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The functioning of oxygen concentrators in resource-limited settings: a situation assessment in two countries
S F La Vincente1, D Peel, S Carai
1Centre for International Child Health, Department of Paediatrics, University of Melbourne, Murdoch Childrens Research Institute, Royal Children's Hospital, Melbourne, Victoria, Australia. sophie.lavincente@rch.org.au
Insights
Many oxygen concentrators remain functional for years in Malawi and Mongolia, showing sustained use is possible. However, performance varies, highlighting the need for quality equipment and maintenance resources.
Area of Science:
- Biomedical Engineering
- Global Health
- Pediatric Care
Background:
- Oxygen concentrators are vital for treating children in resource-limited settings.
- Long-term use of oxygen concentrators in Malawi and Mongolia has been established.
- Assessing the functionality of these devices is crucial for sustained oxygen therapy.
Purpose of the Study:
- To evaluate the functioning of oxygen concentrators in pediatric wards in Malawi and Mongolia.
- To understand the long-term performance and reliability of oxygen concentrators in resource-limited environments.
Main Methods:
- Systematic assessment of oxygen concentrators in 15 hospitals in Malawi and nine in Mongolia.
- Evaluation of concentrator functionality after a median of 48 months in Malawi and 36 months in Mongolia.
- Analysis of concentrator performance across different brands and usage hours.
Main Results:
- Three-quarters of concentrators in Malawi (28/36) and half in Mongolia (13/25) were functional.
- Concentrators can remain functional up to 30,000 hours, but some failed prematurely.
- Significant variation in performance between brands and inadequate maintenance resources were observed.
Conclusions:
- Widespread use of oxygen concentrators can be sustained in resource-limited settings.
- Substantial variation in concentrator performance necessitates careful equipment procurement.
- Adequate resources for maintenance are critical for ensuring long-term functionality of oxygen concentrators.
Setting:
The paediatric wards of hospitals in Malawi and Mongolia.
Objective:
To describe oxygen concentrator functioning in two countries with widespread, long-term use of concentrators as a primary source of oxygen for treating children.
Design:
A systematic assessment of concentrators in the paediatric wards of 15 hospitals in Malawi and nine hospitals in Mongolia.
Results:
Oxygen concentrators had been installed for a median of 48 months (interquartile range [IQR] 6-60) and 36 months (IQR 12-96), respectively, prior to the evaluation in Malawi and Mongolia. Concentrators were the primary source of oxygen. Three quarters of the concentrators assessed in Malawi (28/36) and half those assessed in Mongolia (13/25) were functional. Concentrators were found to remain functional with up to 30 000 h of use. However, several concentrators were functioning very poorly despite limited use. Concentrators from a number of different manufacturers were evaluated, and there was marked variation in performance between brands. Inadequate resources for maintenance were reported in both countries.
Conclusion:
Years after installation of oxygen concentrators, many machines were still functioning, indicating that widespread use can be sustained in resource-limited settings. However, concentrator performance varied substantially. Procurement of high-quality and appropriate equipment is critical, and resources should be made available for ongoing maintenance.
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