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Molecular phenotypes of critical illness confer prognostic and biological enrichment in sub-Saharan Africa: a prospective cohort study from Uganda.
Thorax
December 2024
Department of Arbovirology, Emerging and Re-emerging Infectious Diseases, Uganda Virus Research Institute, Entebbe, Uganda.
The generalisability of critical illness molecular phenotypes to low- and middle-income countries (LMICs) is unknown. We show that molecular phenotypes derived in high-income countries (hyperinflammatory and hypoinflammatory, reactive and uninflamed) stratify sepsis patients in Uganda by physiological severity, mortality risk and dysregulation of key pathobiological domains. A classifier model including data available at the LMIC bedside modestly discriminated phenotype assignment (area under the receiver operating characteristic curve (AUROC) 0.
View Article and Find Full Text PDFTwo rare cases of severe community-acquired bloodstream infections: a clinical case report.
Front Immunol
December 2024
Department of Intensive Care Unit, Peking University International Hospital, Beijing, China.
Background: The escalating demographic shift towards an aging population and the widespread occurrence of immunological diseases have contributed to an elevation in the frequency of community-acquired infections. Notably, among these infections, community-acquired bloodstream infections (CABSI) stand out due to their significant lethality. Detailed medical history inquiries, assessment of underlying immune status, detection of the source of infection, and initial precise identification and treatment of the infectious agents can improve the prognosis of CABSI.
View Article and Find Full Text PDFWeekly dihydroartemisinin-piperaquine versus monthly sulfadoxine-pyrimethamine for malaria chemoprevention in children with sickle cell anaemia in Uganda and Malawi (CHEMCHA): a randomised, double-blind, placebo-controlled trial.
Lancet Infect Dis
December 2024
Training and Research Unit of Excellence, Blantyre, Malawi; School of Global and Public Health, Kamuzu University of Health Sciences, Blantyre, Malawi.
Background: In many sub-Saharan African countries, it is recommended that children with sickle cell anaemia receive malaria chemoprevention with monthly sulfadoxine-pyrimethamine or daily proguanil as the standard of care. However, the efficacy of these interventions is compromised by high-grade antifolate resistance of Plasmodium falciparum and poor adherence. We aimed to compare the efficacy of weekly dihydroartemisinin-piperaquine and monthly sulfadoxine-pyrimethamine for the prevention of clinical malaria in children with sickle cell anaemia in areas with high-grade sulfadoxine-pyrimethamine resistance of P falciparum in Uganda and Malawi.
View Article and Find Full Text PDFSalmonella infections are widely known to cause gastroenteritis, especially in areas of poor hygiene and sanitation. Common symptoms include sustained fever, chills, and abdominal pain. Sepsis, disseminated intravascular coagulation (DIC), various neurological manifestations, and multiorgan failure are other uncommon presentations.
View Article and Find Full Text PDFHypoxic hepatitis in survivors of cardiac arrest: A systematic review and -analysis.
Resusc Plus
December 2024
Department of Critical Care Medicine, Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing 100053, China.
Background: Hypoxic hepatitis (HH) is commonly seen in critically ill patients, such as those with cardiac shock, sepsis, and respiratory failure. However, data are limited regarding its impact on the prognosis of patients with cardiac arrest (CA).
Methods: We conducted a systematic review and meta-analysis of studies from PubMed, EMBASE, and the Cochrane Library from inception to July 30, 2024.
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