Stratifying Sepsis in Uganda Using Rapid Pathogen Diagnostics and Clinical Data: A Prospective Cohort Study

Area of Science:

• Global Health
• Infectious Diseases
• Clinical Diagnostics

Background:

• Sepsis poses a significant global health challenge, particularly in sub-Saharan Africa, due to diverse pathogens and limited diagnostic capabilities.
• Effective antimicrobial management of sepsis is hindered by challenges in pathogen identification in resource-limited settings.

Purpose of the Study:

• To stratify sepsis patients in Uganda using rapid diagnostics for common pathogens.
• To compare clinical characteristics and 30-day outcomes across pathogen-identified sepsis subgroups.
• To assess the utility of rapid diagnostics for improving sepsis management in sub-Saharan Africa.

Main Methods:

• A prospective cohort study of 301 adults with suspected sepsis in Uganda.
• Utilized rapid diagnostics for Human Immunodeficiency Virus (HIV), Tuberculosis (TB), malaria, and influenza.
• Compared clinical data and 30-day mortality across identified pathogen subgroups.

Main Results:

• 53% of patients were HIV-infected; 20% had malaria, 17% TB, and 6% influenza.
• HIV-associated TB patients exhibited the highest frequency of multi-organ failure.
• 30-day mortality rates varied significantly, with HIV-associated TB patients having the highest mortality (40%).

Conclusions:

• Sepsis in Uganda disproportionately affects young, HIV-infected adults, often with severe HIV-associated TB.
• Rapid pathogen diagnostics can aid in stratifying sepsis patients and informing antimicrobial strategies in sub-Saharan Africa.
• Integrating rapid diagnostics into emergency care may improve sepsis triage and treatment outcomes in the region.