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Technology

Cost effective technology addresses breathing problems in children

Sally Mueni, a resident of Donholm Estate in Nairobi still grieves the death of her seven month old child who died two years ago. She vividly recalls the chilly September morning when her son Brian Mutuku developed breathing problems.

"I immediately rushed him to a nearby hospital where he was given antibiotics and put on oxygen but nothing changed. So he died."

Ms Mueni's predicament is shared by thousands of families across sub-Saharan Africa, where most health facilities lack sophisticated medical equipment or expertise required for certain delicate procedures.

To address such challenges, the Kenya Paediatric Association (KPA) in collaboration with experts from Columbia University (USA) and the Centre for Public Health Research (CPHR) is now training medical practitioners on a breathing therapy known as Continuous Positive Airway Pressure (CPAP).

Through the use of CPAP machines, the therapy provides a constant flow of air at a set pressure into the lungs of patients with breathing problems. This in turn opens up the airways allowing those affected to breathe well.

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At the recently concluded 2014 International Congress of Tropical Paediatrics, Dr Patrick Wilson, a paediatrician at Columbia University noted that the technology has been in use since the 1970s.

"It has helped us save millions of lives in the developed world yet such technologies have been absent in Africa where they are needed,” he said.

Dr Wilson cited cost and human resource constraints as major contributors to this technological gap. “That's why we want to train health professionals on CPAP. They will then pass the knowledge to others," he said.

A pilot study conducted in Ghana showed that CPAP significantly addressed breathing problems among children given the therapy. “So we know that it can work very well in Africa.”

As a common practice, breathing tubes are used to address breathing difficulties in children who do not respond to medicine and oxygen given to them. However, such equipment may lack in remote health centers and dispensaries frequented by most Kenyans. Dr Wilson noted that CPAP would therefore be ideal in these settings.

Unlike breathing tubes that can only be inserted by highly skilled medical personnel, he says, CPAP therapy is easy to administer. “Trained nurses and clinicians can comfortably use this technology which is also less risky.”

The CPAP trainings – currently targeting hospitals in Kisumu, Siaya, Nairobi and Kisii Counties – began in 2014.

Globally, two million children under the age of five die annually due to acute respiratory infections. These children—admitted to hospitals with life-threatening conditions like pneumonia, malaria, sepsis and severe anaemia—are often unable to breathe normally. This can result in congestive heart failure, respiratory arrest and even death.

While invasive mechanical ventilation (using breathing tubes) can save them, it’s often too expensive and technically complex to be successful in African countries like Kenya.

Therefore, health experts are often looking out for alternative user friendly and low cost interventions - such as CPAP – to address treatment challenges in Africa.

Once CPAP is massively rolled out in the country, the Ministry of Health hopes that it will significantly reduce the more than 20,000 deaths yearly caused by pneumonia – the second cause of health related deaths in Kenya based on the 2014 Kenya Economic Survey.

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