Oxygen concentrators offer cost savings for developing countries

Dobson, Michael

doi:10.1111/j.1365-2044.1991.tb09413.x

Cited by 38 publications

(19 citation statements)

References 2 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…A number of independent reports of successful use of concentrators in developing countries have been made. 7,8,[13][14][15][16][17][18][19][20][21] However, important concentrator failure in tropical country environments has also been reported, and where they have been used successfully on a significant scale, the capacity to repair the equipment has been present. 12,15,22 In order for this technology to fulfill its potential, there is a need for data to guide the choice of models to help minimize the chance of failure for technical reasons.…”

Section: Discussionmentioning

confidence: 99%

Oxygen Concentrators for Use in Tropical Countries

Peel

Howie

2009

Journal of Clinical Engineering

View full text Add to dashboard Cite

Oxygen for the treatment of sick patients in tropical countries is in very short supply. Oxygen concentrators, which filter nitrogen from atmospheric air to produce 90% oxygen, have considerable potential to meet this need. However, being produced mainly for North American and European home use, many concentrators may not be well suited to use in challenging tropical conditions. This report gives a detailed evaluation of 11 models of oxygen concentrator on the basis of the information supplied by their manufacturers. The aim of the survey was to identify concentrators specified to operate in the heat and humidity of tropical countries and to identify which would be most suitable based also on their cost-effectiveness, energy efficiency, and maintenance requirements. Six of the 11 models surveyed were specified to operate at up to 408C and 95% relative humidity. The highest ranking models for performance, cost, and energy efficiency were from one manufacturer, AirSep, which was the only manufacturer to produce independent data showing successful use of their concentrators in a tropical country.Oxygen for medical use is in short supply in developing countries. 1-3 Oxygen is needed to treat patients whose blood oxygen levels are low (hypoxemia) 4 and is also needed for use during administration of anesthesia for surgery. Hypoxemia can be due to a variety of reasons, but usually, it is because gas exchange in the lungs has been impaired, commonly because of infection. Pneumonia, a serious infection of the lungs, particularly affects the youngest and the oldest members of the community. Pneumonia is the leading cause of death in young children globally, accounting for around 2 million of 10 million deaths annually for those younger than 5 years and presents a major obstacle to achieving the health-related UN Millennium Development Goals. 5,6 The conventional means of supplying oxygen is by compressed gas cylinders. The standard process of producing oxygen to fill cylinders requires high-energy consumption, making the end product expensive. 7 Furthermore, the logistical barriers to successfully distributing oxygen cylinders to health facilities in developing countries are considerable thereby compounding the supply problem at the patient level.Increasingly oxygen concentrators are being used as an alternative source of medical oxygen in developing countries. 8 These devices, which take atmospheric air and filter out the nitrogen to produce around 90% pure oxygen, 9 have been used in developed countries for decades particularly for home treatment of those with chronic lung conditions. 10 The concentrator market has developed over the last 30 years, and there are currently many manufacturers worldwide. Several millions of concentrators have been manufactured, and the performance of new models improves steadily. Costs have come down as a result of economies of scale.Although concentrators have potential to alleviate the oxygen shortage in the developing world, there are important obstacles to their success. These are the ...

show abstract

Section: Discussionmentioning

confidence: 99%

Oxygen Concentrators for Use in Tropical Countries

Peel

Howie

2009

Journal of Clinical Engineering

View full text Add to dashboard Cite

show abstract

“…Published reports on the benefits of oxygen concentrators are positive. 7,[20][21][22][23][24][25][26][27][28][29] Nevertheless, the limitations of this body of literature should be considered. The most comprehensive work in this area has been led by MB Dobson.…”

Section: Discussionmentioning

confidence: 99%

“…7,23,25,26 His careful 1991 report, which modelled costs in three sizes of hospital in Papua New Guinea, predicted a saving of 25%-75% with concentrators compared to cylinders, but did not include transport costs and did not address operational feasibility issues in much detail. 25 A seminal 1996 paper on a field trial in Egypt showed that concentrators could succeed on a large scale when introduced with an appropriate programme of technical support and staff training. 23 The limitations of this study were its short duration (1 year) and the questionable generalizability of its findings, given Egypt's atypically good infrastructure.…”

Section: Discussionmentioning

confidence: 99%

Meeting oxygen needs in Africa: an options analysis from the Gambia

Howie¹,

Hill²,

Ebonyi³

et al. 2009

Bull World Health Org

View full text Add to dashboard Cite

Objective To compare oxygen supply options for health facilities in the Gambia and develop a decision-making algorithm for choosing oxygen delivery systems in Africa and the rest of the developing world. Methods Oxygen cylinders and concentrators were compared in terms of functionality and cost. Interviews with key informants using locally developed and adapted WHO instruments, operational assessments, cost-modelling and cost measurements were undertaken to determine whether oxygen cylinders or concentrators were the better choice. An algorithm and a software tool to guide the choice of oxygen delivery system were constructed. Findings In the Gambia, oxygen concentrators have significant advantages compared to cylinders where power is reliable; in other settings, cylinders are preferable as long as transporting them is feasible. Cylinder costs are greatly influenced by leakage, which is common, whereas concentrator costs are affected by the cost of power far more than by capital costs. Only two of 12 facilities in the Gambia were found suitable for concentrators; at the remaining 10 facilities, cylinders were the better option. Conclusion Neither concentrators nor cylinders are well suited to every situation, but a simple options assessment can determine which is better in each setting. Nationally this would result in improved supply and lower costs by comparison with conventional cylinders alone, although ensuring a reliable supply would remain a challenge. The decision algorithm and software tool designed for the Gambia could be applied in other developing countries.Une traduction en français de ce résumé figure à la fin de l'article. Al final del artículo se facilita una traducción al español. ‫املقالة.‬ ‫لهذه‬ ‫الكامل‬ ‫النص‬ ‫نهاية‬ ‫يف‬ ‫الخالصة‬ ‫لهذه‬ ‫العربية‬ ‫الرتجمة‬

show abstract

“…25,26 There is now evidence that ensuring ample supplies of oxygen and promoting a routine, systematic approach to screening for hypoxemia by using pulse oximetry are associated with improved quality of care and reduced mortality rates and that the required technology is affordable and sustainable in district-level hospitals and outpatient clinics in developing countries. 25,[27][28][29][30][31] However, a significant proportion of the children in the current study had hypoxemia, which clearly indicates the importance of accurate diagnosis of hypoxemia in determining the safety of outpatient treatment. 32 Pulse oximetry would enable accurate identification of hypoxemia and might increase the safety and cost-effectiveness of this recommendation, 33 and this diagnostic tool should be included.…”

Section: Discussionmentioning

confidence: 47%