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<p>Background: Sepsis is a leading cause of death and disability globally. Despite
a high burden of sepsis in sub-Saharan Africa, clinical data for sepsis in that setting
are limited. We sought to describe the clinical characteristics, management, and outcomes
in a cohort of adults and adolescents with sepsis in northern Tanzania. We also assessed
for associations between clinical factors and in-hospital mortality.</p><p>Methods:
We carried out a prospective observational cohort study at Kilimanjaro Christian Medical
Centre in Moshi, Tanzania. We collected data on demographics, baseline clinical characteristics,
and management, with an emphasis on hours 0-6 after arrival to the Emergency Department.
Log risk regression was carried out to assess for associations between demographic
and clinical factors and our primary outcome of in-hospital death. Separate multivariable
regression analyses were conducted for both antimicrobial administration by hour 6
and administration of intravenous (IV) fluids >1L by hour 6 and the outcome of in-hospital
mortality.</p><p>Results: Fifty-eight participants were included in our analysis.
Seventeen (29.3%) participants died in-hospital. Baseline characteristics associated
with inpatient mortality included inability to drink unassisted, respiratory rate
>30 breaths per minute, hypoxia, and altered mentation. Less than half of participants
received any antimicrobial by hour 6, and most participants received <1L of IV fluids.
HIV antibody testing was performed for only one participant in the first 6 hours.
On multivariable analysis, neither antimicrobial administration nor IV fluids >1L
by hour 6 was associated with inpatient mortality.</p><p>Conclusion: Sepsis in northern
Tanzania carries a high risk of in-hospital mortality. Further research is urgently
needed to establish the highest-yield interventions suited to the unique characteristics
of sepsis in sSA.</p>
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