Solar-Powered Oxygen Delivery in Low-Resource Settings

Abstract

Oxygen is an essential medicine for life-threatening hypoxemic illnesses, including pneumonia, which is currently the leading cause of childhood mortality worldwide. 1,2 However, oxygen is not available in many pediatric wards in lowincome countries. In a survey of 12 African countries, only 44% of 231 health centers, district hospitals, and provincial or general hospitals had access to oxygen on a continuous basis. 3 Pragmatic solutions are needed to improve access to oxygen in low-resource settings. In resource-constrained settings, compressed oxygen cylinders and oxygen concentrators are commonly used. Oxygen cylinders are ready to use and do not require any electricity; however, their availability may be compromised by weak stock management, the need for transportation from supplier to hospital, and leakage from ill-fitting regulators. Oxygen concentrators generate oxygen on site from ambient air through selective adsorption of nitrogen using aluminum silicate sieve beds. Concentrators overcome the logistical supply barriers of cylinder oxygen, require minimal service and maintenance, and are more user-friendly than cylinders. However, oxygen concentrators require a continuous and reliable source of electricity. A systematic review found that only 34% of hospitals in sub-Saharan Africa have reliable access to electricity. 4 Interruptions in oxygen therapy owing to power outages are therefore frequent and potentially fatal in the settings in which most deaths from pneumonia occur. 4

Solar-powered oxygen delivery for the treatment of children with hypoxemia: protocol for a cluster-randomized stepped-wedge controlled trial in Uganda

“…A multi-hospital effectiveness study in Papua New Guinea demonstrated a reduction in mortality from childhood pneumonia from 5.0% to 3.2% (35% reduction in mortality) after implementation of an enhanced O 2 delivery system [13]. We have previously described and implemented a novel strategy for O 2 delivery that could be implemented in remote locations with minimal access to an electrical power supply: solar-powered oxygen (SPO 2 ) delivery [14,15]. SPO 2 is an effective solution for supplemental O 2 in low-resource settings [14][15][16].…”

“…We have previously described and implemented a novel strategy for O 2 delivery that could be implemented in remote locations with minimal access to an electrical power supply: solar-powered oxygen (SPO 2 ) delivery [14,15]. SPO 2 is an effective solution for supplemental O 2 in low-resource settings [14][15][16]. Our systems have been described in detail previously and implemented at two hospitals in Uganda [14][15][16].…”

“…SPO 2 is an effective solution for supplemental O 2 in low-resource settings [14][15][16]. Our systems have been described in detail previously and implemented at two hospitals in Uganda [14][15][16]. In brief, photovoltaic cells installed on the roofs of hospitals collect solar energy, which is stored as electricity in a battery bank, then used to power an O 2 concentrator for production of medical grade O 2 .…”

“…In brief, photovoltaic cells installed on the roofs of hospitals collect solar energy, which is stored as electricity in a battery bank, then used to power an O 2 concentrator for production of medical grade O 2 . We previously demonstrated the feasibility, safety, and efficacy of SPO 2 through a proof-of-concept study and a randomized controlled trial (RCT), showing clinical non-inferiority compared to cylinder O 2 [14][15][16]. We enrolled 130 children with hypoxemia admitted to two Ugandan hospitals and showed that the length of stay was not prolonged in patients randomized to SPO 2 , relative to children randomized to cylinder O 2 [15].…”

“…We previously demonstrated the feasibility, safety, and efficacy of SPO 2 through a proof-of-concept study and a randomized controlled trial (RCT), showing clinical non-inferiority compared to cylinder O 2 [14][15][16]. We enrolled 130 children with hypoxemia admitted to two Ugandan hospitals and showed that the length of stay was not prolonged in patients randomized to SPO 2 , relative to children randomized to cylinder O 2 [15]. Further, we did not detect statistically significant differences in mortality between SPO 2 and cylinder O 2 .…”