate criterion cannot be readily made in substantial number of hospitals in LIMC.…”

Section: Special Considerations In Low-income and Middle-income Countmentioning

confidence: 99%

AME evidence series 001—The Society for Translational Medicine: clinical practice guidelines for diagnosis and early identification of sepsis in the hospital

Zhang¹,

Smischney²,

Zhang³

et al. 2016

J. Thorac. Dis.

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Sepsis is a heterogeneous disease caused by an infection stimulus that triggers several complex local and systemic immuno-inflammatory reactions, which results in multiple organ dysfunction and significant morbidity and mortality. The diagnosis of sepsis is challenging because there is no gold standard for diagnosis. As a result, the clinical diagnosis of sepsis is ever changing to meet the clinical and research requirements. Moreover, although there are many novel biomarkers and screening tools for predicting the risk of sepsis, the diagnostic performance and effectiveness of these measures are less than satisfactory, and there is insufficient evidence to recommend clinical use of these new techniques. As a consequence, diagnostic criteria for sepsis need regular revision to cope with emerging evidence. This review aims to present the most updated information on diagnosis and early recognition of sepsis. Recommendations for

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Section: Special Considerations In Low-income and Middle-income Countmentioning

confidence: 99%

AME evidence series 001—The Society for Translational Medicine: clinical practice guidelines for diagnosis and early identification of sepsis in the hospital

Zhang¹,

Smischney²,

Zhang³

et al. 2016

J. Thorac. Dis.

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“…Admission into ICU may be required if the patient (Baelani et al, 2011;Dünser et al, 2006). The reported disease characteristics and mortality rates of patients admitted to ICUs in sub-Saharan Africa vary widely from one population to another (Oke, 2001;Okafor, 2009;Merah et al, 2006).…”

Section: Introductionmentioning

confidence: 99%

Clinical outcomes of patients admitted in intensive care units of Nigist Eleni Mohammed Memorial Hospital of Hosanna, Southern Ethiopia

Obsa¹,

Adem²,

Gete³

2017

Int. J. Med. Med. Sci.

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An intensive care unit is a special department of hospital or health care facility that provides intensive treatment medicine. Critically ill patients are admitted to the intensive care unit to reduce morbidity and mortality associated with acute illness, trauma or surgical procedures. This study aimed to assess clinical outcomes of patients admitted in intensive care units of Nigist Eleni Mohammed Memorial Hospital of Hosanna from January 2015 to January 2016. Institutional based cross sectional study design was conducted. All the study participants admitted to intensive care unit were included. Regular supervision and follow up was made. Data was entered into Epi info version 7 by investigators and was transported to SPSS version 20 for analysis. Bivariate and multivariate analysis was used to identify factors associated with patient's outcome. A total of 280 clients were enrolled into the study of which 46.42% died. About 26% of patients were found in the age group of 20 to 24 years and majority of them were male (58.2%). Patient with head injury is about six times more likely to die in the intensive care unit than patients with small bowel obstruction (AOR 6.620 (95% CI ((468-93.584). There were poor outcomes of patients admitted to intensive care unit so that it was strongly recommended to improve quality of care.Key word: Ethiopia, intensive care unit, cause of death, hospital discharge.

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“…A possible reason is that the guidelines have failed to incorporate the realities and inequities of different health-care systems and limitation of resources in developing countries. Baelani et al [5,9,17].…”

Section: Modify Surviving Sepsis Campaign Guidelinesmentioning

confidence: 99%

Optimizing Quality of Care for Septic Patients in Developing Countries

Saleh¹

2015

SOJAPM

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Open Access Opiniondeveloping countries. Although data on the burden of sepsis in developing countries is lacking in the published literature, the incidence and mortality are likely to be disproportionally high in developing countries compared to developed countries [4][5][6][7][8][9][10]. The Brazilian Sepsis Epidemiological Study has confirmed this conclusion by evaluating 1383 patients who were admitted to five different intensive care units. The investigators discovered that the incidence of sepsis, severe sepsis, and septic shock were 61.4, 35.6, and 30.0 per 1000 days, respectively [6]. The mortality of patients with sepsis, severe sepsis, and septic shock were 34.7%, 47.3%, and 52.2%, respectively [6]. These high incidences and mortalities of sepsis in developing countries may be caused by their quality of healthcare, lack of access to healthcare and educational efforts targeting sepsis, and shortage of resources.It is also important to note that severe sepsis is likely to complicate malnutrition, malaria, maternal conditions, and chronic illnesses, including HIV/AIDS, diabetes, and cancer in developing countries [4][5]8]. For instance, Bane et al. [7] Evaluated HIV-positive patients who were admitted to an Ethiopian hospital and noticed that sepsis and septic shock were among the most common causes of mortality due to their immunosuppressant [4,7]. Sani et al. [4,8]. Reviewed the causes of death among patients with AIDS over 4 years in a Nigerian hospital As a result of their calculations, 455 of 4574 patients (9.9%) were admitted due to their HIV/AIDS-related diagnoses, which caused 176 deaths (38.7%) over the period [4,8]. The most common causes of these deaths were tuberculosis (33.4%) and sepsis (23.8%). This indicates that immunosuppressant secondary to acute illnesses and chronic conditions in developing countries may thus potentially significantly increase the incidence and mortality of sepsis in developing countries [4].similarly, a large prospective study evaluating 1,235 Brazilian patients admitted to 90 Brazilian icus demonstrated that there was a clear association between infection and mortality [10]. Furthermore, the overall ICU mortality rate was 28.4% with the higher rate in the infected patients than in non-infected patients (37.6% vs 13.2%) [10]. Likewise, the in-hospital mortality rate was 34.2%, with 44.2% in the infected patients and 17.7% in non-infected patients. The authors performed a multivariate analysis and concluded that the significant factors associated with the incidence of infection were emergency surgery (OR 2.89), mechanical ventilation (OR AbstractSepsis is a major cause of morbidity and mortality in intensive care units. It affects millions of people worldwide annually, causing hundreds of thousands deaths and health-care expenditure of at least $16.7 billion per year. This highlights the significance of diagnosing and treating septic patients emergently. Unfortunately, developing countries are struggling with limited resources, lack of educational efforts targeting se...

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Availability of critical care resources to treat patients with severe sepsis or septic shock in Africa: a self-reported, continent-wide survey of anaesthesia providers

Cited by 208 publications

References 28 publications

AME evidence series 001—The Society for Translational Medicine: clinical practice guidelines for diagnosis and early identification of sepsis in the hospital

AME evidence series 001—The Society for Translational Medicine: clinical practice guidelines for diagnosis and early identification of sepsis in the hospital

Clinical outcomes of patients admitted in intensive care units of Nigist Eleni Mohammed Memorial Hospital of Hosanna, Southern Ethiopia

Optimizing Quality of Care for Septic Patients in Developing Countries

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