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Oxygen delivery systems for adults in Sub-Saharan Africa: A scoping review.

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Date
2021-05-08
Authors
Navuluri, Neelima
Srour, Maria L
Kussin, Peter S
Murdoch, David M
MacIntyre, Neil R
Que, Loretta G
Thielman, Nathan M
McCollum, Eric D
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(8 total)
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Abstract
<h4>Background</h4>Respiratory diseases are the leading cause of death and disability worldwide. 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.<h4>Methods</h4>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.<h4>Results</h4>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.<h4>Conclusions</h4>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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Journal article
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https://hdl.handle.net/10161/23263
Published Version (Please cite this version)
10.7189/jogh.11.04018
Publication Info
Navuluri, Neelima; Srour, Maria L; Kussin, Peter S; Murdoch, David M; MacIntyre, Neil R; Que, Loretta G; ... McCollum, Eric D (2021). Oxygen delivery systems for adults in Sub-Saharan Africa: A scoping review. Journal of global health, 11. pp. 04018. 10.7189/jogh.11.04018. Retrieved from https://hdl.handle.net/10161/23263.
This is constructed from limited available data and may be imprecise. To cite this article, please review & use the official citation provided by the journal.
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Scholars@Duke

Kussin

Peter Samuel Kussin

Professor of Medicine
The majority of my effort is devoted to clinical care of patients with advanced lung disease and teaching. I spend four months a year in Eldoret Kenya working at Moi Teaching and Referral Hospital as part of The Duke Hubert Yeargan Institute for Global Health and AMPATH- a consortium of North American Medical Schools collaborating with Moi University School of Medicine and Moi Teaching and Referral Hospital. I work primarily in the intensive care unit and medicine wards. I am involv
MacIntyre

Neil Ross MacIntyre Jr.

Professor of Medicine
1) Mechanical Ventilation and respiratory failure. Current projects involve studying patient-ventilator interactions during modes of support that require patient activity. The focus is on ventilatory muscle function during these assisted modes. Other projects include evaluating respiratory system mechanics in acute respiratory failure and the role of ECMO in the adult. Duke is also one of several institutions in the NIH ARDS Network, a consortium designed to perform multi-center trials
Murdoch

David Martin Murdoch

Associate Professor of Medicine
As a physician and researcher, my career has been driven by a passion for linking the basic and clinical sciences with the primary goal of understanding the disease pathogenesis. Through my training in epidemiology, basic science immunology, and clinical medicine, I have acquired a breadth of experience, knowledge, collaborators, and an adaptability which has culminated in a research focus on the reconstitution of immune responses and systemic inflammation in immunocompromised patients and vulne
Navuluri

Neelima Navuluri

Assistant Professor of Medicine
Que

Loretta Georgina Que

Professor of Medicine
My research interests focus on studying the role of nitric oxide and related enzymes in the pathogenesis of lung disease, specifically that caused by nitrosative/oxidative stress. Proposed studies are performed in cell culture and applied to animal models of disease, then examined in human disease where relevant. It is our hope that by better understanding the role of NO and reactive nitrogen species in mediating inflammation, and regulating cell signaling, that we will not only help to unr
Thielman

Nathan Maclyn Thielman

Professor of Medicine
Broadly, my research focuses on a range of clinical and social issues that affect persons living with or at risk for HIV infection in resource-poor settings. In Tanzania, our group is applying novel methods to optimize HIV testing uptake among high-risk groups. We recently demonstrated that the Discrete Choice Experiment (DCE), a form of stated preference survey research, is a robust tool for identifying (a) which characteristics of HIV testing options are most preferred by different populati
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