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A landmark multi-country objective proceedings has shown that a structured, sustainable attack to infection prevention and curen tin prevention women's lives, cutting terrible maternal infections and deaths by astir one-third (32%) compared to accustomed care. The maternal program of prevention and curen (APT-Sepsis) was developed by researchers astatine nan University of Liverpool, nan World Health Organization (WHO) and nan UN's Special Programme successful Human Reproduction (HRP).
Maternal infection and sepsis stay among nan starring causes of maternal decease worldwide. Every 30 minutes a mother dies from a sepsis-related origin location successful nan world, pinch nan top load borne by women successful debased and income countries. The Active Prevention and Treatment of Maternal Sepsis (APT-Sepsis) involution tackles this situation done an integrated program focused connected 3 areas: improving manus hygiene, strengthening infection prevention and management, and enhancing sepsis attraction pinch nan FAST-M sepsis bundle.
The trial, conducted crossed 59 hospitals successful Malawi and Uganda and involving much than 430,000 women, assessed whether system improvements successful infection prevention, early recognition, and timely curen of maternal sepsis could prevention lives. Findings from nan proceedings show that moreover wrong a very resource-limited situation this innovative attack made it imaginable to support healthcare workers to amended maternal outcomes and tin beryllium sustained successful resource-limited wellness systems.
The study study revealed that nan APT-Sepsis involution not only reduced nan incidence of maternal infection-related mortality aliases terrible morbidity by 32%, but that nan programme was arsenic effective successful some Uganda and Malawi. The effectiveness was sustained complete time, expanding steadily from nan first period of nan involution to nan last month, erstwhile a 47% simplification was achieved.
The programme supported healthcare providers to:
- Improve compliance pinch hand-hygiene standards.
- Adopt evidence-based practices for infection prevention and management.
- Detect sepsis early and present curen utilizing nan FAST-M bundle (fluids, antibiotics, root control, transportation if required, and monitoring).
Professor David Lissauer, NIHR Professor of Global Maternal and Fetal Health astatine nan University of Liverpool, said: "These results are hugely significant. For excessively long, maternal sepsis has been a starring but neglected origin of preventable maternal deaths worldwide. Our findings show that APT-Sepsis provides a practical, sustainable, and effective solution. With a 32% simplification successful infection-related maternal deaths and life-threatening complications, this program has nan imaginable to toggle shape care. Policymakers now person compelling grounds to standard up these interventions truthful that less women dice from preventable infections during gestation and childbirth."
Jeremy Farrar, Assistant Director-General, WHO, said: "The APT-Sepsis programme is simply a testament to what tin beryllium achieved erstwhile science, argumentation and frontline attraction travel together. Reducing maternal infections and deaths by complete 30% is not conscionable a objective occurrence - it's a telephone to action for world wellness systems to prioritize infection prevention successful maternal care. We must guarantee these life-saving practices are scaled and sustained crossed each settings."
Fungaro Lydia, Midwife and APT Champion astatine Arua Regional Referral Hospital, Uganda said: "I want to convey APT-Sepsis for coming to our rescue. Previously, we had nary reliable measurement of monitoring mothers. We utilized to do things successful our ain way, but now, pinch nan intervention, we tin observe threat early."
Henry Mwandumba, Programme Director astatine nan Malawi Liverpool Wellcome Research Programme, MLW, said: "We are immensely proud that MLW contributed to a task that has delivered specified a important simplification successful maternal infections and deaths. This is simply a testament to our committedness to improving nan wellness and wellbeing of women successful Malawi and reflects nan dedication of our squad and partners, and look guardant to seeing really this involution pioneered successful Malawi tin beryllium scaled-up to thief mothers worldwide"
The proceedings demonstrates that structured, system-level interventions tin flooded long-standing barriers specified arsenic inconsistent adherence to infection-prevention practices and delays successful nan nickname and curen of sepsis.
By embedding improved practices wrong existing wellness systems - and without relying connected costly further resources - APT-Sepsis is designed to connection a low-cost, sustainable and quickly scalable exemplary for nationalist and world wellness programmes seeking to amended maternal endurance globally.
The proceedings was managed by nan Department of Women's and Childrens Health and nan Liverpool Clinical Trials Centre astatine nan University of Liverpool and nan Malawi-Liverpool-Wellcome
Research Programme, Malawi and Infectious Diseases Institute, Makereke University, Uganda.
This activity was funded by nan UK Medical Research Council (MRC) nan National Institute for Health and Care Research (NIHR), UK AID, nan UK Foreign, Commonwealth and Development Office and MSD for Mothers done nan Joint Global Health Trials Scheme.
The activity of Professor David Lissauer and Professor Catriona Waitt (University of Liverpool and nan Infectious Diseases Institute, Makerere University) is supported by NIHR Global Health Research Professorships.
Source:
Journal reference:
Lissauer, D., et al. (2025). A Multicomponent Intervention to Improve Maternal Infection Outcomes. New England Journal of Medicine. doi: 10.1056/nejmoa2512698. https://www.nejm.org/doi/full/10.1056/NEJMoa2512698
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