Sepsis in Low- and Middle-Income Countries

  • Luciano Cesar Pontes Azevedo
  • Flavia Ribeiro Machado


Sepsis is one of the oldest and most complex syndromes in medicine that still poses a significant challenge to healthcare professionals worldwide. Despite current epidemiological data suggesting a huge global burden of sepsis, knowledge regarding the incidence, prevalence, and mortality rates of sepsis is scarce, especially in low- and middle-income countries, which comprise 85% of the world’s population and usually have higher mortality rates than high-income countries. Possible reasons for the increased mortality due to sepsis in low- and middle-income countries are low sepsis awareness among the lay public and healthcare workers, care provision constraints, inadequate access to intensive care, a high incidence of nosocomial infections, and ineffective preventive measures. To understand the impact of sepsis on healthcare in resource-limited areas, adequately designed studies from low- and middle-income countries assessing the epidemiology, long-term outcomes, and quality improvement initiatives for sepsis are urgently needed. The purpose of this review is to discuss the epidemiology of sepsis in low- and middle-income countries and the differences between these patterns and those in high-income countries that may be responsible for the increased case fatalities, as well as quality improvement initiatives for sepsis care in resource-constrained settings.


Sepsis Septic shock Epidemiology Low-income countries Developing countries High-income countries Resource poor settings Middle-income countries 


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Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  • Luciano Cesar Pontes Azevedo
    • 1
    • 2
    • 3
  • Flavia Ribeiro Machado
    • 3
    • 4
  1. 1.Discipline of Emergency MedicineUniversity of São PauloSão PauloBrazil
  2. 2.Hospital Sirio-LibanesSão PauloBrazil
  3. 3.Latin-American Sepsis InstituteR. Pedro de Toledo, 980 cj 94 São PauloSão PauloBrazil
  4. 4.Discipline of Anesthesiology, Pain and Intensive CareFederal University of São PauloSão PauloBrazil

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