Julia Harrison, MD
Nominated From: University of Minnesota
Research Site: Mulago Hospital
Research Area: Maternal and child health, pediatric sepsis, HIV, surgery
Primary Mentors: Dr. Jennifer Rickard
Research Project
Neonatal and Pediatric HIV and Sepsis on a Pediatric Surgery Ward in Uganda: A Prospective Study Standardizing HIV Testing and Sepsis Resuscitation and Treatment Algorithms to Guide Clinical Care
HIV prevalence among pediatric surgical patients presenting with sepsis in Uganda is not known. Sepsis is one of the leading causes of morbidity and mortality for children and neonates worldwide and is a leading surgical presentation of pediatric patients with HIV. The 2020 Surviving Sepsis Campaign laid out a series of recommendations for best practices regarding pediatric and neonatal sepsis. This project aims to both evaluate the HIV screening process for pediatric surgical patients presenting with sepsis and adapt the Surviving Sepsis Campaign recommendations to the resource setting on the pediatric surgery ward of Mulago Hospital in Kampala, Uganda. Using a mixed method approach, we will create and implement a standardized HIV testing and referral policy for children and neonates presenting with sepsis, as well as a resuscitation and treatment algorithm for septic shock and sepsis associated organ dysfunction. With this, we aim to standardize HIV testing and management of pediatric and neonatal sepsis on the pediatric surgery ward. We hypothesize that this will identify previously undiagnosed HIV cases as well as elucidate its prevalence among pediatric surgical patients, improve compliance with key clinical parameters of sepsis management, expedite operative interventions for source control, and ultimately decrease morbidity and mortality among pediatric surgical patients at Mulago Hospital.
Research Significance
Both HIV and sepsis disproportionately affect children in resource-limited settings. Surgical patients suffer from a variety of illnesses and injuries that are different from what most commonly causes sepsis. There is a dearth of research regarding optimal management of pediatric and neonatal sepsis in resource limited settings, especially in surgical patients. This study will provide valuable insight into the patterns of sepsis and HIV among pediatric surgical patients in Uganda. It will also serve as a potential roadmap for the wider implementation of standardized HIV testing and sepsis resuscitation and treatment algorithms among surgical patients in resource-limited settings.
Publications
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