Raising awareness on sepsis to save lives

Sepsis is a silent killer across sub-Saharan Africa, claiming an estimated two million lives annually.

Yet this staggering figure likely falls short of the true impact, as sepsis often goes undiagnosed, unreported, and unrecorded as a cause of death in the region. Prof Nadiya Ahmed, Mediclinic Group General Manager of Clinical Services, stresses the critical need for greater awareness and understanding of sepsis to prevent it and save lives. "Sepsis is a common complication of infection that frequently results in death or serious disability. However, and despite its massive death toll, sepsis remains widely under-recognised and under-prioritised by the general public, healthcare workers, and influential decision-makers."

Vulnerable populations are most at risk of sepsis. "Sepsis is often associated with immune compromised individuals such as those with HIV and tuberculosis, leading to poor outcomes," Ahmed explains. "While individuals with impaired immune systems are indeed at higher risk, children, pregnant women, and the elderly remain the most vulnerable population."

In fact, sepsis is the third-leading cause of maternal mortality worldwide, responsible for 11% of global maternal deaths. With more than two-thirds (69%) of maternal deaths occurring in the African region, the continent is expected to have particularly high rates of maternal mortality attributed to sepsis.

In neonatal health, sepsis is similarly devastating. It is the third-leading cause of death worldwide, accounting for 6.8% of neonatal fatalities. The situation is particularly dire in sub-Saharan Africa, where sepsis-related neonatal mortality rates range from 17% to 29%. Riani Retief, Mediclinic Southern Africa’s Clinical Quality Specialist, says that these statistics highlight the importance of early recognition and prompt treatment of sepsis in South Africa and other parts of Africa.

“Far too often, people suffering from sepsis only seek medical attention when it’s already too late, and by then it is very difficult to turn around. However, if treated early, sepsis is potentially reversible,” Retief explains.

Every year, World Sepsis Day is observed on 13 September to raise global awareness of this life-threatening condition. It serves as an urgent reminder of the need for increased education, early detection, and rapid treatment to reduce the devastating impact of sepsis, particularly in regions like sub-Saharan Africa, where the burden is especially heavy. Many people in these areas may lack the necessary awareness and education to recognise the sneaky symptoms, which is compounded by sepsis often being referred to as a "silent killer" since its symptoms can be difficult to detect early on.

This September, Retief is urging everyone to familiarise themselves with the TIME^TM  acronym (created by Sepsis Alliance), which is an easy way to learn and remember the crucial signs and symptoms to look out for. “Common signs of sepsis include a high Temperature, signs of Infection, Mental decline and feeling Extremely ill.”

Infections that lead to sepsis often originate in the lungs, urinary tract, skin, or gastrointestinal tract. Other critical warning signs therefore include passing no urine for 12 – 24 hours or noticing mottled or discoloured skin – both of which warrant immediate medical attention.

Sepsis progresses through three stages, beginning with an infection that triggers a systemic inflammatory response, which advances to life threatening organ dysfunction and, ultimately if untreated, septic shock. As the condition worsens, the chances of recovery decrease significantly, with in-hospital mortality rates rising from 19% in the initial stage to 39% in severe sepsis. The impact of this condition, however, doesn’t end with survival. Around 40% of people who develop sepsis are estimated to suffer from Post-Sepsis Syndrome (PSS), which includes long-term physical, cognitive, and psychological aftereffects. These can range from chronic pain and fatigue to memory issues, anxiety, and depression, significantly affecting the quality of life of survivors.

While early treatment is essential, Retief emphasises that the best way to reduce the risk of sepsis is to avoid infections altogether. “The primary way to prevent sepsis is by practising basic hygiene and good sanitation, starting with proper hand hygiene and safe food preparation."

Retief notes that one positive outcome of the COVID-19 pandemic was the increased awareness of good hand hygiene. "Using proper soap or an alcohol-based hand rub containing at least 70% alcohol is crucial. Handwashing isn’t just about the soap or alcohol; it's also about the mechanical movement of hands and fingers that helps clean them."

"Remember, a simple act like keeping your hands clean can help save lives," Retief concludes.