Gupta and Lissauer
Sepsis, which occurs when infection leads to life threatening organ dysfunction, is one of the main causes of maternal death, especially in low income countries (Say, 2014). Early diagnosis followed by timely intervention with the correct treatment is essential to reduce these preventable deaths, yet improving sepsis care has been relatively neglected by international efforts, and has only recently become the focus for action by the World Health Organisation and major international donors. (WHO Statement on maternal sepsis, 2017).
The measurement of lactate is part of the gold standard of sepsis care, and a key requirement of the American Surviving Sepsis Campaign guidelines and in the UK the NICE guidelines for sepsis. This marker helps clinicians detect sepsis rapidly, determines severity and guides subsequent management.
The World Health Organisation maternal sepsis working group, of which we are part, has identified the lack of maternal lactate monitoring as a major barrier to the provision of high quality maternal sepsis care. Innovation to make this available in low resources setting, where there is the greatest need, is urgently required.
This project will develop a low cost point-of-care sensor for quantitation of lactate in blood samples collected via finger prick. The blood sample will be introduced in the sensor by capillary action to reduce errors as a result of inaccuracies in sample volumes. The student will also have the opportunity to visit sites where the team are currently running maternal sepsis quality improvement studies at 13 health faciltiies in Malawi. There they will be able to understand the requirements of the device and gain feedback from future users.
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