Presentation, management, and outcomes of sepsis in adults and children admitted to a rural Ugandan hospital: A prospective observational cohort study.

Journal: PloS one

Volume: 12

Issue: 2

Year of Publication: 2017

Affiliated Institutions:  International Respiratory and Severe Illness Center, University of Washington, Seattle, Washington, United States of America. Department of Paediatrics and Child Health, Bwindi Community Hospital, Kanungu, Uganda.

Abstract summary 

Limited data are available on sepsis in low-resource settings, particularly outside of urban referral centers. We conducted a prospective observational single-center cohort study in May 2013 to assess the presentation, management and outcomes of adult and pediatric patients admitted with sepsis to a community hospital in rural Uganda.We consecutively screened all patients admitted to medical wards who met sepsis criteria. We evaluated eligible patients within 24 hours of presentation and 24-48 hours after admission, and followed them until hospital discharge. In addition to chart review, mental status evaluation, peripheral capillary oxygen saturation, and point-of-care venous whole blood lactate and glucose testing were performed.Of 56 eligible patients, we analyzed data on 51 (20 adults and 31 children). Median age was 8 years (IQR 2-23 years). Sepsis accounted for a quarter of all adult and pediatric medical ward admissions during the study period. HIV prevalence among adults was 30%. On enrollment, over half of patients had elevated point-of-care whole blood lactate, few were hypoglycemic or had altered mental status, and one third were hypoxic. Over 80% of patients received at least one antibiotic, all severely hypoxic patients received supplemental oxygen, and half of patients with elevated lactate received fluid resuscitation. The most common causes of sepsis were malaria and pneumonia. In-hospital mortality was 3.9%.This study highlights the importance of sepsis among adult and pediatric patients admitted to a rural Ugandan hospital and underscores the need for continued research on sepsis in low resource settings.

Authors & Co-authors:  Rudd Kristina E KE Tutaryebwa Leonard K LK West T Eoin TE

Study Outcome 

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Statistics
Citations :  Lozano R, Naghavi M, Foreman K, Lim S, Shibuya K, Aboyans V, et al. Global and regional mortality from 235 causes of death for 20 age groups in 1990 and 2010: a systematic analysis for the Global Burden of Disease Study 2010. Lancet. 2012;380: 2095–128. 10.1016/S0140-6736(12)61728-0
Authors :  3
Identifiers
Doi : e0171422
SSN : 1932-6203
Study Population
Male,Female
Mesh Terms
Adolescent
Other Terms
Study Design
Cohort Study,Cross Sectional Study
Study Approach
Country of Study
Uganda
Publication Country
United States