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Reducing preterm mortality in eastern Uganda: the impact of introducing low-cost bubble CPAP on neonates <1500 g

F Okello1,2, E Egiru3, J Ikiror4

  • 1Mbale Campus, Busitema University, P.O.Box 1460, Mbale, Uganda.

BMC Pediatrics
|September 6, 2019
PubMed

Insights

Low-cost bubble continuous positive airway pressure (bCPAP) significantly reduced mortality in very-low-birth-weight neonates with respiratory distress syndrome in Uganda. This affordable intervention shows promise for improving survival rates in low-income countries.

Area of Science:

  • Neonatal Medicine
  • Public Health
  • Medical Devices

Background:

  • Complications of prematurity, particularly respiratory distress syndrome (RDS), are a leading cause of under-five mortality.
  • Limited treatment options for RDS exist in low-income countries (LICs).
  • Low-cost bubble continuous positive airway pressure (bCPAP) devices offer a simple, affordable solution for RDS in neonatal units.

Purpose of the Study:

  • To evaluate the impact of introducing bCPAP on the outcomes of very-low-birth-weight (VLBW) neonates in a LIC.
  • To compare mortality rates in VLBW neonates before and after the implementation of bCPAP therapy.
  • To assess the effectiveness of an affordable intervention in a resource-limited setting.

Main Methods:

  • Retrospective study of VLBW neonates (<1500g) at Mbale Regional Referral Hospital Neonatal Unit in Uganda.
  • Comparison of outcomes between a pre-bCPAP period (14 months) and a post-bCPAP period (18 months).
  • bCPAP was applied to preterm neonates with RDS when clinically indicated and devices were available.

Main Results:

  • Mortality rate decreased from 39.2% in the pre-bCPAP period to 26.5% in the post-bCPAP period (P=0.012).
  • Overall mortality reduction of 44% was observed (OR 0.56, 95% CI 0.36-0.86, P=0.01).
  • No significant differences were found in birthweight, sex, or presence of respiratory distress/apnea between the groups.

Conclusions:

  • Resource-appropriate neonatal care, like bCPAP, can significantly reduce neonatal deaths in LICs.
  • The introduction of low-cost bCPAP led to a significant improvement in VLBW neonate survival.
  • This affordable intervention holds potential for substantial impact on global neonatal mortality rates.
Abstract

Keywords:
AfricaBubble CPAPLow-income countryNeonatePretermRespiratory distress syndrome

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