Orikiriza Patrick, Ruhangaza Deogratius, Ayebare David S, Bizimana Ezechiel, Niyibizi Jean Baptiste, Nshimiyimana Irene, Mujyuwisha Louis, Bekele Abebe
Division of Basic Medical Sciences, School of Medicine, University of Global Health Equity, Kigali, Rwanda.
Department of Pathology, Butaro District Hospital, Burera, Rwanda.
PLoS One. 2025 Jun 27;20(6):e0327425. doi: 10.1371/journal.pone.0327425. eCollection 2025.
Pediatric sepsis poses a significant health challenge in Sub-Saharan Africa, with limited data on prevalence and pathogen profiles. This study determined the prevalence of pediatric sepsis, identified bacterial pathogens, and evaluated associated risk factors among children aged 1-59 months at Butaro Hospital, Rwanda.
A cross-sectional study was conducted from March 2022 to December 2022. The study included 114 children aged 1-59 months with suspected sepsis admitted to the pediatric ward at Butaro Hospital. Blood cultures were analyzed, and risk factors assessed using multiple logistic regression. Data were analyzed using Stata 17.
Of 114 enrolled children, 60.5% (n = 69) had positive blood cultures (95% CI: 51.2-69.1). Among these 69 children, the majority were females, 70.0% (n = 35) (95% CI: 53.7-81.3) and below 6 months 68.1% (n = 15) (95% CI: 45.3-84.7). Pathogenic bacteria identified were Coagulase-Negative Staphylococci (CNS), 59.4% (n = 41) and Staphylococcus aureus, 40.6% (n = 28). Female gender (AOR = 2.4, 95% CI: 1.0-5.4, p = 0.045) and leukocytosis (AOR = 6.0, 95% CI: 2.0-20.2, p = 0.003) were the risk factors for sepsis.
The study reveals a high prevalence of sepsis among children under-five, especially females and less than 6 months with female gender and diagnosis with leukocytosis being a significant risk factor. Diagnostic strategies should focus on WBC counts to better manage at-risk children. These single-center study results however may not be broadly representative due to regional and resource differences, but they offer valuable insights for improving pediatric care in similar low-resource settings.
小儿败血症在撒哈拉以南非洲地区构成了重大的健康挑战，关于其患病率和病原体谱的数据有限。本研究确定了卢旺达布塔罗医院1至59个月儿童中小儿败血症的患病率，鉴定了细菌病原体，并评估了相关危险因素。
于2022年3月至2022年12月进行了一项横断面研究。该研究纳入了布塔罗医院儿科病房收治的114名1至59个月疑似败血症儿童。对血培养进行分析，并使用多因素逻辑回归评估危险因素。数据使用Stata 17进行分析。
在114名入组儿童中，60.5%（n = 69）血培养呈阳性（95%置信区间：51.2 - 69.1）。在这69名儿童中，大多数为女性，占70.0%（n = 35）（95%置信区间：53.7 - 81.3），6个月以下儿童占68.1%（n = 15）（95%置信区间：45.3 - 84.7）。鉴定出的病原菌为凝固酶阴性葡萄球菌（CNS），占59.4%（n = 41），金黄色葡萄球菌占40.6%（n = 28）。女性性别（比值比 = 2.4，95%置信区间：1.0 - 5.4，p = 0.045）和白细胞增多症（比值比 = 6.0，95%置信区间：2.0 - 20.2，p = 0.003）是败血症的危险因素。
该研究揭示了五岁以下儿童中败血症的高患病率，尤其是女性以及6个月以下儿童，女性性别和白细胞增多症诊断是重要危险因素。诊断策略应关注白细胞计数，以更好地管理高危儿童。然而，由于地区和资源差异，这些单中心研究结果可能不具有广泛代表性，但它们为改善类似低资源环境下的儿科护理提供了有价值的见解。
