The Pan African Medical Journal (Aug 2015)
Sepsis in Africa: practical steps to stem the tide
Abstract
Sepsis is a leading cause of morbidity and mortality worldwide and particularly in Africa where awareness is low and resources are limited. There are limited reports on the epidemiology, management and outcomes of the sepsis syndromes from Africa. However, this region is likely to account for a significant proportion of the global burden of sepsis which goes unrecognized. It is imperative to address this through research, increased awareness, capacity building and introduction of practical clinical guidelines. Infections are responsible for an estimated 300 million annual deaths worldwide, the majority from developing countries [1]. Sepsis can be triggered by almost any infection and is responsible for an estimated 8 million annual deaths worldwide [1]. In the United Kingdom (UK), sepsis is the third most important cause of death in hospital with an average management cost of ,20,000 per admission [2]. Given the high incidence of Human Immunodeficiency Virus (HIV) and other infections in the African continent, it is likely that the burden of sepsis is at least equal if not higher than estimates from Europe and North America. Why are sepsis related cases and deaths under-reported? firstly, health care professionals often miss the diagnosis or fail to document it in the clinical notes. Secondly, the World Health Organisation (WHO) Global Burden of Disease Report (GBDR) does not include sepsis as a cause of death. The GBDR is one of the leading information sources for healthcare decision-making worldwide. Although deaths from infections occur most commonly as a result of sepsis, the GBDR lists only the underlying infections as cause of death. It is therefore not surprising that sepsis occurs only as "neonatal" sepsis and is ranked 16th place, despite about 60% of deaths in children under five being due to severe infections. Thirdly, guidelines for coding of sepsis are often difficult to use especially in under resourced and busy developing world healthcare settings.
Keywords
