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dc.contributor.authorKawaza, Kondwani
Machen, Heather E.
Brown, Jocelyn
Mwanza, Zondiwe
Iniguez, Suzanne
Al, Gest
Smith, E. O'Brian
Oden, Maria
Richards-Kortum, Rebecca R.
Molyneux, Elizabeth
dc.date.accessioned 2014-02-14T21:19:55Z
dc.date.available 2014-02-14T21:19:55Z
dc.date.issued 2014
dc.identifier.citation Kawaza, Kondwani, Machen, Heather E., Brown, Jocelyn, et al.. "Efficacy of a Low-Cost Bubble CPAP System in Treatment of Respiratory Distress in a Neonatal Ward in Malawi." PLoS ONE, 9, no. 1 (2014) Public Library of Science: e86327. http://dx.doi.org/10.1371/journal.pone.0086327.
dc.identifier.urihttps://hdl.handle.net/1911/75472
dc.description.abstract Respiratory failure is a leading cause of neonatal mortality in the developing world. Bubble continuous positive airway pressure (bCPAP) is a safe, effective intervention for infants with respiratory distress and is widely used in developed countries. Because of its high cost, bCPAP is not widely utilized in low-resource settings. We evaluated the performance of a new bCPAP system to treat severe respiratory distress in a low resource setting, comparing it to nasal oxygen therapy, the current standard of care. We conducted a non-randomized convenience sample study to test the efficacy of a low-cost bCPAP system treating newborns with severe respiratory distress in the neonatal ward of Queen Elizabeth Central Hospital, in Blantyre,Malawi. Neonates weighing .1,000 g and presenting with severe respiratory distress who fulfilled inclusion criteria received nasal bCPAP if a device was available; if not, they received standard care. Clinical assessments were made during treatment and outcomes compared for the two groups. 87 neonates (62 bCPAP, 25 controls) were recruited. Survival rate for neonates receiving bCPAP was 71.0% (44/62)compared with 44.0% (11/25) for controls. 65.5% (19/29) of very low birth weight neonates receiving bCPAP survived to discharge compared to 15.4% (1/13) of controls. 64.6% (31/48) of neonates with respiratory distress syndrome (RDS)receiving bCPAP survived to discharge, compared to 23.5% (4/17) of controls. 61.5% (16/26) of neonates with sepsis receiving bCPAP survived to discharge, while none of the seven neonates with sepsis in the control group survived. Use of a low-cost bCPAP system to treat neonatal respiratory distress resulted in 27% absolute improvement in survival. The beneficial effect was greater for neonates with very low birth weight, RDS, or sepsis. Implementing appropriate bCPAP devices could reduce neonatal mortality in developing countries.
dc.language.iso eng
dc.publisher Public Library of Science
dc.rights This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
dc.rights.urihttps://creativecommons.org/licenses/by/4.0/
dc.title Efficacy of a Low-Cost Bubble CPAP System in Treatment of Respiratory Distress in a Neonatal Ward in Malawi
dc.type Journal article
dc.contributor.funder Saving Lives at Birth Partners
dc.contributor.funder African Network for Drugs and Diagnostics Innovation
dc.contributor.funder United States Agency for International Development
dc.citation.journalTitle PLoS ONE
dc.citation.volumeNumber 9
dc.citation.issueNumber 1
dc.type.dcmi Text
dc.identifier.doihttp://dx.doi.org/10.1371/journal.pone.0086327
dc.identifier.pmcid PMC3906032
dc.identifier.pmid 24489715
dc.identifier.grantID AID-OAA-A-13-00014 (United States Agency for International Development)
dc.type.publication publisher version
dc.citation.firstpage e86327


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This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Except where otherwise noted, this item's license is described as This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.