PMID- 33274064
OWN - NLM
STAT- MEDLINE
DCOM- 20210803
LR  - 20220910
IS  - 2047-2986 (Electronic)
IS  - 2047-2978 (Print)
IS  - 2047-2978 (Linking)
VI  - 10
IP  - 2
DP  - 2020 Dec
TI  - The development and implementation of an oxygen treatment solution for health 
      facilities in low and middle-income countries.
PG  - 020425
LID - 10.7189/jogh.10.020425 [doi]
LID - 020425
AB  - BACKGROUND: Oxygen reduces mortality from severe pneumonia and is a vital part of 
      case management, but achieving reliable access to oxygen is challenging in low 
      and middle-income country (LMIC) settings. We developed and field tested two 
      oxygen supply solutions suitable for the realities of LMIC health facilities. 
      METHODS: A Health Needs Assessment identified a technology gap preventing 
      reliable oxygen supplies in Gambian hospitals. We used simultaneous engineering 
      to develop two solutions: a Mains-Power Storage (Mains-PS) system consisting of 
      an oxygen concentrator and batteries connected to mains power, and a Solar-Power 
      Storage (Solar-PS) system (with batteries charged by photovoltaic panels) and 
      evaluated them in health facilities in The Gambia and Fiji to assess reliability, 
      usability and costs. RESULTS: The Mains-PS system delivered the specified >/=85% 
      (+/-3%) oxygen concentration in 100% of 1-2 weekly measurements over 12 months, 
      which was available to 100% of hypoxaemic patients, and 100% of users rated 
      ease-of-use as at least 'good' (90% very good or excellent). The Solar-PS system 
      delivered >/=85% +/- 3%) oxygen concentration in 100% of 1-2 weekly measurements, was 
      available to 100% of patients needing oxygen, and 100% of users rated ease-of-use 
      at least very good.Costs for the systems (in US dollars) were: PS$9519, Solar-PS 
      standard version $20 718. The of oxygen for a standardised 30-bed health facility 
      using 1.7 million litres of oxygen per year was: for cylinders 3.2 cents (c)/L in 
      The Gambia and 6.8 c/L in Fiji, for the PS system 1.2 c/L in both countries, and 
      for the Solar-PS system 1.5 c/L in both countries. CONCLUSIONS: The oxygen 
      systems developed and tested delivered high-quality, reliable, cost-efficient 
      oxygen in LMIC contexts, and were easy to operate. Reliable oxygen supplies are 
      achievable in LMIC health facilities like those in The Gambia and Fiji.
CI  - Copyright (c) 2020 by the Journal of Global Health. All rights reserved.
FAU - Howie, Stephen Rc
AU  - Howie SR
AD  - Medical Research Council Unit The Gambia at London School of Hygiene & Tropical 
      Medicine, Fajara, The Gambia.
AD  - Department of Paediatrics: Child & Youth Health, University of Auckland, 
      Auckland, New Zealand.
FAU - Ebruke, Bernard E
AU  - Ebruke BE
AD  - Medical Research Council Unit The Gambia at London School of Hygiene & Tropical 
      Medicine, Fajara, The Gambia.
FAU - Gil, Mireia
AU  - Gil M
AD  - Azimut360 SCCL, Barcelona, Spain.
FAU - Bradley, Beverly
AU  - Bradley B
AD  - University of Toronto, Toronto, Canada.
FAU - Nyassi, Ebrima
AU  - Nyassi E
AD  - Medical Research Council Unit The Gambia at London School of Hygiene & Tropical 
      Medicine, Fajara, The Gambia.
FAU - Edmonds, Timothy
AU  - Edmonds T
AD  - Cure Kids New Zealand, Auckland, New Zealand.
AD  - Cure Kids Fiji, Suva, Fiji.
FAU - Boladuadua, Sainimere
AU  - Boladuadua S
AD  - Cure Kids Fiji, Suva, Fiji.
FAU - Rasili, Senimili
AU  - Rasili S
AD  - Ministry of Health and Medical Services, Suva, Fiji.
FAU - Rafai, Eric
AU  - Rafai E
AD  - Ministry of Health and Medical Services, Suva, Fiji.
FAU - Mackenzie, Grant
AU  - Mackenzie G
AD  - Medical Research Council Unit The Gambia at London School of Hygiene & Tropical 
      Medicine, Basse, The Gambia.
AD  - Murdoch Children's Research Institute, Melbourne, Australia.
AD  - London School of Hygiene & Tropical Medicine, London, UK.
FAU - Cheng, Yu Ling
AU  - Cheng YL
AD  - University of Toronto, Toronto, Canada.
FAU - Peel, David
AU  - Peel D
AD  - Ashdown Consultants, East Sussex, UK.
FAU - Vives-Tomas, Joan
AU  - Vives-Tomas J
AD  - Medical Research Council Unit The Gambia at London School of Hygiene & Tropical 
      Medicine, Fajara, The Gambia.
FAU - Zaman, Syed Ma
AU  - Zaman SM
AD  - Medical Research Council Unit The Gambia at London School of Hygiene & Tropical 
      Medicine, Fajara, The Gambia.
AD  - Liverpool School of Tropical Medicine, Liverpool, UK.
LA  - eng
PT  - Journal Article
PT  - Review
PL  - Scotland
TA  - J Glob Health
JT  - Journal of global health
JID - 101578780
RN  - S88TT14065 (Oxygen)
SB  - IM
MH  - *Developing Countries
MH  - Electric Power Supplies
MH  - Fiji
MH  - Gambia
MH  - Health Facilities
MH  - Humans
MH  - Oxygen/*supply & distribution/therapeutic use
MH  - Pneumonia/*therapy
MH  - Reproducibility of Results
MH  - Solar Energy
PMC - PMC7698571
COIS- Conflicts of interest: Stephen Howie and Eric Rafai have received funding from 
      the Medical Research Council and CureKids New Zealand. The authors completed the 
      ICMJE Unified Competing Interest form (available upon request from the 
      corresponding author), and declare no further conflicts of interest.
EDAT- 2020/12/05 06:00
MHDA- 2021/08/04 06:00
PMCR- 2020/08/23
CRDT- 2020/12/04 05:47
PHST- 2020/12/04 05:47 [entrez]
PHST- 2020/12/05 06:00 [pubmed]
PHST- 2021/08/04 06:00 [medline]
PHST- 2020/08/23 00:00 [pmc-release]
AID - jogh-10-020425 [pii]
AID - 10.7189/jogh.10.020425 [doi]
PST - ppublish
SO  - J Glob Health. 2020 Dec;10(2):020425. doi: 10.7189/jogh.10.020425.