NOVEL OXYGEN SOLUTIONS TO PREVENT CHILD PNEUMONIA DEATHS
Lead Research Organisation:
MRC Unit the Gambia
Abstract
Deaths from pneumonia, the leading cause of child deaths worldwide, can be reduced with oxygen, but lack of reliable supplies in developing countries stops most from receiving it. This project aims to improve access to oxygen using novel sustainable solutions.
The objective of this project is to develop an oxygen (O2) delivery system for use in resource-limited settings that will operate reliably and cost-effectively with little or no maintenance and limited or absent mains power. No such solution currently exists. We propose to develop and field test such an oxygen system and to produce a specification that is suitable for production. With such a product lifesaving treatment could reach those for whom it is currently beyond reach, and do so at a much lower cost than traditional oxygen cylinders.
The objective of this project is to develop an oxygen (O2) delivery system for use in resource-limited settings that will operate reliably and cost-effectively with little or no maintenance and limited or absent mains power. No such solution currently exists. We propose to develop and field test such an oxygen system and to produce a specification that is suitable for production. With such a product lifesaving treatment could reach those for whom it is currently beyond reach, and do so at a much lower cost than traditional oxygen cylinders.
Technical Summary
Deaths from pneumonia, the leading killer of children globally, can be prevented with oxygen, but lack of reliable supplies in developing countries stops them getting it. This project aims to improve access to oxygen using novel sustainable solutions.
The objective is to develop an oxygen (O2) delivery system for use in resource-limited settings that will operate 24/7 with little or no maintenance and limited or absent mains power - no such solution currently exists. We propose to develop and field test a 24/7 oxygen system incorporating oxygen concentrator technology and power storage, and independently power it using solar power for contexts where no power is available. With such a product lifesaving treatment could reach those for whom it is currently beyond reach, and do so at a much lower cost than traditional oxygen cylinders.
The objective is to develop an oxygen (O2) delivery system for use in resource-limited settings that will operate 24/7 with little or no maintenance and limited or absent mains power - no such solution currently exists. We propose to develop and field test a 24/7 oxygen system incorporating oxygen concentrator technology and power storage, and independently power it using solar power for contexts where no power is available. With such a product lifesaving treatment could reach those for whom it is currently beyond reach, and do so at a much lower cost than traditional oxygen cylinders.
Planned Impact
1. Who will benefit?
Children, families and communities in developing countries, their governments, child health advocates and policy-makers, private industry, and academics.
2. How will they benefit?
Children, families and communities
The most important potential impact of this research is on child mortality. Almost two million children die every year from pneumonia, which is more than from malaria, HIV/AIDs and tuberculosis combined. Improving access to oxygen has been shown to reduce mortality from childhood pneumonia by one-third. Up to half a million children annually could be saved if they received oxygen (one-third of the 1.5-2 million pneumonia deaths), and oxygen provision is potentially very cost-effective compared to other child health interventions. Deaths could also be prevented from a wide range of hypoxaemic illnesses in childhood (such as birth asphyxia, malaria and sepsis).
This research can potentially impact maternal and other adult mortality also as the product would make oxygen available for any hypoxaemic illness in children or adults.
The timeframe for potential impact on mortality is comparatively short. The project will determine the specification of the end-product in 30 months, paving the way to early commercialisation and uptake.
Governments and society
The positive impact on mortality will enhance standards of living and social cohesion. This lowered mortality is potentially accompanied by a significant cost saving for public health services, as the product is designed to produce oxygen much more cheaply than conventional cylinder oxygen. This cost-saving would potentially free up resources to strengthen other areas of resource-constrained health services.
Child Health advocates and policy-makers
The research will benefit child health advocates and policy-makers who will be able to press for oxygen treatment to move up the child health policy agenda because it will move out of the 'too-hard basket' into the category of a realistically soluble problem. Such groups as the Oxygen working group of the IUATLD, and Child and Adolescent Health at WHO are examples of advocates who will benefit.
Private Industry
A product such as the one that will be developed in this project will potentially provide direct and indirect economic benefits through its commercialistion. There is strong interest within the UK in commercialising the product that results from this project.
Academics
The academic collaboration and outputs resulting from this study are notable and are detailed in the 'Academic Beneficiaries section'
Children, families and communities in developing countries, their governments, child health advocates and policy-makers, private industry, and academics.
2. How will they benefit?
Children, families and communities
The most important potential impact of this research is on child mortality. Almost two million children die every year from pneumonia, which is more than from malaria, HIV/AIDs and tuberculosis combined. Improving access to oxygen has been shown to reduce mortality from childhood pneumonia by one-third. Up to half a million children annually could be saved if they received oxygen (one-third of the 1.5-2 million pneumonia deaths), and oxygen provision is potentially very cost-effective compared to other child health interventions. Deaths could also be prevented from a wide range of hypoxaemic illnesses in childhood (such as birth asphyxia, malaria and sepsis).
This research can potentially impact maternal and other adult mortality also as the product would make oxygen available for any hypoxaemic illness in children or adults.
The timeframe for potential impact on mortality is comparatively short. The project will determine the specification of the end-product in 30 months, paving the way to early commercialisation and uptake.
Governments and society
The positive impact on mortality will enhance standards of living and social cohesion. This lowered mortality is potentially accompanied by a significant cost saving for public health services, as the product is designed to produce oxygen much more cheaply than conventional cylinder oxygen. This cost-saving would potentially free up resources to strengthen other areas of resource-constrained health services.
Child Health advocates and policy-makers
The research will benefit child health advocates and policy-makers who will be able to press for oxygen treatment to move up the child health policy agenda because it will move out of the 'too-hard basket' into the category of a realistically soluble problem. Such groups as the Oxygen working group of the IUATLD, and Child and Adolescent Health at WHO are examples of advocates who will benefit.
Private Industry
A product such as the one that will be developed in this project will potentially provide direct and indirect economic benefits through its commercialistion. There is strong interest within the UK in commercialising the product that results from this project.
Academics
The academic collaboration and outputs resulting from this study are notable and are detailed in the 'Academic Beneficiaries section'
Organisations
People |
ORCID iD |
Description | MANAGEMENT OF SEVERE PNEUMONIA - IUATLD OXYGEN WORKING GROUP |
Geographic Reach | Multiple continents/international |
Policy Influence Type | Participation in a guidance/advisory committee |
Impact | Experience in The Gambia is helping to shape policy so it is more applicable to resource-poor settings. The 2013 meeting of the Oxygen Working Group is intended to produce a published research and policy paper as it has done previously. |
Guideline Title | THE CLINICAL USE OF OXYGEN GUIDELINES |
Description | MANAGEMENT OF SEVERE PNEUMONIA - OXYGEN |
Geographic Reach | Multiple continents/international |
Policy Influence Type | Citation in clinical guidelines |
Impact | Work from the MRC Gambia has shown that most health facilities in The Gambia have unreliable power and limited maintenance capacity. Management of severe pneumonia with oxygen is life-saving, and this guideline is the primary means of guiding developing world health systems in its use. |
Title | Oxygen Options (OxOp) software tool |
Description | This tool helps policy makers and health facility administrators to determine what the best method of oxygen supply for any facility will be and to compare likely costs of the available options in detail |
Type Of Material | Improvements to research infrastructure |
Year Produced | 2009 |
Provided To Others? | Yes |
Impact | This tool is currently being incorporated into the IUATLD Oxygen website. Since its recent promotion in a peer-reviewed publication that used the tool to model options and costs for oxygen treatment in The Gambia (PMID: 19876543 ) the tool has been provided to researchers in Kiribati who are using it for health systems research there |
URL | http://europepmc.org/abstract/MED/19876543 |
Description | Management of severe childhood pneumonia including oxygen therapy |
Organisation | Ashdown Consultants |
Country | United Kingdom |
Sector | Private |
PI Contribution | We have been doing operational field work in oxygen therapy that has identified key barriers to successful use of oxygen in developing countries and that has been addressing those. This work is making an important contribution to local and international policy and practice. |
Collaborator Contribution | This group provides a focus for consensus-building for childhood pneumonia and provides a link to policy development. SH is a member of the Oxygen Working Group of IUATLD CLH and was funded to attend the 2009, 2010, 2011 and 2013 meeting of this group at the IUATLD World Conference and to present our work on oxygen treatment. Ashdown Consultants' Dr David Peel is an engineer and world expert in oxygen for developing countries and has contributed expertise and practical assistance to the oxygen aspects of our work, including by contributing to proposals and publications.The Ministry of Health provide vital local partnership and expertise in the projects. WHO CAH has been supportive of our work in this area, contributing to proposals and publications and providing a link to policy development. Azimut 360 SCCL developed a solar-powered prototype which was field tested at 2 government health facilities in The Gambia and one unit was field tested in Fiji which supplied power to deliver high quality (at least 82%) oxygen 24/7 independent of mains power and oxygen was available for hypoxaemic children for 99% of the time. |
Impact | Publications: 20937173; 20522295; 19876543; 19383191; 18235890; 20937173. This collaboration has resulted in involvement in the IUATLD Oxygen Working group and a contribution to the development of WHO Oxygen therapy handbook Other important non-peer reviewed publications resulting from this collaboration: Oxygen Concentrators for Use in Tropical Countries: A Survey. David Peel, Stephen RC Howie. Journal of Clinical Engineering; October 2009: 205-09 |
Description | Management of severe childhood pneumonia including oxygen therapy |
Organisation | Azimut 360 |
Country | Spain |
Sector | Private |
PI Contribution | We have been doing operational field work in oxygen therapy that has identified key barriers to successful use of oxygen in developing countries and that has been addressing those. This work is making an important contribution to local and international policy and practice. |
Collaborator Contribution | This group provides a focus for consensus-building for childhood pneumonia and provides a link to policy development. SH is a member of the Oxygen Working Group of IUATLD CLH and was funded to attend the 2009, 2010, 2011 and 2013 meeting of this group at the IUATLD World Conference and to present our work on oxygen treatment. Ashdown Consultants' Dr David Peel is an engineer and world expert in oxygen for developing countries and has contributed expertise and practical assistance to the oxygen aspects of our work, including by contributing to proposals and publications.The Ministry of Health provide vital local partnership and expertise in the projects. WHO CAH has been supportive of our work in this area, contributing to proposals and publications and providing a link to policy development. Azimut 360 SCCL developed a solar-powered prototype which was field tested at 2 government health facilities in The Gambia and one unit was field tested in Fiji which supplied power to deliver high quality (at least 82%) oxygen 24/7 independent of mains power and oxygen was available for hypoxaemic children for 99% of the time. |
Impact | Publications: 20937173; 20522295; 19876543; 19383191; 18235890; 20937173. This collaboration has resulted in involvement in the IUATLD Oxygen Working group and a contribution to the development of WHO Oxygen therapy handbook Other important non-peer reviewed publications resulting from this collaboration: Oxygen Concentrators for Use in Tropical Countries: A Survey. David Peel, Stephen RC Howie. Journal of Clinical Engineering; October 2009: 205-09 |
Description | Management of severe childhood pneumonia including oxygen therapy |
Organisation | Government of The Gambia |
Department | Ministry of Health Gambia |
Country | Gambia |
Sector | Public |
PI Contribution | We have been doing operational field work in oxygen therapy that has identified key barriers to successful use of oxygen in developing countries and that has been addressing those. This work is making an important contribution to local and international policy and practice. |
Collaborator Contribution | This group provides a focus for consensus-building for childhood pneumonia and provides a link to policy development. SH is a member of the Oxygen Working Group of IUATLD CLH and was funded to attend the 2009, 2010, 2011 and 2013 meeting of this group at the IUATLD World Conference and to present our work on oxygen treatment. Ashdown Consultants' Dr David Peel is an engineer and world expert in oxygen for developing countries and has contributed expertise and practical assistance to the oxygen aspects of our work, including by contributing to proposals and publications.The Ministry of Health provide vital local partnership and expertise in the projects. WHO CAH has been supportive of our work in this area, contributing to proposals and publications and providing a link to policy development. Azimut 360 SCCL developed a solar-powered prototype which was field tested at 2 government health facilities in The Gambia and one unit was field tested in Fiji which supplied power to deliver high quality (at least 82%) oxygen 24/7 independent of mains power and oxygen was available for hypoxaemic children for 99% of the time. |
Impact | Publications: 20937173; 20522295; 19876543; 19383191; 18235890; 20937173. This collaboration has resulted in involvement in the IUATLD Oxygen Working group and a contribution to the development of WHO Oxygen therapy handbook Other important non-peer reviewed publications resulting from this collaboration: Oxygen Concentrators for Use in Tropical Countries: A Survey. David Peel, Stephen RC Howie. Journal of Clinical Engineering; October 2009: 205-09 |
Description | Management of severe childhood pneumonia including oxygen therapy |
Organisation | International Union Against Tuberculosis and Lung Disease (The Union) |
Country | Global |
Sector | Academic/University |
PI Contribution | We have been doing operational field work in oxygen therapy that has identified key barriers to successful use of oxygen in developing countries and that has been addressing those. This work is making an important contribution to local and international policy and practice. |
Collaborator Contribution | This group provides a focus for consensus-building for childhood pneumonia and provides a link to policy development. SH is a member of the Oxygen Working Group of IUATLD CLH and was funded to attend the 2009, 2010, 2011 and 2013 meeting of this group at the IUATLD World Conference and to present our work on oxygen treatment. Ashdown Consultants' Dr David Peel is an engineer and world expert in oxygen for developing countries and has contributed expertise and practical assistance to the oxygen aspects of our work, including by contributing to proposals and publications.The Ministry of Health provide vital local partnership and expertise in the projects. WHO CAH has been supportive of our work in this area, contributing to proposals and publications and providing a link to policy development. Azimut 360 SCCL developed a solar-powered prototype which was field tested at 2 government health facilities in The Gambia and one unit was field tested in Fiji which supplied power to deliver high quality (at least 82%) oxygen 24/7 independent of mains power and oxygen was available for hypoxaemic children for 99% of the time. |
Impact | Publications: 20937173; 20522295; 19876543; 19383191; 18235890; 20937173. This collaboration has resulted in involvement in the IUATLD Oxygen Working group and a contribution to the development of WHO Oxygen therapy handbook Other important non-peer reviewed publications resulting from this collaboration: Oxygen Concentrators for Use in Tropical Countries: A Survey. David Peel, Stephen RC Howie. Journal of Clinical Engineering; October 2009: 205-09 |
Description | Management of severe childhood pneumonia including oxygen therapy |
Organisation | World Health Organization (WHO) |
Department | Maternal, Newborn, Child and Adolescent Health |
Country | Switzerland |
Sector | Public |
PI Contribution | We have been doing operational field work in oxygen therapy that has identified key barriers to successful use of oxygen in developing countries and that has been addressing those. This work is making an important contribution to local and international policy and practice. |
Collaborator Contribution | This group provides a focus for consensus-building for childhood pneumonia and provides a link to policy development. SH is a member of the Oxygen Working Group of IUATLD CLH and was funded to attend the 2009, 2010, 2011 and 2013 meeting of this group at the IUATLD World Conference and to present our work on oxygen treatment. Ashdown Consultants' Dr David Peel is an engineer and world expert in oxygen for developing countries and has contributed expertise and practical assistance to the oxygen aspects of our work, including by contributing to proposals and publications.The Ministry of Health provide vital local partnership and expertise in the projects. WHO CAH has been supportive of our work in this area, contributing to proposals and publications and providing a link to policy development. Azimut 360 SCCL developed a solar-powered prototype which was field tested at 2 government health facilities in The Gambia and one unit was field tested in Fiji which supplied power to deliver high quality (at least 82%) oxygen 24/7 independent of mains power and oxygen was available for hypoxaemic children for 99% of the time. |
Impact | Publications: 20937173; 20522295; 19876543; 19383191; 18235890; 20937173. This collaboration has resulted in involvement in the IUATLD Oxygen Working group and a contribution to the development of WHO Oxygen therapy handbook Other important non-peer reviewed publications resulting from this collaboration: Oxygen Concentrators for Use in Tropical Countries: A Survey. David Peel, Stephen RC Howie. Journal of Clinical Engineering; October 2009: 205-09 |
Title | Oxygen delivery system |
Description | A novel oxygen delivery system for use in developing country health facilities is under development. Funding has been secured under the MRC DPFS scheme to pursue this further |
Type | Therapeutic Intervention - Medical Devices |
Current Stage Of Development | Refinement. Non-clinical |
Year Development Stage Completed | 2012 |
Development Status | Under active development/distribution |
Impact | This product represents a development from earlier oxygen delivery work that has improved patient care in more than one health facility in The Gambia. The ultimate aim is to contribute to mortality reduction |
Description | MRC Insight Blog |
Form Of Engagement Activity | A magazine, newsletter or online publication |
Part Of Official Scheme? | Yes |
Type Of Presentation | Paper Presentation |
Geographic Reach | International |
Primary Audience | Public/other audiences |
Results and Impact | The Blog post went online on 26 March 2013 Not known. However, there has been a good deal of outside interest in the Oxygen project, including from technology development groups. How much is down to the blog post is not clear. |
Year(s) Of Engagement Activity | 2013 |
URL | http://www.insight.mrc.ac.uk/2013/03/26/no-child-should-die-for-lack-of-oxygen/ |
Description | TAMA - Unit information dissemination newsletter |
Form Of Engagement Activity | A magazine, newsletter or online publication |
Part Of Official Scheme? | Yes |
Type Of Presentation | Paper Presentation |
Geographic Reach | Local |
Primary Audience | Policymakers/politicians |
Results and Impact | An interview detailing the scope of pneumonia-related research at the Unit. Report about oxygen project Not known |
Year(s) Of Engagement Activity | 2009,2013 |