Usability testing of a reusable pulse oximeter probe developed for health-care workers caring for children < 5 years old in low-resource settings

Nicholas Boyd, Carina King, Isabeau A. Walker, Beatiwel Zadutsa, Mike Bernstein, Salahuddin Ahmed, Arunangshu Roy, Abu A.M. Hanif, Subal C. Saha, Kingshuk Majumder, Bejoy Nambiar, Tim Colbourn, Charles Makwenda, Abdullah H. Baqui, Iain Wilson, Eric D. McCollum

Research output: Contribution to journalArticlepeer-review

1 Scopus citations


Hypoxemia measured by pulse oximetry predicts child pneumonia mortality in low-resource settings (LRS). Existing pediatric oximeter probes are prohibitively expensive and/or difficult to use, limiting LRS implementation. Using a human-centered design, we developed a low-cost, reusable pediatric oximeter probe for LRS health-care workers (HCWs). Here, we report probe usability testing. Fifty-one HCWs from Malawi, Bangladesh, and the United Kingdom participated, and seven experts provided reference measurements. Health-care workers and experts measured the peripheral arterial oxyhemoglobin saturation (SpO2) independently in < 5 year olds. Health-care worker measurements were classed as successful if recorded in 5 minutes (or shorter) and physiologically appropriate for the child, using expert measurements as the reference. All expert measurements were considered successful if obtained in < 5 minutes. We analyzed the proportion of successful SpO2 measurements obtained in < 1, < 2, and < 5 minutes and used multivariable logistic regression to predict < 1 minute successful measurements. We conducted four testing rounds with probe modifications between rounds, and obtained 1,307 SpO2 readings. Overall, 67% (876) of measurements were successful and achieved in < 1 minute, 81% (1,059) < 2 minutes, and 90% (1,181) < 5 minutes. Compared with neonates, increasing age (infant adjusted odds ratio [aOR]; 1.87,95%confidence interval [CI]: 1.16, 3.02; toddler aOR: 4.33,95%CI: 2.36, 7.97; child aOR; 3.90, 95% CI: 1.73, 8.81) and being asleep versus being calm (aOR; 3.53, 95% CI: 1.89, 6.58), were associated with < 1 minute successful measurements. In conclusion, wedesigned a novel, reusable pediatric oximetry probe that was effectively used by LRS HCWs on children. This probe may be suitable for LRS implementation.

Original languageEnglish (US)
Pages (from-to)1096-1104
Number of pages9
JournalAmerican Journal of Tropical Medicine and Hygiene
Issue number4
StatePublished - 2018

ASJC Scopus subject areas

  • Parasitology
  • Virology
  • Infectious Diseases


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