Reply: Critical Care in Sub-Saharan Africa: Is It Readyfor Prime Time?

Abstract

We appreciate the opportunity to respond to Drs. Touray and Sanyang’s thoughtful comments on our analysis of intensive care unit(ICU) outcomes at a national referral hospital in Western Kenya (1). We agree that the high mortality reported across studies examining critical care in low- and middle-income countries highlights a major dilemma facing health care policymakers in these settings. Due to rapid advances in medical care and technology, the steadily increasing prevalence of noncommunicable diseases and rising public expectation for broader availability of critical care services, a strong impetus exists for building critical care capacity in sub-Saharan Africa. However,the resources, infrastructure,and policies necessary to provide comprehensive critical care are not consistently available even at a large national referral hospital, such as our institution.