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Research Snapshot Theater: Sepsis/Infectious Disease, Adult

Subphenotypes of Infection Site and Organ Failure Predict Mortality in Adults With Sepsis in Africa

Monday, March 23, 2026
10:15 AM - 11:15 AM Central Time
Location: Connections Central - RST 16

  • Phoebe Gruccio, n/a (she/her/hers)

    Virginia

    Disclosure(s): No relevant financial relationship(s) to disclose.

  • RK

    Reagan Kakande, n/a

    Medical Student
    Mbarara University of Science and Technology Department of Medicine

    Disclosure information not submitted.

  • LE

    Louisa Edwards, n/a

    Graduate Student
    Stanford University, Department of Management Science and Engineering

    Disclosure information not submitted.

  • MZ

    Muhammad Zulfiqar, n/a

    Medical Student
    UVA School of Medicine, Division of Infectious Diseases and International Health

    Disclosure information not submitted.

  • MN

    Michael Ndyomugabe, n/a

    Medical Student
    Mbarara University of Science and Technology Department of Medicine

    Disclosure information not submitted.

  • VA

    Victor Adejayan, n/a

    Medical Student
    UVA School of Medicine, Division of Infectious Diseases and International Health

    Disclosure information not submitted.

  • PO

    Philemon Ojuman, n/a

    Medical Student
    Mbarara University of Science and Technology Department of Medicine

    Disclosure information not submitted.

  • WG

    William S. Girard, n/a

    Undergraduate Student
    UVA School of Medicine, Division of Infectious Diseases and International Health

    Disclosure information not submitted.

  • EO

    Eva Otoupalova, MD

    Assistant Professor
    Tulane University School of Medicine

    Disclosure information not submitted.

  • PB

    Paulin R. Banguti, n/a

    Physician
    University of Rwanda, Department of Anesthesia

    Disclosure information not submitted.

  • DH

    Dennis Hopkinson, n/a

    Physician
    University of Rwanda, Department of Anesthesia

    Disclosure information not submitted.

  • JM

    Jean Paul Mvukiyehe, n/a

    Physician
    University of Rwanda, Department of Anesthesia

    Disclosure information not submitted.

  • CG

    Cozie Gwaikolo, n/a

    Physician
    JFK Hospital, Department of Medicine

    Disclosure information not submitted.

  • RS

    Richard Ssekitoleko, N/A

    Physician
    WHO Uganda

    Disclosure information not submitted.

  • ER

    Elisabeth D. Riviello, n/a

    Physician
    Harvard University

    Disclosure information not submitted.

  • EN

    Edwin Nuwagira, N/A

    Physician
    Mbarara University of Science and Technology Department of Medicine

    Disclosure information not submitted.

  • CM

    Christopher C. Moore, MD

    Professor of Medicine
    UVA School of Medicine, Division of Infectious Diseases and International Health

    Disclosure information not submitted.

Introduction: Africa has the highest global incidence of sepsis and associated mortality. Yet, sepsis in Africa remains poorly understood. We aimed to identify associations between infection site, organ dysfunction, and 30-day mortality in adults with sepsis in Africa.


Methods: We analyzed pooled data from patients at the Mbarara Regional Referral Hospital in Uganda, University Hospitals of Kigali and Butare in Rwanda, and JFK Hospital in Liberia (2017-23). We included adults ≥18 years with ≥2 qSOFA criteria. We used logistic regression and latent class analysis to determine clinical subphenotypes associated with 30-day mortality.


Results: Of the 473 patients in the pooled analysis, 306 (65%) were from Uganda, 135 (29%) were from Rwanda, and 32 (7%) were from Liberia; 257 (54%) were female, the median (interquartile) age was 52 (17-95) years, and 127 (27%) were living with HIV. Death by 30-days occurred in 128 (27%).

In the univariate analysis, subphenotype pairs that predicted increased mortality included pulmonary/central nervous system (CNS) infection (odds ratio [OR] 3.13, 95% confidence interval [Cl] 1.15-8.57), CNS infection/respiratory failure (OR 2.83, 95%CI 1.32–6.08), CNS infection/cardiac failure (OR 2.77, 95%Cl 1.41-5.45), CNS infection/multiorgan dysfunction (OR 2.74, 95%Cl 1.42-5.29), CNS infection/altered mental status (AMS) (OR 2.31, 95%Cl 1.24-4.29), pulmonary infection/AMS (OR 2.04, 95%Cl 1.22-3.41), and multiple infection sites/AMS (OR 1.82, 95%Cl 1.01-3.28). Subphenotype pairs that predicted decreased mortality included soft tissue infection/multiorgan dysfunction (OR 0.28, 95%Cl 0.08-0.96) and soft tissue infection/cardiac failure (0.28, 95%Cl 0.08-0.99).

After adjusting for age, sex, and country, subphenotype pairs that predicted increased mortality included pulmonary infection/CNS infection (adjusted OR [AOR] 3.39, 95%CI 1.23-9.30) and pulmonary infection/AMS (AOR 3.26, 95%CI 1.35-7.87). Latent class analysis identified a subphenotype of AMS, cardiac failure, and respiratory failure that was associated with increased mortality (N=138; AOR 2.36, 95%Cl 1.28-4.37).


Conclusions: High-risk subphenotypes of sepsis in Africa included AMS, cardiac failure, and respiratory failure, whereas soft tissue infection was included in low-risk subphenotypes.