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Strategies to Reduce Mortality from Bacterial Sepsis in Adults in Developing Countries

23 Sep 2008

Paul Chinnock

Source: PLoS Medicine (see original article)

Citation: Cheng AC, West TE, Limmathurotsakul D, Peacock SJ (2008) Strategies to Reduce Mortality from Bacterial Sepsis in Adults in Developing Countries. PLoS Med 5(8): e175

2008 Cheng et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

A neglected infectious cause of death in developing countries is bacterial sepsis. While there is no available data on the mortality burden from this condition, Allen Cheng and colleagues point out that:

‘Estimates of the burden of lower respiratory tract infections, meningitis, and ‘other infections’, of which a significant proportion are associated with severe sepsis, show that the majority of deaths and disability-adjusted life years lost occur in low-income countries. Additionally, severe sepsis is likely to complicate a varying proportion of cases of malaria, HIV/AIDS, diabetes, maternal conditions, and cancer deaths globally.’

Drawing particularly on what they regard as the five key papers in this field, Cheng et al. discuss the identification and treatment of bacterial sepsis. They also consider such issues as training, cost-effectiveness and prevention.

Earlier this year, an update was published of a set of international guidelines, ‘Surviving Sepsis’, which define the standard of care for patients with severe sepsis in the developed world but, according to Cheng et al., do not incorporate the realities of health care in resource-constrained settings. They say that ways must be found to translate modern management strategies into the context of the developing world. In their view, ‘Principles of management may be adapted from current guidelines, particularly low-cost interventions targeted at early sepsis.’

Nevertheless, they recognise that a shortage of adequate diagnostic facilities is major obstacle. Effective primary prevention is therefore essential.

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