International Healthcare: Sepsis Prevalence and Management Report

This report provides a comprehensive analysis of sepsis within the context of international healthcare, exploring its definition, prevalence, and management. It delves into the issues and debates surrounding the definition of sepsis, examining how social, political, economic, and environmental factors influence its prevalence and management globally. The report assesses the impact of internationalization, economic disparities, environmental conditions, and political landscapes on sepsis, highlighting the challenges faced by low- and middle-income countries. Furthermore, it evaluates the strengths and limitations of universal prevention, diagnosis, and management strategies for sepsis, offering insights into the complexities of addressing this life-threatening condition. The report concludes by emphasizing the need for comprehensive strategies to combat sepsis effectively, considering both its global impact and the specific challenges faced by different regions and populations.

Social, Political and
Environmental Issues in
International Healthcare

Table of Contents
INTRODUCTION...........................................................................................................................3
MAIN BODY..................................................................................................................................3
Task A..............................................................................................................................................3
Issues and debates surroundings definition and dimensions of health in relation to Sepsis........3
Task B..............................................................................................................................................5
Impact of International, Economic, Environment and Political in prevalence and management
of Sepsis.......................................................................................................................................5
Assessment of prevalence of Sepsis............................................................................................7
Strength and Limitation of “Universal prevention, diagnosis and management of Sepsis”........8
Reflection.........................................................................................................................................9
CONCLUSION..............................................................................................................................10
REFERENCES..............................................................................................................................11

INTRODUCTION
Health can be described in various forms and one of the simplest meanings of health is
being free from any type of illness and disease. Health which is most important area of focus for
human being and this is focused by government of nations. Health is an important criterion for
the success and growth of a country and region. This study will also based on discussion over
health and its related aspects. In relation with health the centre of the discussion is Sepsis. Sepsis
is a life threatening which is caused by infection and response of body to that infection. This
study will discuss about issues and debates surrounding definition of Sepsis. Impact of
internationalization and various other elements on prevalence and management of Sepsis and
strength and limitations of universal prevention, diagnosis and management of Sepsis will also
be discussed in the study.
MAIN BODY
Task A
Issues and debates surroundings definition and dimensions of health in relation to Sepsis
Common in nature but Sepsis is a deadly disease and various definition and explanations
have been given regarding Sepsis. Sepsis was characterised by rotting flesh and festering
wounds. Galen described Sepsis as a laudable event which is required for healing of the wound.
Sepsis later was recast as a systematic infection which is referred as blood poisoning. Regarding
this germ theory cannot completely describe the Sepsis and many patients died even after
removal of the inciting pathogen. Later in 1992 it was proposed that the host and not the germ
was responsible for pathogenesis of Sepsis (Force, 2018). Sepsis was defined by them as
systematic inflammatory response to infection. Sepsis yet aroused in response to many different
pathogens and septicemia was not helpful in this case. Severe Sepsis was instead proposed by the
investigators, this is to describe cases where Sepsis become complicated because of acute organ
dysfunction and septic shock term was proposed for a subset of Sepsis cases which were
complicated because of hypotension even there is adequate fluid resuscitation along with
perfusion abnormalities.

Regarding Sepsis research in past 20 years revealed that many of the patients develop
acute organ dysfunction as a response to infection but without excess of inflammatory excess. In
order to clarify terminology and reflect current understanding of the pathobiology of Sepsis, third
international consensus definition was proposed by Sepsis definition task force in 2016
specifying that Sepsis is a dysregulated host response to infection that leads to acute organ
dysfunction. This definition of Sepsis differentiates it from uncomplicated infection which does
not result in any kind of organ dysfunction or death (Meyer and et.al., 2018). Septic shock was
also specified in third international consensus definition that septic shock can be defined as a
subset of sepsis cases in which underlying circulatory and cellular abnormalities are profound
enough to substantially increase risk of mortality.
This above discussion clarifies that Sepsis is in discussion from many centuries and as
researcher found its varied symptoms and their effect regarding core of Sepsis they keep
changing and improving the existing definition. All the definitions of Sepsis remain in context of
infection and organ dysfunction.
This is considered that epidemiological burden of Sepsis is difficult to ascertain and it is
estimated that more than 30 million people worldwide will be affected from this and this will
lead to 6 million deaths. Sepsis is not restricted to any age and it is estimated that more than 3
million newborns and 1.2 million children suffer from Sepsis globally every year. This is
considered that maternal Sepsis is the reason for one in ten deaths associated with pregnancy and
child birth and this also cause 1 million newborn deaths.
Sepsis can be developed because of infection acquired from both community and from
health care setting. These infections are often resistant to antibiotics they can lead to
deteriorating clinical condition.
Regarding Sepsis this is not limited to any particular age and health condition anyone can
be affected by Sepsis condition but some vulnerable population which involve elderly people,
pregnant women, neonates, patients already hospitalized, liver cirrhosis, cancer, kidney disease
and people with HIV/AIDS are more likely to get affected because of this.
In relation with Sepsis Antibiotics is one of the factors for debate regarding Sepsis (Agyeman
and et.al., 2017). Antibiotics related updated guidelines recommend that IV antibiotics can be

initiated within one hour of patient presenting with Sepsis or septic shock. Regarding another
point of view presented states that worry which focus on speed of increasing infection may lead
to unnecessary prescription of broad-spectrum antibiotics this also is possible because of
competition in hospitals to comply with the guidelines. This is a serious concern because
antibiotics is the most initial and important step in treatment of Sepsis and septic shock and at the
same time possibility of unnecessary prescription is there regarding Sepsis treatment. This can
also lead to dilemma whether antibiotics should be prescribed or not.
New definition of Sepsis is also an issue for debate this is because new definition incorporates a
requirement for organ dysfunction and their trial in treatment may lead to prognostic enrichment.
This means treatment of severally affected ill patient who could have been benefited from Sepsis
focused therapies. This means that when patient can be benefited from the treatment which is
given to patient when the symptoms are not completely developed without clinical trials which
involve that patient needs to be treated when they develop symptoms like Sepsis. Earlier
treatment and treatment before development of complete Sepsis can increase possibilities of
patient being treated and avoid severe symptoms of the Sepsis (Howell and Davis, 2017). But on
the other hand this decision and determination of patient having and developing symptoms like
Sepsis is also create difficulty. This happens because of heterogeneity of the symptoms of Sepsis,
this suggest that precision medicine may hold the key the therapeutic breakthroughs.
Task B
Impact of International, Economic, Environment and Political in prevalence and management of
Sepsis
Sepsis is a disease whose prevalence is worldwide but in countries which are of middle
income and lower income faces more threat from Sepsis. These are under developed countries
and such countries houses most of the deaths due to Sepsis. This also gets affected by various
factors and where prevalence might be less affected because of such factors management of
Sepsis gets severely affected by these factors which are known as internationalization, economic,
environmental and political factors.

Internationalization plays an important role in management of Sepsis because countries
which are internationalized are able to get assistance from other countries (Rhee and et.al.,
2019). This specifically helps those countries whose domestic capabilities are lacking in
management of Sepsis. This also affects prevalence as countries can get assistance from other
countries specifically for the research and knowledge over the issues which are known as
prevention of Sepsis. Countries that are able to deliver health services of international level also
lacks prevalence of Sepsis because this starts and prevails because of infection and bacteria and
such countries apply effective measures to control infection and bacteria.
Economic factor is one of the most affecting factors in prevalence and management of
Sepsis. This is because countries that are middle income and low income countries face the most
burden of Sepsis. These countries are higher in deaths due to Sepsis and other symptoms due to
Sepsis. Countries which are middle and low income also become place for 95% deaths because
of maternal Sepsis. Deaths of neonatal because of Sepsis are also highest in middle and low
income countries. The reason for Sepsis being prevailed in middle and low income countries is
that their health care system is not effective and other than this they also do not adopt any
effective measure for controlling infection because of germs and bacteria.
Environment factor is also important contributor in development, prevalence and
management of Sepsis (Machado and et.al., 2017). Severe Sepsis is considered to be more
common in months which are colder. In UK Sepsis is 35% higher in winter than it is in summer.
The case fatality rate is also higher in winter in comparison with summer even after similarity in
severe of illness in summer and winter. Respiratory infections have greatest change because of
seasonal change and highest incidents of this happen in winter or can be said in colder months.
The seasonal variation relates to climate and this varies on the basis of regional differences. This
also has effect and relationship with exposure to light because shorter exposure to sunlight was
associated with a reduced risk of death.
Political factors are also responsible and related with prevalence and management of
Sepsis because political factor is related with leadership of a country. This involves people who
are related with managing and reducing the prevalence of Sepsis. Countries where political factor
is favourable and political leaders take responsibility of the health of people in the country are
more effective at managing Sepsis (Papali and et.al., 2017). They also take responsibility for

better health of the citizens of their country and result in improved health and reduced risk of
Sepsis.
Assessment of prevalence of Sepsis
Prevalence of Sepsis is significantly affected by factors like education, health services,
politics and economic condition of the country. This is the reason that developing countries
which are having low and middle income are more likely to face the challenge of Sepsis because
their health care are not highly qualitative and other factors which can prevent Sepsis are also not
properly employed (Medugu and et.al., 2018). African countries are considered to face challenge
of the Sepsis and one such country in Africa is Nigeria. Nigeria is a developing country and it
has been found that there are several reasons because of which Sepsis is prevailing in the
Nigeria. Reasons because of which Sepsis is prevailed in Nigeria is that their diagnosis is also
not effective. In many of the cases it was found that diagnosis for Sepsis does not meet required
criteria and this is why they are not properly treated. Diagnosis and proper diagnosis is important
so that patient can be properly treated and can be provided most suitable treatment. After a
research on Sepsis in Nigeria it was concluded that management of Sepsis is suboptimal and
mortality rate was high. This requires adoption of high standard guideline for prevention,
diagnosis and management of Sepsis.
Prevalence of Sepsis in UK the number of people diagnosed with Sepsis is increasing
every year in UK. According to NHS England estimated 37000 deaths are associated with
condition of Sepsis. This also becomes difficult when people who survive from Sepsis suffer ling
term physical and mental problems and this creates a challenge for health system in UK
(Frankling and et.al., 2019). The effect of after Sepsis involves post-traumatic disorder, chronic
pain and organ dysfunction these are all challenges for health care system because patient who
recovers from Sepsis and survive this get into different type of medical condition. Patients with
such conditions are regularly supported by health care workers and this make significant
contribution in improvement of such condition. This is challenge for UK and for a developed
country and for a high income country that this many patients are there dealing with and
developing Sepsis. Mortality rate due to Sepsis is also high in UK. This requires that UK needs
to find flaws in its system and work accordingly in order to deal with Sepsis.

Strength and Limitation of “Universal prevention, diagnosis and management of Sepsis”
Universal prevention diagnosis and management of Sepsis is important and there are
reasons which require this. Reduction in people affecting from Sepsis and reducing the mortality
rate because of Sepsis is one the key reason which requires that universally prevented diagnosed
and managed (World Health Organization, 2018). This is a disease which in prevailed worldwide
and countries might have high and low impact of Sepsis on its population because of their
management but yet there is Sepsis and it cannot be completely vanished from the world. This is
because reasons which cause Sepsis are very common and people who might be affected by this
are also common. In improving this condition a universal approach can show significant result
because this will involve all the countries regardless of their economic condition and current
health care system and facility.
Strength of this are-
 It will focus on all over world and they will be able to prevent diagnosis and manage
Sepsis according to similar standards.
 Standards which are determined for the world is more effective and possibilities contains
in such standards are also high.
 Countries will be able to participate and employ better health care and will be able to
manage Sepsis with more care and diligence regardless of their economic and social
status.
 Countries with low domestic expertise in health care will be able to get assistance from
countries who are expert in health care.
 Sustainable development involves every aspect of the situation in sustainable growth and
development of world it is important that Sepsis which is a deadly disease is dealt by
every country in the world.
 Prevention will allow for setting equal standards for all the countries so that they can
apply them in order to prevent further prevalence of Sepsis.
 Diagnosis in universal manner will help in determining measures and criteria for
diagnosis of the Sepsis. This will also contribute in setting standards so that Sepsis can be
diagnosed at its earliest phase. This is important so that patient can be treated without
their health and body getting severely affected.

 Management of Sepsis at universal manner will allow setting standards that countries can
follow during managing and treating Sepsis (Saito, Allegranzi and Pittet, 2018). This will
allow countries to follow management tactics and strategies which are followed by
developed and advanced countries.
Weaknesses
Universal prevention, diagnosis and management are an effective concept and measure to
prevent, diagnosis and management of Sepsis in the world. But there are some weaknesses which
are associated with this.
 Standards can be set for the world in order to prevent, diagnosis and manage Sepsis but
after setting standards responsibility remains with the countries how they are able to
employ standards in their country.
 Country’s health care system should be able to deal with and employ standards of the
prevention, diagnosis and management of Sepsis. This requires countries to develop a
system where they can apply and employ universal standards.
 This can be said but universal prevention, diagnosis and management is a challenging
task and requires best efforts of those countries where Sepsis is highly prevailed.
Sepsis is one of the cause and relevant cause of maternal mortality and death of neonatal and
children under five year of age. This means that prevention and dealing with Sepsis will
definitely contribute to sustainable development goals. Sustainable development is very much
related with neonatal and their lives and this make it importantly that their lives are saved so that
they can contribute their part in sustainable development (English, Williams and Soto, 2016).
Sustainable development also involves reduction in mortality and improving clinical conditions
and this is why this combating Sepsis will contribute in sustainable development goals.
Reflection
Sepsis is a life threatening illness and disease and this is very important to prevent this in
order to ensure safety and life of millions of people. There are many countries specifically those
with high income and advanced and effective health care and management facilities who have
managed to prevent Sepsis and reduce its effect by proper management so that possibility of

prevailing Sepsis can be reduced at its earliest level (Melzer, 2019). Later these countries also
have advanced healthcare and through this they can help people and save their live. Going
through above discussion and completing this study helped me in understanding various aspects
of health care which affect Sepsis. Sepsis is more likely to affect countries which are low and
middle income and most common reason behind this is that such countries do not adhere to
standards of care and safety. This is a disease which is caused because of bacteria and germs and
countries do not have adequate measures through which they can deal with bacteria and germs in
their surroundings. This is also caused because of unhygienic environment low income countries
also does not have adequate measures to maintain hygiene and this is also affected by education
level of people in such countries. All these factors collectively cause Sepsis and later they cannot
manage this because of improper and inadequate health care facility. going through the
information while preparing this study I also get to know that it is not very difficult to prevent
Sepsis is adequate care is followed by the individuals. Sepsis is a disease which is caused
because of infection and people after any possibility of infection can prevent this by taking
proper care. I found some of the ways in which Sepsis can be prevented after a infection these
are staying up-to-date with vaccination, through this individual will be able to prevent infection
which ultimately can result in Sepsis (English, Williams and Soto, 2016). Seeking treatment for
possible infection, in this if individual found that they have infection of they might get infected
because of any incident they should seek for the treatment as soon as possible. Taking antibiotics
as directed by the doctor is another way through which Sepsis can be prevented.
CONCLUSION
On the basis of above discussion it can be concluded that Sepsis is a challenge for health
care system because of its deadly nature. Though, by applying effective healthcare and early
recognition and timely treatment this can be dealt effectively. In relations with its prevalence in
countries with low and middle income it can be said that this is not necessary but factor in low
and middle income countries are more likely to face such challenges. Dealing with Sepsis on
universal manner is important so that sustainable development goals can be achieved. Sepsis is
one of the most relevant reasons for neonatal mortality and this is why it is important that this is
timely prevented so that maternal mortality and death of children can be reduced.

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