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. 2021 May 8:11:04018.
doi: 10.7189/jogh.11.04018.

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

Neelima Navuluri  1   2 , Maria L Srour  3 , Peter S Kussin  1   2 , David M Murdoch  1 , Neil R MacIntyre  1 , Loretta G Que  1 , Nathan M Thielman  2   4 , Eric D McCollum  5
Affiliations

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

Neelima Navuluri et al. J Glob Health. .

Abstract

Background: 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.

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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Conflict of interest statement

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.

Figures

Figure 1
Figure 1
PRISMA flowchart detailing study selection. *Did not describe current state of oxygen availability, provision and/or oxygen delivery mechanisms or were studies based entirely outside of SSA.
Figure 2
Figure 2
Countries represented in available studies. *First number indicates number studies in total, including studies which included multiple sites. Number in parenthesis indicates number of single-site studies.
See this image and copyright information in PMC

References

    1. Societies FoIR. The Global Impact of Respiratory Disease – Second Edition. Sheffield, European Respiratory Society; 2017.
    1. Heffner JE.The Story of Oxygen. Respir Care. 2013;58:18-31. 10.4187/respcare.01831 - DOI - PubMed
    1. Nocturnal Oxygen Therapy Trial Group Continuous or nocturnal oxygen therapy in hypoxemic chronic obstructive lung disease: a clinical trial. Ann Intern Med. 1980;93:391-8. 10.7326/0003-4819-93-3-391 - DOI - PubMed
    1. Report of the Medical Research Council Working Party Long term domiciliary oxygen therapy in chronic hypoxic cor pulmonale complicating chronic bronchitis and emphysema. Lancet. 1981;1:681-6. - PubMed
    1. World Health Organization. WHO Model List of Essential Medicines. 2017. Available: https://apps.who.int/iris/bitstream/handle/10665/273826/EML-20-eng.pdf?ua=1. Accessed: 28 October 2019.

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