title: Surviving sepsis in low-income and middle-income countries: new directions for care and research.
abstract: Sepsis is a disorder characterised by systemic inflammation secondary to infection. Despite recent progress in the understanding and treatment of sepsis, no data or recommendations exist that detail effective approaches to sepsis care in resource-limited low-income and middle-income countries (LMICs). Although few data exist on the burden of sepsis in LMICs, the prevalence of HIV and other comorbid conditions in some LMICs suggest that sepsis is a substantial contributor to mortality in these regions. In well-resourced countries, sepsis management relies on protocols and complex invasive technologies not widely available in most LMICs. However, the key concepts and components of sepsis management are potentially translatable to resource-limited environments. Health personnel in LMICs should be educated in the recognition of sepsis and the importance of early and appropriate antibiotic use. Simple and low-cost standardised laboratory testing should be emphasised to allow accurate diagnosis, prognosis, and monitoring of treatment response. Evidence-based interventions and treatment algorithms tailored to LMIC ecology and resources should thus be developed and validated.
authors.affiliation: Section of Emergency Medicine, Department of Surgery, Yale University School of Medicine, New Haven, CT 06519, USA. joseph.u.becker@yale.edu
authors.forename: Joseph U
authors.initials: JU
authors.lastname: Becker
authors.forename: Christian
authors.initials: C
authors.lastname: Theodosis
authors.forename: Shevin T
authors.initials: ST
authors.lastname: Jacob
authors.forename: Charles R
authors.initials: CR
authors.lastname: Wira
authors.forename: Nora Ellen
authors.initials: NE
authors.lastname: Groce
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D019090:Case Management; D015897:Comorbidity; D003906:Developing Countries; D006801:Humans; D015995:Prevalence; D018805:Sepsis / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology* / Q000401:mortality*
chemical_list: D000900:Anti-Bacterial Agents