Project Lead(s): Michael Hawkes
Respiratory tract infections are the leading killer of children under age five, with 98% of these deaths occurring in developing countries.
Bacterial pneumonia, tuberculosis, sepsis and severe malaria are common infectious etiologies; all lead to respiratory distress.
Oxygen therapy is essential but is often unavailable in remote, low-resource settings.
The objective of the project was to evaluate the use of solar energy to concentrate oxygen from ambient air and oxygenate children with hypoxemia in a resource-limited setting (without electricity) in Uganda.
A pilot study was done in 28 critically ill patients.
The median age was six months and 45% were female. At presentation, all were hypoxemic (SaO2<90%), 74% were tachypneic and 33% had a temperature >37.5°C. Diagnoses included pneumonia (79%), malaria (21%) and sepsis (14%).
The daily energy generated by the device was a median 7.5kWh. Power consumption by the oxygen concentrator was 300W and did not vary according to the flow rate of oxygen generated. The oxygen content was 88–92%.
In the pilot study using solar-powered oxygen, peripheral saturation was increased to >95% in 25 patients (89%); for the remaining three patients, oxygenation improved to >90%, but the patients died before recovery of lung function.
Duration of hospitalization was a median three days (range of 1–28 days).
Outcomes were as follows: 19 patients discharged without disability, one discharged with cerebral palsy, two transferred to another facility, and six died.
The project team has completed a randomized controlled trial (RCT) comparing solar-powered oxygen delivery to standard delivery, using oxygen cylinders across sentinel sites in Uganda. The RCT demonstrated non-inferiority of solar-powered oxygen delivery, compared to the conventional method of oxygen delivery using cylinders.
Results of the pilot study were disseminated in conference presentations and published in The International Journal of Tuberculosis and Lung Disease. The RCT trial protocol has been published in Trials, and a manuscript was under preparation.