BBC: 'Alarming' one in five deaths due to sepsis

17 January, 2020

Dear HIFA and CHIFA colleagues,

Extracts and a comment from me below. Full text here: https://www.bbc.co.uk/news/health-39219765

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'Alarming' one in five deaths due to sepsis

By James Gallagher

One in five deaths around the world is caused by sepsis, also known as blood poisoning, shows the most comprehensive analysis of the condition...

Previous global estimates, which came up with a figure of 19 million cases and 5 million deaths, were based on just a handful of western countries.

This analysis, published in the Lancet and based on medical records from 195 nations, shows there are 49 million cases a year. https://www.thelancet.com/pb-assets/Lancet/pdfs/PIIS0140673619329897.pdf

The 11 million deaths from sepsis account for one in five of all deaths around the world.

"I've worked in rural Uganda, and sepsis is what we saw every single day," said researcher, assistant professor Kristina Rudd.

"My colleagues treating patients on the ground in low- and middle-income countries every day have been saying this for years, that sepsis is a major problem.

"So in a way I wasn't actually that surprised - on the other hand I didn't expect it to be double the previous estimate."...

Children were most at risk with four in 10 cases in children under the age of five...

What can be done about it?

Reducing the number of infections can reduce the number of cases of sepsis.

For many countries, this means good sanitation, clean water and access to vaccines.

The other challenge is to get better at identifying patients with sepsis in order to treat them before it is too late.

Early treatment with antibiotics or anti-virals to clear an infection can make a massive difference...

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Comment (Neil PW): The BBC article doesn't address the underlying causes but the full text of the Lancet article notes: 'many of these cases of sepsis are suspected to be due to nosocomial infections; patients admitted to hospital for non-infectious conditions could be exposed to infection risk either from invasive devices such as central venous or urinary catheters or through inadequate handwashing practices among healthcare workers'. The implication is that nosocomial infections may be increasing in LMICs. Another issue is the proportion of sepsis cases that are due to antimicrobial-resistant bacteria - this question does not appear to be addressed in the paper, which makes only one passing reference to antimicrobial resistance. Early diagnosis and referral; quality of care in health facilities (including and especially hand hygiene, patient safety, clean water, sanitation); and appropriate use of antibiotics (which must be underpinned by access to reliable information on selection and use of antibiotics) will all be fundamental to reduce future mortality from sepsis.

Best wishes, Neil

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HIFA profile: Neil Pakenham-Walsh is coordinator of the HIFA global health campaign (Healthcare Information For All - www.hifa.org ), a global community with more than 19,000 members in 177 countries, interacting on six global forums in four languages. Twitter: @hifa_org FB: facebook.com/HIFAdotORG neil@hifa.org