Evidence map›Paper›PMID 42907788›Full record

ArticleBMC pediatrics2026

Time-critical sepsis interventions and clinical outcomes among children in a tertiary Tanzanian emergency department.

Abigail M Sorensen, Raya Y Mussa, Erasto M Sunzula, Victoria M Mlele, Scott P Oltman, Cecilia L Msemwa, Lushona K Mathias, Kathleen S Sun, Jazmin M Baez-Maidana, Juma A Mfinanga and 6 more

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Article in BMC pediatrics, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

16 authors.

Abigail M Sorensen *Department of Pediatrics, University of California San Francisco, Box 0110, 550 16 St, Floor 4, San Francisco, CA, 94143, USA. abigail.sorensen@ucsf.edu.ORCID http://orcid.org/0000-0001-8444-4968
Raya Y Mussa *Muhimbili National Hospital, Dar Es Salaam, Tanzania.
Erasto M SunzulaMuhimbili University of Health and Allied Sciences, Dar Es Salaam, Tanzania.
Victoria M MleleMuhimbili National Hospital, Dar Es Salaam, Tanzania.
Scott P OltmanDepartment of Epidemiology & Biostatistics, University of California San Francisco, San Francisco, CA, USA.ORCID http://orcid.org/0000-0002-6560-3334
Cecilia L MsemwaMuhimbili University of Health and Allied Sciences, Dar Es Salaam, Tanzania.
Lushona K MathiasMuhimbili University of Health and Allied Sciences, Dar Es Salaam, Tanzania.
Kathleen S SunDepartment of Pediatrics, University of California San Francisco, Box 0110, 550 16 St, Floor 4, San Francisco, CA, 94143, USA.
Jazmin M Baez-MaidanaDepartment of Pediatrics, University of California San Francisco, Box 0110, 550 16 St, Floor 4, San Francisco, CA, 94143, USA.
Juma A MfinangaMuhimbili National Hospital, Dar Es Salaam, Tanzania.
Victoria T ChuDepartment of Pediatrics, University of California San Francisco, Box 0110, 550 16 St, Floor 4, San Francisco, CA, 94143, USA.ORCID http://orcid.org/0000-0002-7480-965X
Anneka M HooftDepartment of Pediatrics, University of California San Francisco, Box 0110, 550 16 St, Floor 4, San Francisco, CA, 94143, USA.ORCID http://orcid.org/0000-0002-9684-419X
Namala P MkopiMuhimbili National Hospital, Dar Es Salaam, Tanzania.
Joel P ManyahiMuhimbili University of Health and Allied Sciences, Dar Es Salaam, Tanzania.ORCID http://orcid.org/0000-0002-1388-3901
Teresa B Kortz *Department of Pediatrics, University of California San Francisco, Box 0110, 550 16 St, Floor 4, San Francisco, CA, 94143, USA.ORCID http://orcid.org/0000-0003-3326-1736
Hendry R Sawe *Muhimbili University of Health and Allied Sciences, Dar Es Salaam, Tanzania.ORCID http://orcid.org/0000-0002-0395-5385

Funding

National Institute of Allergy and Infectious Diseases K23AI144029NIH HHS 5T32HD049303
6 · The paper itself

Abstract

backgroundPediatric sepsis remains a leading cause of mortality in resource-limited settings. We evaluated the delivery of time-critical sepsis interventions and their association with in-hospital mortality among children in Tanzania.

methodsWe conducted a secondary analysis of a prospective cohort of children (28 days to 14 years) presenting with sepsis to the Emergency Medicine Department at Muhimbili National Hospital, Dar es Salaam, Tanzania (July 2022 to November 2024). Sepsis was defined as fever and at least one World Health Organization warning sign. Local pediatric sepsis guidelines recommend antibiotics and intravenous fluids (IVF) for all patients with sepsis, regardless of the source. Primary exposures were receipt and timing of antibiotics and IVF. The primary outcome was in-hospital mortality. Multivariable logistic regression adjusted for age, nutritional status, referral status, and illness severity.

resultsAmong 755 children, 61.2% (n = 462) received antibiotics, and 55.6% (n = 420) received IVF. Median time to intervention was 2.4 h (IQR 1.6-3.7). 35.5% (n = 268) received both interventions, and only 3.7% (n = 28) received them within one hour. In-hospital mortality was 19.6% (n = 148), with a median time to death of 4.1 days (IQR 1.6-9.5). In a multivariable analysis, time to initiation of both antibiotics and IVF was not significantly associated with in-hospital mortality (adjusted OR 1.29; 95% CI 0.83-2.0; p = 0.264). When modeled continuously, a longer time to IVF administration was associated with increased mortality risk (HR 1.05 per hour delay; 95% CI 1.01-1.10).

conclusionsReceipt of time-critical sepsis interventions (antibiotics and IVF) was delayed and inconsistent, with no observed association with decreased mortality, although residual confounding may remain. This both highlights gaps in early evidence-based care delivery and suggests additional, system-related influences on pediatric sepsis outcomes. Our findings underscore the need for context-specific strategies to strengthen pediatric sepsis management in resource-limited settings.

Indexed as

Anti-Bacterial AgentsEmergency Service, HospitalFluid TherapySepsisTime-to-TreatmentAdolescentChildChild, PreschoolFemaleHospital MortalityHumansInfantInfant, NewbornMaleProspective StudiesResource-Limited SettingsAnti-Bacterial AgentsEarly medical interventionGlobal healthIntensive care unitsPediatricResource-limited settingsSepsis

Identifiers

PMID42907788
PMCPMC13688723

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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.