ArticleThe Journal of infection2015
Sepsis carries a high mortality among hospitalised adults in Malawi in the era of antiretroviral therapy scale-up: a longitudinal cohort study.
Article in The Journal of infection, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers, 2 of them syntheses that pooled it.
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Who cites it
20 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Aetiology and outcomes of sepsis in adults in sub-Saharan Africa: a systematic review and meta-analysis.Critical care (London, England) · 2019Pooled it
- A Systematic Review of the Incidence, Risk Factors and Case Fatality Rates of Invasive Nontyphoidal Salmonella (iNTS) Disease in Africa (1966 to 2014).PLoS neglected tropical diseases · 2017Pooled it
- Ensuring effective transitions in care for hospitalized people living with HIV.Frontiers in public health · 2026Review
- Molecular Characterization of Staphylococcus aureus and Coagulase-Negative Staphylococci Isolates at a Rural Hospital in Southern Malawi.BioMed research international · 2026Article
- Outcomes and risk factors in HIV-positive patients with sepsis: a retrospective study.European journal of medical research · 2025Article
- Prognostic value of combined stratification using TyG index and CD4Frontiers in medicine · 2025Article
- Ceftriaxone Resistance in the Surgical Adult Intensive Care Unit at Muhimbili National Hospital, Dar es Salaam, Tanzania.The East African health research journal · 2025Article
- Community-acquired pneumonia and its predictors of mortality in rural southwestern Nigeria: A-five year retrospective observational study.African journal of emergency medicine : Revue africaine de la medecine d'urgence · 2022Article
- A Longitudinal, Observational Study of Etiology and Long-Term Outcomes of Sepsis in Malawi Revealing the Key Role of Disseminated Tuberculosis.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2022Observational
- On prioritising global health's triple crisis of sepsis, COVID-19 and antimicrobial resistance: a mixed-methods study from Malawi.BMC health services research · 2022Article
- Prevalence and outcome of sepsis and septic shock in intensive care units in Addis Ababa, Ethiopia: A prospective observational study.African journal of emergency medicine : Revue africaine de la medecine d'urgence · 2021Article
- Clinical and microbiological characterization of sepsis and evaluation of sepsis scores.PloS one · 2021Observational
- Improving sepsis care in Africa: an opportunity for change?The Pan African medical journal · 2021Article
- Kigali Surgical Sepsis (KiSS) Score: A New Tool to Predict Outcomes in Surgical Patients with Sepsis in Low- and Middle-Income Settings.World journal of surgery · 2020Article
- Presentation and outcome of suspected sepsis in a high-HIV burden, high antiretroviral coverage setting.International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases · 2020Article
- The Prevalence and Outcomes of Sepsis in Adult Patients in Two Hospitals in Malawi.The American journal of tropical medicine and hygiene · 2020Article
- ChloS-HRM, a novel assay to identify chloramphenicol-susceptible Escherichia coli and Klebsiella pneumoniae in Malawi.The Journal of antimicrobial chemotherapy · 2019Article
- Validating a novel index (SWAT-Bp) to predict mortality risk of community-acquired pneumonia in Malawi.Malawi medical journal : the journal of Medical Association of Malawi · 2018Article
- The management of intra-abdominal infections from a global perspective: 2017 WSES guidelines for management of intra-abdominal infections.World journal of emergency surgery : WJES · 2017Review
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Abstract
objectiveTo assess mortality risk among adults presenting to an African teaching hospital with sepsis and severe sepsis in a setting of high HIV prevalence and widespread ART uptake.
methodsProspective cohort study of adults (age ≥16 years) admitted with clinical suspicion of severe infection between November 2008 and January 2009 to Queen Elizabeth Central Hospital, a 1250-bed government-funded hospital in Blantyre, Malawi. Demographic, clinical and laboratory information, including blood and cerebrospinal fluid cultures were obtained on admission.
resultsData from 213 patients (181 with sepsis and 32 with severe sepsis; M:F = 2:3) were analysed. 161 (75.6%) patients were HIV-positive. Overall mortality was 22%, rising to 50% amongst patients with severe sepsis. The mortality of all sepsis patients commenced on antiretroviral therapy (ART) within 90 days was 11/28 (39.3%) compared with 7/42 (16.7%) among all sepsis patients on ART for greater than 90 days (p = 0.050). Independent associations with death were hypoxia (OR = 2.4; 95% CI, 1.1-5.1) and systolic hypotension (OR 7.0; 95% CI: 2.4-20.4).
conclusionsSepsis and severe sepsis carry high mortality among hospitalised adults in Malawi. Measures to reduce this, including early identification and targeted intervention in high-risk patients, especially HIV-positive individuals recently commenced on ART, are urgently required.
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