ArticlePloS one2021
Unmet need of essential treatments for critical illness in Malawi.
Article in PloS one, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT06051526 (The African Critical Illness Outcomes Study), which is not on this map. Cited by 19 papers, 2 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
The African Critical Illness Outcomes Study
Who cites it
19 citing papers in PubMed, 2 syntheses or guidelines pooled it, 34 citations in OpenAlex.
- Critical care delivery across health care systems in low-income and low-middle-income country settings: A systematic review.Journal of global health · 2023Pooled it
- Resource use, availability and cost in the provision of critical care in Tanzania: a systematic review.BMJ open · 2022Pooled it
- Lessons learned from the promotion of Essential Emergency and Critical Care in Tanzania - a qualitative study.BMJ open · 2025Article
- The Epidemiology and Impact of Hypoxemia in Sub-Saharan Africa: Prevalence, Practices, and Outcomes.Annals of the American Thoracic Society · 2025Article
- The Future Hospital in Global Health Systems: The Future Hospital Within the Healthcare System.The International journal of health planning and management · 2025Review
- The African Critical Illness Outcomes Study (ACIOS): a point prevalence study of critical illness in 22 nations in Africa.Lancet (London, England) · 2025Article
- Hospital readiness for the provision of care to critically ill patients in Tanzania- an in-depth cross-sectional study.BMC health services research · 2024Article
- Critical care capacity and care bundles on medical wards in Malawi: a cross-sectional study.BMC health services research · 2023Article
- The World Health Assembly resolution on integrated emergency, critical, and operative care for universal health coverage and protection from health emergencies: a golden opportunity to attenuate the global burden of acute and critical illness.Intensive care medicine · 2023Article
- The burden of critical illness among adults in a Swedish region-a population-based point-prevalence study.European journal of medical research · 2023Article
- A health systems approach to critical care delivery in low-resource settings: a narrative review.Intensive care medicine · 2023Review
- Technical Innovation in Critical Care in a World of Constraints: Lessons from the COVID-19 Pandemic.American journal of respiratory and critical care medicine · 2023Article
- Essential emergency and critical care as a health system response to critical illness and the COVID19 pandemic: what does it cost?Cost effectiveness and resource allocation : C/E · 2023Article
- Policies and resources for strengthening of emergency and critical care services in the context of the global COVID-19 pandemic in Kenya.PLOS global public health · 2023Article
- Critical Care Units in Malawi: A Cross-Sectional Study.Annals of global health · 2023Article
- Oxygen as an Essential Medicine.Critical care clinics · 2022Review
- Oxygen provision to severely ill COVID-19 patients at the peak of the 2020 pandemic in a Swedish district hospital.PloS one · 2022Article
- Essential Emergency and Critical Care: a consensus among global clinical experts.BMJ global health · 2021Article
- Measuring oxygen access: lessons from health facility assessments in Lagos, Nigeria.BMJ global health · 2021Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors at 4 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundCritical illness is common throughout the world and has been the focus of a dramatic increase in attention during the COVID-19 pandemic. Severely deranged vital signs such as hypoxia, hypotension and low conscious level can identify critical illness. These vital signs are simple to check and treatments that aim to correct derangements are established, basic and low-cost. The aim of the study was to estimate the unmet need of such essential treatments for severely deranged vital signs in all adults admitted to hospitals in Malawi.
methodsWe conducted a point prevalence cross-sectional study of adult hospitalized patients in Malawi. All in-patients aged ≥18 on single days Queen Elizabeth Central Hospital (QECH) and Chiradzulu District Hospital (CDH) were screened. Patients with hypoxia (oxygen saturation <90%), hypotension (systolic blood pressure <90mmHg) and reduced conscious level (Glasgow Coma Scale <9) were included in the study. The a-priori defined essential treatments were oxygen therapy for hypoxia, intravenous fluid for hypotension and an action to protect the airway for reduced consciousness (placing the patient in the lateral position, insertion of an oro-pharyngeal airway or endo-tracheal tube or manual airway protection).
resultsOf the 1135 hospital in-patients screened, 45 (4.0%) had hypoxia, 103 (9.1%) had hypotension, and 17 (1.5%) had a reduced conscious level. Of those with hypoxia, 40 were not receiving oxygen (88.9%). Of those with hypotension, 94 were not receiving intravenous fluids (91.3%). Of those with a reduced conscious level, nine were not receiving an action to protect the airway (53.0%).
conclusionThere was a large unmet need of essential treatments for critical illness in two hospitals in Malawi.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.