Population Incidence and Mortality of Sepsis in an Urban African Setting, 2013–2016
| Autor: | Michael Abouyannis, Joseph M. Lewis, Nicholas A. Feasey, Jamie Rylance, Grace Chatsika, Grace Katha, Mulinda Nyirenda |
|---|---|
| Rok vydání: | 2019 |
| Předmět: |
Adult
Microbiology (medical) Malawi medicine.medical_specialty Population Developing country 01 natural sciences sepsis Sepsis 03 medical and health sciences 0302 clinical medicine Epidemiology medicine Humans Hospital Mortality 030212 general & internal medicine 0101 mathematics education education.field_of_study business.industry Incidence Public health Incidence (epidemiology) 010102 general mathematics medicine.disease Hospitals Systemic inflammatory response syndrome Major Articles and Commentaries AcademicSubjects/MED00290 Infectious Diseases Africa south of the Sahara Emergency medicine Population data epidemiology low-resource setting business |
| Zdroj: | Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America |
| ISSN: | 1537-6591 1058-4838 |
| Popis: | Background Sepsis is an important cause of mortality globally, although population incidence estimates from low-income settings, including sub-Saharan Africa, are absent. We aimed to estimate sepsis incidence burden using routinely available data from a large urban hospital in Malawi. Methods We linked routine-care databases at Queen Elizabeth Central Hospital, Blantyre, Malawi, to provide admission and discharge data for 217 149 adults from 2013–2016. Using a definition of sepsis based on systemic inflammatory response syndrome criteria and Blantyre census population data, we calculated population incidence estimates of sepsis and severe sepsis and used negative binomial regression to assess for trends over time. Missing data were multiply imputed with chained equations. Results We estimate that the incidence rate of emergency department–attending sepsis and severe sepsis in adults was 1772 per 100 000 person-years (95% confidence interval [CI], 1754–1789) and 303 per 100 000 person-years (95% CI, 295–310), respectively, between 2013 and 2016, with a year-on-year decrease in incidence. In-hospital mortality for patients admitted to the hospital with sepsis and severe sepsis was 23.7% (95% CI, 22.7–24.7%) and 28.1% (95% CI, 26.1 – 30.0%), respectively, with no clear change over time. Conclusions Sepsis incidence is higher in Blantyre, Malawi, than in high-income settings, from where the majority of sepsis incidence data are derived. Worldwide sepsis burden is likely to be underestimated, and data from low-income countries are needed to inform the public health response. Sepsis epidemiology in sub-Saharan Africa (sSA) is poorly described. Using large databases from a Malawian teaching hospital, we present some of the first estimates of sepsis population incidence from sSA and find it to be high compared with high-income settings. |
| Databáze: | OpenAIRE |
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