Division of Internal Medicine, St Michael's Hospital, University of Toronto, Toronto, Ontario, Canada.
University of British Columbia and British Columbia Children's Hospital, Vancouver, British Columbia, Canada.
J Infect. 2017 Jun;74 Suppl 1:S61-S65. doi: 10.1016/S0163-4453(17)30193-7.
Sepsis in children is a complex syndrome that develops from various infections and results in 15-30% mortality in high-income countries and up to 50% or higher in low-income countries. Worldwide, this represents an annual burden of 30 million cases resulting in 8 million deaths. Not surprisingly, there is a significantly higher burden in low-income countries with children there being 18 times more likely to die before the age of 5 years compared to high-income countries. Factors such as commercial air travel, climate change, and unchecked population growth have contributed to the growing burden of infectious diseases and ensuing sepsis. In this article, we review the important role of global advocacy to improve public awareness of sepsis; increase access to essential medicines and vaccines; improve use of evidence-based treatment guidelines; raise awareness of antimicrobial resistance and encourage antibiotic stewardship; and, develop resilient health systems that can cope with health crises. Advocacy in these areas can assist nations in reaching the United Nations sustainable development goals (UN SDGs) of low rates of neonatal and under-5 mortality.
儿童脓毒症是一种复杂的综合征，由各种感染引起，在高收入国家的死亡率为 15-30%，在低收入国家高达 50%或更高。在全球范围内，这代表着每年有 3000 万例病例的负担，导致 800 万人死亡。毫不奇怪，在低收入国家，儿童的负担明显更重，与高收入国家相比，5 岁以下儿童死亡的可能性高出 18 倍。商业航空旅行、气候变化和人口不受控制的增长等因素导致了传染病和随之而来的脓毒症负担的增加。在本文中，我们回顾了全球宣传在提高公众对脓毒症的认识、增加基本药物和疫苗的可及性、改善基于证据的治疗指南的使用、提高对抗生素耐药性的认识和鼓励抗生素管理以及开发能够应对卫生危机的有弹性的卫生系统方面的重要作用。在这些领域的宣传可以帮助各国实现联合国可持续发展目标（UN SDGs）中新生儿和 5 岁以下儿童死亡率低的目标。
