Research and Reports in Tropical Medicine (Dec 2023)
Improving the Treatment of Neonatal Sepsis in Resource-Limited Settings: Gaps and Recommendations
Abstract
Sarah Sturrock,1 Samantha Sadoo,2 Carol Nanyunja,3 Kirsty Le Doare1,4,5 1Centre for Neonatal and Paediatric Infection, St George’s, University of London, London, UK; 2Department of Infectious Disease Epidemiology and International Health, London School of Hygiene & Tropical Medicine, London, UK; 3MRC/UVRI and LSHTM Uganda Research Unit, Entebbe, Uganda; 4UK Health Security Agency, Salisbury, UK; 5Makerere University, Johns Hopkins University, Kampala, UgandaCorrespondence: Sarah Sturrock, Centre for Neonatal and Paediatric Infection, Maternal and Neonatal Vaccine Immunology Research Group, St George’s, University of London, Cranmer Terrace, London, SW17 0RE, United Kingdom, Tel +44 7855 478 360, Email [email protected]: Neonatal sepsis causes significant global morbidity and mortality, with the highest burden in resource-limited settings where 99% of neonatal deaths occur. There are multiple challenges to achieving successful treatment of neonates in this setting. Firstly, reliable and low-cost strategies for risk identification are urgently needed to facilitate treatment as early as possible. Improved laboratory capacity to allow identification of causative organisms would support antimicrobial stewardship. Antibiotic treatment is still hampered by availability, but also increasingly by antimicrobial resistance – making surveillance of organisms and judicious antibiotic use a priority. Finally, supportive care is key in the management of the neonate with sepsis and has been underrecognized as a priority in resource-limited settings. This includes fluid balance and nutritional support in the acute phase, and follow-up care in order to mitigate complications and optimise long-term outcomes. There is much more work to be done in identifying the holistic needs of neonates and their families to provide effective family-integrated interventions and complete the package of neonatal sepsis management in resource-limited settings.Keywords: neonate, low- and middle-income countries, antimicrobial resistance, outcomes, sepsis
