20 February 2019
Centre for International Child Health, BC Children’s Hospital & Global Sepsis Alliance
The Centre for International Child Health (CICH) at the BC Children’s Hospital and the Global Sepsis Alliance (GSA) commit to reduce the burden of sepsis on children under five living in low and middle income countries. Education and advocacy, led by GSA, will be international in scope and includes annual World Sepsis Day events every September 13. GSA will also spearhead new education, collaboration and research initiatives related to the May 2017 adoption of the World Health Assembly resolution to improve, prevent, diagnose, and manage sepsis.
Capacity building and prevention efforts, led by CICH, will centre on a CAD $1.3 million three-year commitment to continue work in rural Uganda to identify children who are at risk of dying from infection and develop scalable, evidence-based interventions to prevent these deaths. So far, CICH has found five simple and easy-to-measure parameters that can identify children at high risk. By tracking these parameters using a mobile phone application, health care workers can identify high-risk children and provide additional post-discharge support, such as referrals for visits with community health workers. CICH is now coordinating a large study involving 8,700 children to further validate and develop the program. By 2020, CICH’s work on a program of Smart Discharges will achieve the following goals: (1) improve the identification of children at high risk of relapse and death following sepsis; (2) improve the discharge process so that 100% of children identified as high risk receive additional support at discharge; (3) triple post-discharge health-seeking behaviour and health care system use by high-risk children; and ultimately (4) reduce post-discharge mortality by as much as 30% in high-risk children. When rolled out across Uganda, Smart Discharges will save tens of thousands of lives yearly.
Through advocacy efforts by the Global Sepsis Alliance (GSA), on Friday, May 26th, 2017, the World Health Assembly and the World Health Organization made sepsis a global health priority, by adopting a resolution to improve, prevent, diagnose, and manage sepsis. The resolution urges the 194 United Nation Member States to implement appropriate measures to reduce the human and health economic burden of sepsis. The resolution also requests the Director-General of the WHO, draw attention to the public health impact of sepsis and to 1) publish a report on sepsis and its global consequences by the end of 2018, 2) support the Member States adequately, 3) collaborate with other UN organizations, and 4) report to the 2020 WHA on the implementation of this resolution. On September 5th and 6th, the GSA hosted the 2nd World Sepsis Congress which brought free online access of over 100 speakers from 30 countries to give presentations on all aspects of sepsis.
In rural Uganda, the Centre for International Child Health (CICH) has initiated work at four major referral hospitals starting on March 1, 2017. This project’s goal is to develop a strategy for improved health care delivery following hospital discharge of newborns and children under five years old with sepsis. These sites included Mbarara Regional Referral Hospital (MRRH-Mbarara), Holy Innocents Children’s Hospital (HICH), Masaka Regional Referral Hospital (MRRH-Masaka) and Jinja Regional Referral Hospital (JRRH), where children under 5 years old have started receiving post-discharge care following hospital admission from sepsis from discharge nurses. Families will be receiving discharge kits, basic education on caring for children during the vulnerable post-discharge period and will be referred to their local health centre for follow-up after their discharge from the hospital. 419 (226 boys and 191 girls) children under 5 years old have been impacted by the project between March 1st and October 31st, 2017. We expect to see over 8000 children following a hospital admission of sepsis through this work.
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