{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,15]],"date-time":"2026-06-15T17:55:24Z","timestamp":1781546124244,"version":"3.54.5"},"reference-count":31,"publisher":"Public Library of Science (PLoS)","issue":"6","license":[{"start":{"date-parts":[[2026,6,15]],"date-time":"2026-06-15T00:00:00Z","timestamp":1781481600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS One"],"abstract":"\n Background<\/jats:title>\n Sepsis continues to pose a significant global health challenge, particularly in low- and middle-income countries, which face a disproportionate burden of sepsis and sepsis-related deaths. The estimated prevalence of sepsis and sepsis-related mortality is higher in intensive care units than in hospitals overall. The burden can be higher in tertiary referral centers that receive patients from different regions.<\/jats:p>\n This study aimed to determine the prevalence of sepsis, its outcomes, and the factors associated with these outcomes among adult patients admitted to the Intensive Care Unit (ICU) of the Muhimbili National Hospital (MNH) in Tanzania.<\/jats:p>\n <\/jats:sec>\n \n Methodology<\/jats:title>\n This prospective cohort study was conducted over a period of six months from May 16 to November 16, 2023, at MNH. A total of 248 patients were admitted during the study period and screened for sepsis on admission or for the development of sepsis during their ICU stay. Sepsis was defined according to the Sepsis-3 criteria as a suspected infection with a Sequential Organ Failure Assessment (SOFA) score \u22652 within 24 h of ICU admission. Proportions were used for descriptive statistics, and modified Poisson regression analysis was used to identify independent predictors of mortality at a 95% confidence interval, with P\u2009<\u20090.05 indicating statistical significance.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n The prevalence of sepsis was 41.5%. The respiratory system was the most common source of infection (32%), and 22.3% of patients had more than one infection site. The ICU mortality rate was 55.3%, with 35% of patients developing systemic complications during their ICU stay.<\/jats:p>\n Factors independently associated with mortality included multiple comorbidities (aPR 3.35, 95% confidence interval [CI], 1.20\u20139.32; p\u2009=\u20090.021) and a higher SOFA score (aPR 7.08, 95% CI 3.48\u201314.4; p\u2009<\u20090.001). Early initiation of antibiotics was independently associated with improved survival (aPR 0.47, 95% CI 0.27\u20130.84; p\u2009=\u20090.011).<\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n This study revealed a high prevalence of sepsis and sepsis-related mortality in the ICU. A high SOFA score and multiple complications were independent predictors of mortality. Early initiation of antibiotic therapy was an independent predictor of survival. This underscores the importance of early treatment, close monitoring, and aggressive management in patients with predictors of poor outcome.<\/jats:p>\n <\/jats:sec>","DOI":"10.1371\/journal.pone.0351137","type":"journal-article","created":{"date-parts":[[2026,6,15]],"date-time":"2026-06-15T17:25:40Z","timestamp":1781544340000},"page":"e0351137","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":0,"title":["Prevalence, outcomes, and predictors of mortality among adult intensive care unit patients with sepsis at a Tertiary Hospital in Tanzania: A prospective cohort study"],"prefix":"10.1371","volume":"21","author":[{"ORCID":"https:\/\/orcid.org\/0009-0004-8986-7328","authenticated-orcid":true,"given":"Atala","family":"Jongo","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Edwin","family":"Lugazia","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Salehe","family":"Mrutu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amina Abillah","family":"Omari","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hassani","family":"Msanga","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ansbert Sweetbert","family":"Ndebea","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Felix Paul","family":"Amani","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2026,6,15]]},"reference":[{"issue":"8","key":"pone.0351137.ref001","doi-asserted-by":"crossref","first-page":"801","DOI":"10.1001\/jama.2016.0287","article-title":"The Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3)","volume":"315","author":"M Singer","year":"2016","journal-title":"JAMA"},{"key":"pone.0351137.ref002","doi-asserted-by":"crossref","first-page":"16045","DOI":"10.1038\/nrdp.2016.45","article-title":"Sepsis and septic shock","volume":"2","author":"RS Hotchkiss","year":"2016","journal-title":"Nat Rev Dis Primers"},{"issue":"1","key":"pone.0351137.ref003","doi-asserted-by":"crossref","first-page":"6","DOI":"10.4046\/trd.2018.0041","article-title":"Sepsis: early recognition and optimized treatment","volume":"82","author":"HI Kim","year":"2018","journal-title":"Tuberc Respir Dis (Seoul)"},{"issue":"11","key":"pone.0351137.ref004","doi-asserted-by":"crossref","first-page":"1123","DOI":"10.1016\/j.cmi.2018.03.032","article-title":"Accuracy of quick Sequential Organ Failure Assessment (qSOFA) score and systemic inflammatory response syndrome (SIRS) criteria for predicting mortality in hospitalized patients with suspected infection: a meta-analysis of observational studies","volume":"24","author":"S Maitra","year":"2018","journal-title":"Clin Microbiol Infect"},{"issue":"7","key":"pone.0351137.ref005","doi-asserted-by":"crossref","first-page":"906","DOI":"10.1164\/rccm.201604-0854OC","article-title":"Quick Sepsis-related Organ Failure Assessment, Systemic Inflammatory Response Syndrome, and Early Warning Scores for Detecting Clinical Deterioration in Infected Patients outside the Intensive Care Unit","volume":"195","author":"MM Churpek","year":"2017","journal-title":"Am J Respir Crit Care Med"},{"issue":"1","key":"pone.0351137.ref006","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1097\/CCM.0000000000000723","article-title":"Surviving Sepsis Campaign: association between performance metrics and outcomes in a 7.5-year study","volume":"43","author":"MM Levy","year":"2015","journal-title":"Crit Care Med"},{"issue":"2","key":"pone.0351137.ref007","doi-asserted-by":"crossref","first-page":"165","DOI":"10.1007\/s00134-012-2769-8","article-title":"Surviving Sepsis Campaign: international guidelines for management of severe sepsis and septic shock, 2012","volume":"39","author":"RP Dellinger","year":"2013","journal-title":"Intensive Care Med"},{"issue":"8","key":"pone.0351137.ref008","doi-asserted-by":"crossref","first-page":"1536","DOI":"10.1007\/s00134-020-06106-2","article-title":"Epidemiology and burden of sepsis acquired in hospitals and intensive care units: a systematic review and meta-analysis","volume":"46","author":"R Markwart","year":"2020","journal-title":"Intensive Care Med"},{"issue":"5","key":"pone.0351137.ref009","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0251321","article-title":"Sepsis in two hospitals in Rwanda: A retrospective cohort study of presentation, management, outcomes, and predictors of mortality","volume":"16","author":"DA Hopkinson","year":"2021","journal-title":"PLoS One"},{"key":"pone.0351137.ref010","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.jhin.2023.11.012","article-title":"Prevalence and mortality rate of sepsis among adults admitted to hospitals in sub-Saharan Africa: a systematic review and meta-analysis","volume":"144","author":"GT Kiya","year":"2024","journal-title":"J Hosp Infect"},{"key":"pone.0351137.ref011","first-page":"2741271","article-title":"Characteristics of Adult Sepsis Patients in the Intensive Care Units in a Tertiary Hospital in Jordan: An Observational Study","volume":"2021","author":"AHA Abu-Humaidan","year":"2021","journal-title":"Crit Care Res Pract"},{"key":"pone.0351137.ref012","doi-asserted-by":"crossref","first-page":"4378635","DOI":"10.1155\/2024\/4378635","article-title":"Mortality due to Sepsis and Its Associated Factors Among Patients Admitted to Intensive Care Units of Southern Amhara Public Hospitals, Ethiopia","volume":"2024","author":"SA Getu","year":"2024","journal-title":"Biomed Res Int"},{"issue":"1","key":"pone.0351137.ref013","doi-asserted-by":"crossref","first-page":"9963","DOI":"10.1038\/s41598-024-59031-5","article-title":"Characteristics and outcomes of patients admitted to intensive care units in Uganda: a descriptive nationwide multicentre prospective study","volume":"14","author":"P Atumanya","year":"2024","journal-title":"Sci Rep"},{"key":"pone.0351137.ref014","doi-asserted-by":"crossref","DOI":"10.3389\/femer.2024.1405753","article-title":"Incidence of mortality and its predictors among septic shock patients admitted to the intensive care unit of comprehensive specialized hospitals in the northwest of Amhara, Ethiopia","volume":"2","author":"T Ayenew Mekuria","year":"2024","journal-title":"Front Disaster Emerg Med"},{"issue":"1","key":"pone.0351137.ref015","doi-asserted-by":"crossref","first-page":"516","DOI":"10.1186\/s12887-026-06840-4","article-title":"Prevalence and bacteriological profile of pathogens causing neonatal sepsis in Tanzania: a systematic review with meta-analysis","volume":"26","author":"DR Msanga","year":"2026","journal-title":"BMC Pediatr"},{"issue":"6","key":"pone.0351137.ref016","doi-asserted-by":"crossref","first-page":"120","DOI":"10.21315\/mjms2023.30.6.12","article-title":"Prevalence and Outcome of Sepsis: Mortality and Prolonged Intensive Care Unit Stay among Sepsis Patients Admitted to a Tertiary Centre in Malaysia","volume":"30","author":"KA Kari","year":"2023","journal-title":"Malays J Med Sci"},{"issue":"1","key":"pone.0351137.ref017","doi-asserted-by":"crossref","first-page":"375","DOI":"10.1186\/s13054-024-05176-8","article-title":"A multicentre prospective registry of one thousand sepsis patients admitted in Indian ICUs: (SEPSIS INDIA) study","volume":"28","author":"S Todi","year":"2024","journal-title":"Critical Care"},{"issue":"7","key":"pone.0351137.ref018","doi-asserted-by":"crossref","first-page":"571","DOI":"10.1089\/sur.2020.047","article-title":"Sepsis and septic shock in low- and middle-income countries","volume":"21","author":"AH Stephen","year":"2020","journal-title":"Surg Infect (Larchmt)"},{"issue":"5","key":"pone.0351137.ref019","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0251321","article-title":"Sepsis in two hospitals in Rwanda: A retrospective cohort study of presentation, management, outcomes, and predictors of mortality","volume":"16","author":"DA Hopkinson","year":"2021","journal-title":"PLoS One"},{"key":"pone.0351137.ref020","doi-asserted-by":"crossref","first-page":"61","DOI":"10.2147\/PROM.S450502","article-title":"Determinants of Mortality of Patients Admitted to the Intensive Care Unit at Debre Berhan Comprehensive Specialized Hospital: A Retrospective Cohort Study","volume":"15","author":"EE Melaku","year":"2024","journal-title":"Patient Relat Outcome Meas"},{"issue":"03","key":"pone.0351137.ref021","doi-asserted-by":"crossref","first-page":"37","DOI":"10.4236\/ojim.2015.53008","article-title":"Community-Acquired Severe Sepsis: A Prospective Cohort Study","volume":"05","author":"C Sousa","year":"2015","journal-title":"OJIM"},{"issue":"1","key":"pone.0351137.ref022","doi-asserted-by":"crossref","DOI":"10.1186\/s13054-025-05672-5","article-title":"Adult patients with sepsis in the ICU in Lubumbashi, Democratic Republic of Congo","volume":"29","author":"M Muteya Manika","year":"2025","journal-title":"Crit Care"},{"issue":"19","key":"pone.0351137.ref023","doi-asserted-by":"crossref","first-page":"6691","DOI":"10.3390\/jcm14196691","article-title":"The Burden of Sepsis and Septic Shock in the Intensive Care Unit","volume":"14","author":"L La Via","year":"2025","journal-title":"J Clin Med"},{"issue":"4","key":"pone.0351137.ref024","first-page":"629","article-title":"Organ dysfunction in sepsis: an ominous trajectory from infection to death","volume":"92","author":"C Caraballo","year":"2019","journal-title":"Yale J Biol Med"},{"issue":"1","key":"pone.0351137.ref025","doi-asserted-by":"crossref","first-page":"188","DOI":"10.1016\/j.afjem.2020.10.001","article-title":"Prevalence and outcome of sepsis and septic shock in intensive care units in Addis Ababa, Ethiopia: A prospective observational study","volume":"11","author":"HA Mulatu","year":"2021","journal-title":"Afr J Emerg Med"},{"issue":"9","key":"pone.0351137.ref026","doi-asserted-by":"crossref","first-page":"2017","DOI":"10.3390\/ijerph15092017","article-title":"The Early Recognition and Management of Sepsis in Sub-Saharan African Adults: A Systematic Review and Meta-Analysis","volume":"15","author":"B Morton","year":"2018","journal-title":"Int J Environ Res Public Health"},{"issue":"4","key":"pone.0351137.ref027","first-page":"250","article-title":"A prospective, observational severe sepsis\/septic shock registry in a tertiary hospital in the province of Guipuzcoa (Spain)","volume":"36","author":"I Azk\u00e1rate","year":"2012","journal-title":"Med Intensiva"},{"issue":"3","key":"pone.0351137.ref028","article-title":"Sequential Organ Failure Assessment (SOFA) Score for predicting mortality in patients with sepsis in Vietnamese intensive care units: a multicentre, cross-sectional study","volume":"13","author":"SN Do","year":"2023","journal-title":"BMJ Open"},{"issue":"12","key":"pone.0351137.ref029","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pgph.0005643","article-title":"Factors predicting discharge outcomes of sepsis patients admitted to intensive care unit in a major tertiary care hospital: A retrospective study from Palestine","volume":"5","author":"E Ashqar","year":"2025","journal-title":"PLOS Glob Public Health"},{"issue":"7","key":"pone.0351137.ref030","doi-asserted-by":"crossref","first-page":"1223","DOI":"10.1007\/s10096-019-03529-8","article-title":"Delay of appropriate antibiotic treatment is associated with high mortality in patients with community-onset sepsis in a Swedish setting","volume":"38","author":"M Andersson","year":"2019","journal-title":"Eur J Clin Microbiol Infect Dis"},{"issue":"11","key":"pone.0351137.ref031","doi-asserted-by":"crossref","DOI":"10.1097\/MD.0000000000029096","article-title":"Risk factors for mortality from sepsis in an intensive care unit in Ecuador: A prospective study","volume":"101","author":"JW V\u00e9lez","year":"2022","journal-title":"Medicine (Baltimore)"}],"container-title":["PLOS One"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0351137","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,15]],"date-time":"2026-06-15T17:25:45Z","timestamp":1781544345000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0351137"}},"subtitle":[],"editor":[{"given":"Ramya","family":"Iyadurai","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2026,6,15]]},"references-count":31,"journal-issue":{"issue":"6","published-online":{"date-parts":[[2026,6,15]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pone.0351137","relation":{},"ISSN":["1932-6203"],"issn-type":[{"value":"1932-6203","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,6,15]]}}}