Effect of Treatment of Premature Infants with Respiratory Distress Using Low-cost Bubble CPAP in a Rural African Hospital
Abstract
BACKGROUND: Kenya's neonatal mortality rate remains unacceptably high, at 22 deaths per 1000 live births, with a third of those attributable to prematurity. Respiratory distress syndrome (RDS) is the single most important cause of morbidity and mortality in the premature neonate. Continuous positive airway pressure (CPAP) is a proven modality of therapy but is rarely used in low-resource settings. We report on the introduction of bubble CPAP (BCPAP), a low-cost method of delivering CPAP appropriate to our setting, by comparing survival-to-discharge before and after the technology was introduced. METHODS: The inpatient hospital records of all preterm infants (<37 weeks) diagnosed with RDS in the AIC Kijabe Hospital Nursery during two 18-month periods before and after the introduction of BCPAP (46 infants enrolled from 1 November 2007 to 30 April 2009 vs. 72 infants enrolled from 1 November 2009 to 30 April 2011) were reviewed. Differences in survival-to-discharge rates between the two time periods were analyzed. RESULTS: The survival-to-discharge rate was higher in Period 2 (after the introduction of BCPAP) than in Period 1 (pre-BCPAP) (85% vs. 61%, p = 0.007). Similarly, there were lower referral rates of preterm infants with RDS in Period 2 than Period 1 (4% vs. 17%, p = 0.037). CONCLUSION: BCPAP has contributed significantly to favorable outcomes for preterm infants with RDS at AIC Kijabe Hospital. The use of this simple technology should be considered and studied for expansion to all hospitals in Kenya that care for preterm infants.
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Previous work in sub-Saharan Africa largely examined barriers and enablers as issues that emerged from efficacy and safety studies.
“Previous work in sub-Saharan Africa largely examined barriers and enablers as issues that emerged from efficacy and safety studies [5,13,21,22].”
From Barriers and enablers of implementing bubble Continuous Positive Airway Pressure (CPAP): Perspectives of health professionals in Malawi (2020) · cites this paper as [21]
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Nyondo-Mipando, A. L., Woo Kinshella, M.-L., Bohne, C., Suwedi-Kapesa, L. C., Salimu, S., Banda, M., Newberry, L., Njirammadzi, J., Hiwa, T., Chiwaya, B., et al. (2020) · PLOS ONE · doi:10.1371/journal.pone.0228915 · Cited by 54 · see citing works
- Authors
- Myhre, J., Immaculate, M., Okeyo, B., Anand, M., Omoding, A., Myhre, L., Okeyo, L., Barasa, I., & Letchford, S.
- Affiliations
- Kijabe Hospital (KE)
- ORCID
- Okeyo, Bob
- Venue
- Journal of Tropical Pediatrics
- Publisher
- Oxford University Press (OUP)
- Published
- 2016-04-25
- Volume
- 62
- Issue
- 5
- Pages
- 385-389
- ISSN
- 0142-6338 (ISSN-L)
- 1465-3664
- OpenAlex
- W2343205110
- Cited by
- 38
- References
- 9
- Citations by year
- 2026: 1 · 2025: 5 · 2024: 2 · 2023: 1 · 2022: 5 · 2021: 4 · 2020: 13 · 2019: 5 · 2018: 2
- FWCI
- 2.09
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of Tropical Pediatrics (publishedVersion)
- PubMed (publishedVersion)
- HighWire Press Open Archive (submittedVersion)
- Topics
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Neonatal Respiratory Health Research
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Infant Development and Preterm Care
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Respiratory Support and Mechanisms
- Keywords
- bubble CPAP, continuous positive airway pressure, respiratory distress syndrome, preterm infants, neonatal survival, resource-limited settings, neonatal mortality, rural hospitals
- MeSH terms
- Female, Hospitals, Rural, Humans, Infant, Infant, Newborn, Infant, Premature, Intensive Care Units, Neonatal, Kenya, Male, Oxygen Inhalation Therapy, Respiratory Distress Syndrome, Newborn, Retrospective Studies, Rural Population, Survival Rate, Survival Analysis, Treatment Outcome, Infant, Very Low Birth Weight, Continuous Positive Airway Pressure
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