{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,12]],"date-time":"2026-09-12T04:00:01Z","timestamp":1789185601561,"version":"build-2803163510"},"reference-count":17,"publisher":"American Society of Tropical Medicine and Hygiene","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,7,2]]},"abstract":"<jats:title>ABSTRACT.<\/jats:title>\n<jats:p>Scoring systems for organ dysfunction (e.g., the quick Sepsis-related Organ Failure Assessment [qSOFA], Modified Early Warning Score [MEWS], and Universal Vital Assessment [UVA]) are proposed as clinical criteria for sepsis. The content validity of these scoring systems is poorly understood in sub-Saharan Africa, where the global sepsis burden is concentrated. In a prospective cohort of 288 adults hospitalized with suspected sepsis in Uganda, we show that qSOFA, MEWS, and UVA scores were significantly associated with soluble mediators of innate and adaptive immune activation, endothelial dysfunction, and fibrinolysis. Results were consistent after adjustment for demographics, illness duration, and HIV or malaria coinfection. In resource-limited settings in sub-Saharan Africa, organ dysfunction scores may stratify patients at highest risk of poor outcomes and those with more dysregulated host responses. Further studies are needed to better define these relationships, including the temporal dynamics of dysregulated host responses and organ dysfunction in sepsis.<\/jats:p>","DOI":"10.4269\/ajtmh.24-0618","type":"journal-article","created":{"date-parts":[[2025,4,22]],"date-time":"2025-04-22T17:39:49Z","timestamp":1745343589000},"page":"214-217","source":"Crossref","is-referenced-by-count":1,"title":["Associations between Organ Dysfunction Scoring Systems and Dysregulated Host Responses in Adults with Severe Infection in Uganda: A Prospective Cohort Study"],"prefix":"10.4269","volume":"113","author":[{"given":"Jonathan","family":"Tiao","sequence":"first","affiliation":[{"name":"Department of Medicine, Columbia University Irving Medical Center\/NewYork-Presbyterian Hospital, New York, New York;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Barnabas","family":"Bakamutumaho","sequence":"additional","affiliation":[{"name":"Department of Arbovirology, Emerging and Re-emerging Infectious Diseases, Uganda Virus Research Institute, Entebbe, Uganda;"},{"name":"Immunizable Diseases Unit, Uganda Virus Research Institute, Entebbe, Uganda;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicholas","family":"Owor","sequence":"additional","affiliation":[{"name":"Department of Arbovirology, Emerging and Re-emerging Infectious Diseases, Uganda Virus Research Institute, Entebbe, Uganda;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John","family":"Kayiwa","sequence":"additional","affiliation":[{"name":"Department of Arbovirology, Emerging and Re-emerging Infectious Diseases, Uganda Virus Research Institute, Entebbe, Uganda;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joyce","family":"Namulondo","sequence":"additional","affiliation":[{"name":"Department of Arbovirology, Emerging and Re-emerging Infectious Diseases, Uganda Virus Research Institute, Entebbe, Uganda;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Timothy","family":"Byaruhanga","sequence":"additional","affiliation":[{"name":"Department of Arbovirology, Emerging and Re-emerging Infectious Diseases, Uganda Virus Research Institute, Entebbe, Uganda;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Moses","family":"Muwanga","sequence":"additional","affiliation":[{"name":"Entebbe General Referral Hospital, Ministry of Health, Entebbe, Uganda;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher","family":"Nsereko","sequence":"additional","affiliation":[{"name":"Entebbe General Referral Hospital, Ministry of Health, Entebbe, Uganda;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Irene","family":"Nayiga","sequence":"additional","affiliation":[{"name":"Entebbe General Referral Hospital, Ministry of Health, Entebbe, Uganda;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaoyu","family":"Che","sequence":"additional","affiliation":[{"name":"Center for Infection and Immunity, Mailman School of Public Health, Columbia University, New York, New York;"},{"name":"Department of Biostatistics, Columbia University Mailman School of Public Health, New York, New York;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"W. Ian","family":"Lipkin","sequence":"additional","affiliation":[{"name":"Center for Infection and Immunity, Mailman School of Public Health, Columbia University, New York, New York;"},{"name":"Department of Pathology and Cell Biology, Vagelos College of Physicians and Surgeons, Columbia University, New York, New York;"},{"name":"Department of Epidemiology, Columbia University Mailman School of Public Health, New York, New York;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julius J.","family":"Lutwama","sequence":"additional","affiliation":[{"name":"Department of Arbovirology, Emerging and Re-emerging Infectious Diseases, Uganda Virus Research Institute, Entebbe, Uganda;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Max R.","family":"O\u2019Donnell","sequence":"additional","affiliation":[{"name":"Center for Infection and Immunity, Mailman School of Public Health, Columbia University, New York, New York;"},{"name":"Department of Epidemiology, Columbia University Mailman School of Public Health, New York, New York;"},{"name":"Division of Pulmonary, Allergy, and Critical Care Medicine, Department of Medicine, Vagelos College of Physicians and Surgeons, Columbia University, New York, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthew J.","family":"Cummings","sequence":"additional","affiliation":[{"name":"Center for Infection and Immunity, Mailman School of Public Health, Columbia University, New York, New York;"},{"name":"Division of Pulmonary, Allergy, and Critical Care Medicine, Department of Medicine, Vagelos College of Physicians and Surgeons, Columbia University, New York, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2795","reference":[{"key":"b1","series-title":"JAMA","first-page":"801","article-title":"The Third International Consensus Definitions for Sepsis and Septic Shock 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Glob Health","first-page":"e000344","article-title":"Derivation and validation of a universal vital assessment (UVA) score: A tool for predicting mortality in adult hospitalised patients in sub-Saharan Africa","volume":"2","author":"Moore","year":"2017"},{"key":"b7","series-title":"EClinicalMedicine","first-page":"101184","article-title":"A comparison of different scores for diagnosis and mortality prediction of adults with sepsis in low-and-middle-income countries: A systematic review and meta-analysis","volume":"42","author":"Adegbite","year":"2021"},{"key":"b8","series-title":"Am J Trop Med Hyg","first-page":"202","article-title":"A prospective comparison of quick sequential organ failure assessment, systemic inflammatory response syndrome criteria, universal vital assessment, and modified early warning score to predict mortality in patients with suspected infection in Gabon","volume":"100","author":"Schmedding","year":"2019"},{"key":"b9","series-title":"JAMA","first-page":"2202","article-title":"Association of the quick sequential (sepsis-related) organ failure assessment (qSOFA) score with excess hospital mortality in adults with suspected infection in low- and middle-income countries","volume":"319","author":"Rudd","year":"2018"},{"key":"b10","series-title":"Crit Care Med","first-page":"e122","article-title":"Application of a framework to assess the usefulness of alternative sepsis criteria","volume":"44","author":"Seymour","year":"2016"},{"key":"b11","series-title":"Crit Care","first-page":"445","article-title":"Judging quality of current septic shock definitions and criteria","volume":"19","author":"Shankar-Hari","year":"2015"},{"key":"b12","series-title":"Am J Respir Crit Care Med","first-page":"A4988","article-title":"Organ dysfunction scoring systems scale with dysregulated host responses among adults with suspected sepsis in Uganda: A 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