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- ISSN: 0002-9637
- E-ISSN: 1476-1645
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Disclaimer: The funding sources had no role in the design of the study; in the collection, analysis, and interpretation of data; or in writing the manuscript.
Disclosure: The datasets generated and analyzed during the current study are not publicly available because of the risk of compromising individual privacy. The participants did not provide consent for their data to be publicly available. Approval for the study was granted by the University of Malawi College of Medicine Research and Ethics Committee (COMREC P.08/16/2007).
Financial support: T. B. received grants for the study from the Swedish Research Council, Laerdal Foundation, the Association of Anaesthetists of Great Britain and Ireland, Martin Rinds Stiftelse, and Life Support Foundation.
Authors’ addresses: Raphael Kazidule Kayambankadzanja and Felix Namboya, College of Medicine, University of Malawi, Blantyre, Malawi, E-mails: [email protected] and [email protected]. Carl Otto Schell, Global Health, Health Systems and Policy, Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden, Centre for Clinical Research Sörmland, Uppsala University, Uppsala, Sweden, and Department of Internal Medicine, Nyköping Hospital, Nyköping, Sweden, E-mail: [email protected]. Tamara Phiri, Department of Internal Medicine, Queen Elizabeth Central Hospital, Blantyre, Malawi, E-mail: [email protected]. Grace Banda-Katha, Adult Emergency and Trauma Centre, Queen Elizabeth Central Hospital, Blantyre, Malawi, and Department of Emergency Medicine, College of Medicine, University of Malawi, Blantyre, Malawi, E-mail: [email protected]. Samson Kwazizira Mndolo, Department of Anaesthesia and Intensive Care, Queen Elizabeth Central Hospital, Blantyre, Malawi, E-mail: [email protected]. Andy Bauleni, Malaria Alert Centre, College of Medicine, Blantyre, Malawi, E-mail: [email protected]. Markus Castegren, CLINTEC, Karolinska Institutet, Stockholm, Sweden, and Perioperative Medicine & Intensive Care, Karolinska University Hospital, Stockholm, Sweden, E-mail: [email protected]. Tim Baker, College of Medicine, University of Malawi, Blantyre, Malawi, Global Health, Health Systems and Policy, Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden, Department of Anaesthesia and Intensive Care, Queen Elizabeth Central Hospital, Blantyre, Malawi, and Perioperative Medicine & Intensive Care, Karolinska University Hospital, Stockholm, Sweden, E-mail: [email protected].
Notes - The American Society of Tropical Medicine and Hygiene
- Source: The American Journal of Tropical Medicine and Hygiene, Volume 102, Issue 4, 1 Apr 2020, p. 896 - 901
The Prevalence and Outcomes of Sepsis in Adult Patients in Two Hospitals in Malawi
Abstract
Abstract.
There are an estimated 19.4 million sepsis cases every year, many of them in low-income countries. The newly adopted definition of sepsis uses Sequential Organ Failure Assessment Score (SOFA), a score which is not feasible in many low-resource settings. A simpler quick-SOFA (qSOFA) based solely on vital signs score has been devised for identification of suspected sepsis. This study aimed to determine in-hospital prevalence and outcomes of sepsis, as defined as suspected infection and a qSOFA score of 2 or more, in two hospitals in Malawi. The secondary aim was to evaluate qSOFA as a predictor of mortality. A cross-sectional study of adult in-patients in two hospitals in Malawi was conducted using prospectively collected single-day point-prevalence data and in-hospital follow-up. Of 1,135 participants, 81 (7.1%) had sepsis. Septic patients had a higher hospital mortality rate (17.5%) than non-septic infected patients (9.0%, p = 0.027, odds ratio 2.1 [1.1–4.3]), although the difference was not statistically significant after adjustment for baseline characteristics. For in-hospital mortality among patients with suspected infection, qSOFA ≥ 2 had a sensitivity of 31.8%, specificity of 82.1%, a positive predictive value of 17.5%, and a negative predictive value of 91.0%. In conclusion, sepsis is common and is associated with a high risk of death in admitted patients in hospitals in Malawi. In low-resource settings, qSOFA score that uses commonly available vital signs data may be a tool that could be used for identifying patients at risk—both for those with and without a suspected infection.
© The American Society of Tropical Medicine and Hygiene
- 26 Apr 2019
- 05 Nov 2019
- 10 Feb 2020