Sepsis is one of the major causes of death worldwide. Although recent data suggest that mortality rates are decreasing in developed countries, the current situation in low and middle-income countries is uncertain. There is a paucity of data and the few high-quality studies suggest that the sepsis burden is substantial and mortality rates are unacceptably high. In Latin America, most countries are middle-income and face common challenges tackling sepsis. Social inequality with no universal access to qualified public health, limitation in resources and ICU availability, shortage and limited qualification of healthcare workers and low awareness among lay people are common issues. Government policies to tackle the burden of sepsis are generally lacking.
At the Seventieth World Health Assembly in May 2017, Member States of the World Health Organization (WHO) adopted a resolution (WHA70.7) on improving the prevention, diagnosis and treatment of sepsis. The resolution requested WHO to develop guidance for the prevention and management of sepsis, to produce a report on the epidemiology and burden of sepsis, and to support countries to obtain the necessary infrastructure, laboratory capacity, strategies and tools to address sepsis
The Instituto Latinoamericano de Sepsis, ILAS, also known as the Latin America Sepsis Institute (LASI) convened a Latin America (LATAM) countries meeting. This meeting was a joint initiative with the Global Sepsis Alliance and supported by the Pan America Health Organization (PAHO). The main objectives of the meeting were to identify common problems and to move the agenda on sepsis in LATAM countries forward in accordance with the WHO resolution.
The participants were welcome by the ILAS president, Dr Luciano Azevedo who presented the proposed agenda (Appendix 1). Representatives of Argentina, Chile, Colombia, Mexico, Peru, Uruguay were present. A representative of the Consorcio Centroamericano y Del Caribe de Terapia Intensiva (COCECATI) was also present representing the following countries: Belize, Guatemala, El Salvador, Costa Rica, Nicaragua, Panama, Dominican Republic, Puerto Rico and Cuba. The Pan America Health Organization was represented by Pilar Ramon-Pardo from the Central Office in Washington and Romina Oliveira from PAHO office in Brazil. Simon Finfer and Niranjan Kissoon represented the Global Sepsis Alliance. The complete list of participants, including Brazilian members of ILAS, is available at the end of this document (Appendix 2).
After a brief introduction of the ILAS activities over the last 10 years, each of the participants presented data and the status of sepsis awareness and activities in their own country. A PDF version of all presentations is available at ILAS website. The main message was that our countries, regardless of their economic profile, share similar issues of absence of reliable data, low awareness among healthcare professionals and lay people, inadequacy of diagnosis and treatment, lack of preventative strategies and inadequate support for survivors and families. There are currently no national action policies available and quality improvement strategies are incipient in many of the countries.
The presentation of the WHO resolution clarified potential pathways and issues that need to be addressed to change the sepsis scenario in LATAM countries. This was followed by the Global Sepsis Alliance reinforcing the relevance of forming regional alliances through which individual countries can work together to seek common solutions and which provides stronger advocacy that single countries working alone. The participants acknowledged the importance of working as a supranational union and how this could facilitate their own local efforts.
The PAHO presentation clarified all the potential partnerships that could be explored between ILAS and PAHO. Potential projects would be training courses, awareness campaigns and endorsements of ILAS initiatives.
In open discussion an action plan including the following was agreed:
Dr Luciano Azevedo (ILAS president) thanked all participants for their active contributions to this meeting. Participants welcomed the fact that we will have the chance to work together, to share experiences, successes and remaining challenges. All participants acknowledge the importance of having GSA and PAHO as partners in this initiative and described the meeting as a major step forward in the fight against sepsis in LATAM countries.
1 - LASI: 13 years of history - Luciano Azevedo - Click here
2 - Sepsis in Colombia - Fabian Barragan - Click here
3 - Problems related to Sepsis in Uruguay - Gaston Burgui - Click here
4 - Sepsis in Mexico - Luis Antonio Gorordo Delsol - Click here
5 - The SatiSepsis Studies - Elisa Estensoro - Click here
6 - Sepsis: the reality in Chile - Tomás Heskia - Click here
7 - Where are we now in Peru? - Carmen Terrazas Obregon - Click here
8 - WHO resolution: what does it mean? - Flávia Ribeiro Machado - Click here
9 - Why do we need regional alliances? - Simon Finfer - Click here
10 - ILAS meeting: What is next? - Thiago Lisboa - Click here
11 - How PAHO can foster the implementation of the WHO resolution? - Pilar Ramon Click here
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