TY - JOUR
T1 - Oxygen delivery systems for adults in Sub-Saharan Africa
T2 - A scoping review
AU - Navuluri, Neelima
AU - Srour, Maria L.
AU - Kussin, Peter S.
AU - Murdoch, David M.
AU - MacIntyre, Neil R.
AU - Que, Loretta G.
AU - Thielman, Nathan M.
AU - McCollum, Eric D.
N1 - Funding Information:
We thank Megan Von Isenburg and Jordan Wrigley, certified university librarians at Duke University, for their help in constructing the search strings.
Funding Information:
Acknowledgements: We thank Megan Von Isenburg and Jordan Wrigley, certified university librarians at Duke University, for their help in constructing the search strings. Funding: None. Authorship contributions: NN conceptualized and with EM, designed this review. NN conducted the systematic search and literature review. NN and MS completed data extraction, analysis, synthesis, and manuscript drafting. All authors contributed to critical revision of the paper and approved the final manuscript. Competing interests: Dr Navuluri reports grants from CHEST Foundation outside the submitted work. Dr McCollum reports grants from Bill and Melinda Gates Foundation, Pfizer, Sonavi Laboratories, GlaxoSmithKline, and Save the Children (UK) outside the submitted work. Dr MacIntyre provides consultation for Inspirx Pharma, Hillrom, Ventec, and Vyaire outside the submitted work. The authors completed the ICMJE Unified Competing Interest form (available upon request from the corresponding author), and declare no further conflicts of interest.
Publisher Copyright:
© 2021 The Author(s) JoGH © 2021 ISGH
PY - 2021
Y1 - 2021
N2 - Background Respiratory diseases are the leading cause of death and disability world-wide. Oxygen is an essential medicine used to treat hypoxemia from respiratory diseases. However, the availability and utilization of oxygen delivery systems for adults in sub-Saharan Africa is not well-described. We aim to identify and describe existing data around oxygen availability and provision for adults in sub-Saharan Africa, determine knowledge or research gaps, and make recommendations for future research and capacity building. Methods We systematically searched four databases for articles on April 22, 2020, for variations of keywords related to oxygen with a focus on countries in sub-Saharan Africa. Inclusion criteria were studies that included adults and addressed hypoxemia assessment or outcome, oxygen delivery mechanisms, oxygen availability, oxygen provision infrastructure, and oxygen therapy and outcomes. Results: 35 studies representing 22 countries met inclusion criteria. Availability of oxygen delivery systems ranged from 42%-94% between facilities, with wide variability in the consistency of availability. There was also wide reported prevalence of hypoxemia, with most studies focusing on specific populations. In facilities where oxygen is available, health care workers are ill-equipped to identify adult patients with hypoxemia, provide oxygen to those who need it, and titrate or discontinue oxygen appropriately. Oxygen concentrators were shown to be the most cost-effective delivery system in areas where power is readily available. Conclusions There is a substantial need for building capacity for oxygen delivery throughout sub-Saharan Africa. Addressing this critical issue will require innovation and a multi-faceted approach of developing infrastructure, better equipping facilities, and health care worker training.
AB - Background Respiratory diseases are the leading cause of death and disability world-wide. Oxygen is an essential medicine used to treat hypoxemia from respiratory diseases. However, the availability and utilization of oxygen delivery systems for adults in sub-Saharan Africa is not well-described. We aim to identify and describe existing data around oxygen availability and provision for adults in sub-Saharan Africa, determine knowledge or research gaps, and make recommendations for future research and capacity building. Methods We systematically searched four databases for articles on April 22, 2020, for variations of keywords related to oxygen with a focus on countries in sub-Saharan Africa. Inclusion criteria were studies that included adults and addressed hypoxemia assessment or outcome, oxygen delivery mechanisms, oxygen availability, oxygen provision infrastructure, and oxygen therapy and outcomes. Results: 35 studies representing 22 countries met inclusion criteria. Availability of oxygen delivery systems ranged from 42%-94% between facilities, with wide variability in the consistency of availability. There was also wide reported prevalence of hypoxemia, with most studies focusing on specific populations. In facilities where oxygen is available, health care workers are ill-equipped to identify adult patients with hypoxemia, provide oxygen to those who need it, and titrate or discontinue oxygen appropriately. Oxygen concentrators were shown to be the most cost-effective delivery system in areas where power is readily available. Conclusions There is a substantial need for building capacity for oxygen delivery throughout sub-Saharan Africa. Addressing this critical issue will require innovation and a multi-faceted approach of developing infrastructure, better equipping facilities, and health care worker training.
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U2 - 10.7189/JOGH.11.04018
DO - 10.7189/JOGH.11.04018
M3 - Article
C2 - 34026051
AN - SCOPUS:85106708851
SN - 2047-2978
VL - 11
SP - 1
EP - 13
JO - Journal of Global Health
JF - Journal of Global Health
ER -