Peer mentorship in the scale‐up of neonatal continuous positive airway pressure in Malawi

Baiden, Frank

doi:10.1111/apa.15127

Cited by 1 publication

(4 citation statements)

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“…5,6 CPAP has been used in high-income countries for over four decades to manage respiratory distress in neonates and primary pulmonary disease in older infants. 3,7,8 Bubble CPAP (bCPAP) is a simplified variation of CPAP where expiratory resistance is delivered via a tube whose distal opening is put underwater. Customised bCPAP devices that run entirely on humidified air/oxygen flow are used in low-and middle-income countries (LMIC).…”

Section: Introductionmentioning

confidence: 99%

“… 5 , 6 CPAP has been used in high-income countries for over four decades to manage respiratory distress in neonates and primary pulmonary disease in older infants. 3 , 7 , 8 …”

Section: Introductionmentioning

confidence: 99%

“…The use of CPAP in managing acute respiratory distress in neonates and older children in high-income countries has been reported for many years. 3 , 7 , 8 Although relatively recent, the extension of such use in neonates in LMICs is currently increasing. However, its use in older children in LMICs is less widely accepted and is mainly limited to clinical trials.…”

Section: Introductionmentioning

confidence: 99%

“…These challenges are amenable to improvement, as demonstrated in the trials in Ghana and other studies in Malawi. 7 , 15 , 16 It is also relevant to point out that Malawi has the most advanced rollout of neonatal CPAP in sub-Saharan Africa, outside of South Africa. Neonatal CPAP has been introduced into all district hospitals.…”

Section: Introductionmentioning

confidence: 99%

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Continuous positive airway pressure in managing acute respiratory distress in children in district hospitals: evidence for scale-up

Baiden

Wilson

2021

gmj

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In children, acute respiratory distress (ARD) is a clinical presentation requiring emergency management, including mechanical ventilation. Mechanical ventilators are lacking in sub-Saharan Africa. Continuous Positive Airway Pressure (CPAP) is an alternative form of non-invasive respiratory support that has been used in high-income countries for over four decades. Its use in sub-Saharan Africa is, however, limited and often restricted to neonates. Controlled trials in Ghana have shown that the use of CPAP in children younger aged 1-12 months reduces 2-week all-cause mortality from ARD by 60% (RR 0·40, 0·19–0·82; p=0·01). The absolute reduction in mortality of 4% implies one infant life saved for every 25 children treated with CPAP. This paper reviews the findings of the trials in Ghana andcontrasts the findings with those of trials in Bangladesh and Malawi. It makes the case that implementation research (rather than more controlled trials) is now needed to support the routine, safe and effective use of CPAP in managing ARD in older infants in district hospitals in Ghana.

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Section: Introductionmentioning

confidence: 99%

“… 5 , 6 CPAP has been used in high-income countries for over four decades to manage respiratory distress in neonates and primary pulmonary disease in older infants. 3 , 7 , 8 …”

Section: Introductionmentioning

confidence: 99%