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March 2018

Smart Hospital Discharges to Address a Neglected Epidemic in Sepsis in Low- and Middle-Income Countries

Author Affiliations
  • 1University of British Columbia, Vancouver, British Columbia, Canada
  • 2Center for International Child Health, British Columbia Children’s Hospital, Vancouver, British Columbia, Canada
  • 3Maternal Newborn and Child Health Institute, Mbarara University of Science and Technology, Mbarara, Uganda
JAMA Pediatr. 2018;172(3):213-214. doi:10.1001/jamapediatrics.2017.4519

As many children die shortly after hospital discharge following in-hospital treatment for sepsis as during hospital admission.1 Postdischarge mortality is an acute problem in low- and middle-income countries (LMIC), which are plagued by large numbers of socioeconomically disadvantaged children served with limited resources in congested and nonresilient health care systems. Postdischarge deaths are largely ignored despite concerted efforts to address child mortality worldwide during the United Nations (UN) Millennium Declaration era in which member states committed to decreasing mortality for those younger than 5 years by two-thirds between 1990 and 2015. Infectious diseases account for approximately half of childhood deaths, and sepsis is the final common pathway leading to most of these deaths. Although decreases in mortality were substantial, approximately 18 000 deaths still occur daily, mostly from preventable causes, with the major burden being in sub-Saharan Africa and southern Asia.

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