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

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


JournalJournal of Global Health
Article typeJournal research article – Clinical research
Publication date – May – 2021
Authors – Neelima Navuluri, Maria L Srour, Peter S Kussin, David M Murdoch, Neil R MacIntyre, Loretta G Que, Nathan M Thielman, Eric D McCollum
KeywordsOxygen, Respiratory diseases, Sub-Saharan Africa
Open access – Yes
SpecialityCritical care, Health policy, Other
World region Central Africa, Eastern Africa, Southern Africa, Western Africa

Language – English
Submitted to the One Surgery Index on May 28, 2021 at 6:43 am
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

OSI Number – 21108

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