PAEDIATRIC SEPSIS STRATEGIES FOR EARLY DETECTION AND COLLABORATIVE CARE

N DIN; M AZMATULLAH; M KHAN; H ALI

doi:10.54112/bcsrj.v2024i1.1193

Authors

N DIN Cat C Hospital, Madyan Swat, Pakistan
M AZMATULLAH Swat Medical College, Swat, Pakistan
M KHAN Puran Medical Complex Khyber Pakhtunkhwa, Pakistan
H ALI Swat Medical Complex, Pakistan

DOI:

https://doi.org/10.54112/bcsrj.v2024i1.1193

Keywords:

Paediatric Sepsis, Sepsis Early Detection, Antimicrobial Resistance, Biomarkers, Procalcitonin

Abstract

Paediatric sepsis remains a significant cause of mortality and morbidity globally, with a disproportionately high burden in low- and middle-income countries like Pakistan. The high rates of sepsis-related deaths in Pakistan are attributed to delayed diagnosis, inadequate healthcare infrastructure, antimicrobial resistance (AMR), and limited access to appropriate medical care. This review focuses on strategies for early detection and collaborative care approaches in the management of paediatric sepsis, particularly in the context of Pakistan’s healthcare system. Methods: This review synthesizes findings from recent studies (2014-2024) addressing the pathophysiology, risk factors, early detection strategies, and treatment modalities for paediatric sepsis, with an emphasis on the unique challenges faced in Pakistan. It discusses the role of biomarkers, clinical scoring systems, and multidisciplinary care models in improving outcomes for children with sepsis. The review also examines the impact of antimicrobial resistance on sepsis treatment and highlights technological advancements such as artificial intelligence and telemedicine that can aid in early diagnosis. Results: Early detection of paediatric sepsis in Pakistan is hindered by a lack of awareness, inadequate diagnostic tools, and delays in seeking medical care, particularly in rural areas. Biomarkers such as procalcitonin (PCT) and C-reactive protein (CRP) have shown promise in diagnosing sepsis, but their use is limited due to resource constraints. Collaborative care models, incorporating multidisciplinary teams and family-centred care, have improved outcomes in larger urban hospitals but remain underutilized in rural regions. Antimicrobial resistance presents a significant challenge, necessitating more stringent antibiotic stewardship programs. Conclusion: To reduce the burden of paediatric sepsis in Pakistan, efforts must focus on enhancing early detection through the implementation of standardized sepsis protocols, increasing access to diagnostic tools, and promoting collaborative care approaches. Addressing antimicrobial resistance through improved antibiotic stewardship is also critical. The integration of technological solutions, such as AI-based diagnostic tools and telemedicine, offers the potential for improving sepsis outcomes in resource-limited settings.

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References

Kennedy UK, Moulin J, Bührer L, Lim Fang Nian J, Halter L, Böhni L, et al. Sex Differences in Paediatric Sepsis–a Systematic Review and Meta-Analysis.

Khan A, Ul-Haq Z, Fatima S, Ahmed J, Alobaid HM, Fazid S, et al. Long-term impact of multiple micronutrient supplementation on micronutrient status, hemoglobin level, and growth in children 24 to 59 months of age: a non-randomized community-based trial from Pakistan. 2023;15(7):1690.

Fleischmann-Struzek C, Goldfarb DM, Schlattmann P, Schlapbach LJ, Reinhart K, Kissoon NJTLRM. The global burden of paediatric and neonatal sepsis: a systematic review. 2018;6(3):223-30.

Singer M, Deutschman CS, Seymour CW, Shankar-Hari M, Annane D, Bauer M, et al. The third international consensus definitions for sepsis and septic shock (Sepsis-3). 2016;315(8):801-10.

Lassi ZS, Padhani ZA, Rabbani A, Rind F, Salam RA, Das JK, et al. Impact of dietary interventions during pregnancy on maternal, neonatal, and child outcomes in low-and middle-income countries. 2020;12(2):531.

Iqbal S, Bhatti SM, Amir M, Zaman QU, Raza AJPJoM, Sciences H. Scenario of Antibiotic Resistance in Pakistan: A Systematic Review. 2022;16(05):643-.

Alam M, Saleem Z, Haseeb A, Qamar MU, Sheikh A, Abuhussain SSA, et al. Tackling antimicrobial resistance in primary care facilities across Pakistan: current challenges and implications for the future. 2023.

Iqbal MJ, Naeem MJSJoA. Study of External morphometric variants and length-weight relationship of Labeo rohita (Hamilton-1822) fed with varying protein levels. 2018;34(4):749-59.

Gandra S, Alvarez-Uria G, Turner P, Joshi J, Limmathurotsakul D, van Doorn HRJCMR. Antimicrobial resistance surveillance in low-and middle-income countries: progress and challenges in eight South Asian and Southeast Asian countries. 2020;33(3):10.1128/cmr. 00048-19.

Zafar M. Experiences of sexual and reproductive health among women undergoing haemodialysis in Pakistan: A descriptive phenomenological study. 2023.

Ranjit S, Kissoon NJTP. Challenges and solutions in translating sepsis guidelines into practice in resource-limited settings. 2021;10(10):2646.

Atif M, Zia R, Malik I, Ahmad N, Sarwar SJPO. Treatment outcomes, antibiotic use and its resistance pattern among neonatal sepsis patients attending Bahawal Victoria Hospital, Pakistan. 2021;16(1):e0244866.

Nargis W, Ibrahim M, Ahamed BUJIjoci, science i. Procalcitonin versus C-reactive protein: Usefulness as biomarker of sepsis in ICU patient. 2014;4(3):195-9.

Naghavi M, Vollset SE, Ikuta KS, Swetschinski LR, Gray AP, Wool EE, et al. Global burden of bacterial antimicrobial resistance 1990–2021: a systematic analysis with forecasts to 2050. 2024;404(10459):1199-226.

Torres-Fernandez D, Dalsuco J, Bramugy J, Bassat Q, Varo RJERoA-iT. Innovative strategies for the surveillance, prevention, and management of pediatric infections applied to low-income settings. 2024(just-accepted).

TI AA. V. ASC 2023/Spring Congress: Everchanging World: Challenges and Opportunities. 2023.

Larsen GY, Brilli R, Macias CG, Niedner M, Auletta JJ, Balamuth F, et al. Development of a quality improvement learning collaborative to improve pediatric sepsis outcomes. 2021;147(1).

Phiri PG, Chan CW, Wong CJJoPN. The scope of family-centred care practices, and the facilitators and barriers to implementation of family-centred care for hospitalised children and their families in developing countries: an integrative review. 2020;55:10-28.

Ofori B, Twum S, Yeboah SN, Ansah F, Sarpong KANJP. Towards the development of cost-effective point-of-care diagnostic tools for poverty-related infectious diseases in sub-Saharan Africa. 2024;12:e17198.