One in eight patients in hospitals in Africa is critically ill, and one in five of the critically ill die within a week, according to a new study in The Lancet. The researchers behind the largest study of critical illness in Africa to date conclude that many of these lives could have been saved with access to cheap life-saving treatments.
Being critically ill means having severely affected vital functions, such as extremely low blood pressure or low levels of oxygen in the blood. In the new study, researchers show that one in eight patients in African hospitals, 12.5 percent, is in this condition. Of these, one in five, 21 percent, die within a week, compared to 2.7 percent of those who are not critically ill.
A large proportion of critically ill patients, 69 percent, are treated in general wards rather than intensive care units. More than half of critically ill patients, 56 percent, do not receive even the basic critical care they need, such as oxygen therapy, intravenous fluids or simple airway management.
"Our study shows that there is a large and often neglected group of patients with critical illness in Africa," says first author Tim Baker, Associate Professor at the Department of Global Public Health at Karolinska Institutet.
The researchers behind the study emphasise that these are basic but crucial health interventions that can make a big difference.
"If all patients had access to essential emergency and critical care, we could significantly reduce mortality. Moreover, these interventions are inexpensive and can be provided in general wards," says Carl Otto Schell, researcher at the Department of Global Public Health at Karolinska Institutet and one of the initiators of the study.
The study is the first large-scale mapping of critically ill patients in Africa. Nearly 20,000 patients in 180 hospitals in 22 African countries were surveyed in the study.
The study is a collaboration between Karolinska Institutet and universities in South Africa, Tanzania, Ethiopia, Uganda and the UK, and was funded by the National Institute for Health and Care Research (NIHR). The researchers state that there are no conflicts of interest.
Publication: "The African Critical Illness Outcomes Study (ACIOS): A point prevalence study of critical illness in 22 nations in Africa", Tim Baker, Juan Scribante, Muhammed Elhadi, Adesoji O Ademuyiwa, Babatunde Osinaike, Christian Owoo, Daniel Sottie, Karima Khalid, Adam Hewitt-Smith, Arthur Kwizera, Fitsum Kifle Belachew, Degsew Dersso Mengistu, Yared Boru Firissa, Tirunesh Busha Gemechu, Gaudencia Dausab, Unotjari Kauta, Kaveto Sikuvi, Nahla Kechiche, Kelan Bertille Ki, Martin Mukenga, Dolly Munlemvo, Mustapha Bittaye, Abubacarr Jagne, Mohamed Abdinor Omar, Hassan Ali Daoud, Mohamed Faisal, Mahmoud Elfiky, Mpho Seleke, Tarig Fadalla, Alshaima Koko, Alemayehu Bedada, Gilles Niengo Outsouta, Marie Elombila, Ahmed Rhassane El Adib, Meryem Essafti, Dino Lopes, Atilio Morais, Pisirai Ndarukwa, Newten Handireketi, Fred Bulamba, Busisiwe Mrara, Hyla-Louise Kluyts, Marian Kinnes, Gillian J Bedwell, Hanel Duvenage, Gwendoline Arendse, Luke Hannon, Landon Myer, Anneli Hardy, Carl Otto Schell, Rupert M. Pearse, Bruce M Biccard, The Lancet, online 27 February 2025, doi: 10.1101/2024.03.14.2430427
