Oxygen delivery systems for adults in Sub-Saharan Africa: A scoping review.
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 articlePermalink
https://hdl.handle.net/10161/23263Published Version (Please cite this version)
10.7189/jogh.11.04018Publication 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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Show full item recordScholars@Duke
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
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
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
Neelima Navuluri
Assistant Professor of Medicine
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
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
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