Identification of transcriptomic sepsis endotypes in sub-Saharan Africa: derivation, validation, and global alignment in two Ugandan cohorts
Main finding · Mortality by endotype (discovery cohort)Result — go to the resultAbsolute difference 19.3% 95% CI 7.6–30.9%Authors' conclusion
We identified two transcriptomic sepsis endotypes in Uganda that reflect inter-individual differences in targetable pathobiology and confer prognostic enrichment across high-burden infections.
Study context
- Population
- Critically ill adults with sepsis in Uganda (discovery cohort Tororo, rural, N = 243; validation cohort Entebbe, urban, N = 112)discovery N = 243
- Exposure
- USE-2 vs USE-1 transcriptomic sepsis endotypes
- Outcome
- Mortality by endotype (discovery cohort)
Methodological detailstwo cohorts (discovery and validation), unsupervised clustering of whole-blood RNAseq, random forest classifier
- Two cohorts (discovery and validation)
- Unsupervised clustering of whole-blood RNAseq
- Random forest classifier
Main finding
As reported in the abstract
Absolute difference
19.3%
95% CI 7.6–30.9%
By group
USE-2 vs USE-1
absolute difference 19.3% (95% CI 7.6–30.9%)
Observational data: associations, not effects.
Further findings
Validation cohort replication (13-gene classifier)
- Classifier misclassification rate
- 1.43%
- Two endotypes replicated with similar biological and clinical profiles
Alignment with HIC-derived endotypes
- USE-2 strong transcriptional overlap with SRS1 and inflammopathic endotypes but only modest concordance in patient-level assignments
- Overlap with Mars1 variable
Original publication
Identification of transcriptomic sepsis endotypes in sub-Saharan Africa: derivation, validation, and global alignment in two Ugandan cohorts. Intensive Care Med. Published 29 July 2025. doi:10.
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