Influenza preparedness in low-resource settings: a look at oxygen delivery in 12 African countries

  • Janeil M Belle Duke University School of Medicine
  • Hillary J Cohen Maimonides Medical Center
  • Nahoko Shindo World Health Organization Headquarters
  • Matthew L Lim World Health Organization Headquarters
  • Adriana Velazquez-Berumen World Health Organization Headquarters
  • Jean-Bosco Ndihokubwayo World Health Organization Regional Office for Africa
  • Meena N Cherian World Health Organization Headquarters
Keywords: Africa, oxygen, influenza, H1N1, influenza preparedness

Abstract

Background: Pandemic influenza poses a serious threat to populations in low and lower-middle income countries that face delays in access to health care and inadequately equipped facilities. Oxygen is first-line therapy for influenza-related hypoxia and a standard component of emergency respiratory resuscitation, yet remains a scarce resource in many countries.

Methodology: A snapshot survey of oxygen supply and associated infrastructure was performed at 231 health centres and hospitals in twelve African countries using the World Health Organization (WHO) Tool for Situational Analysis to Assess Emergency and Essential Surgical Care. WHO Global Initiative for Emergency and Essential Surgical Care, WHO regional and country offices, and local Ministries of Health facilitated data collection from facilities surveyed. Data was stored in the WHO DataCol SQL database and computerized spreadsheet tools were used to generate descriptive statistics. 

Results: Ninety-nine (43.8%) of facilities surveyed reported uninterrupted access to an oxygen source and 55 (24.6%) possessed a fully functioning oxygen concentrator.  Electricity was fully available at only 81 (35.1%) health facilities.

Conclusions:  In addition to efforts to secure vaccines and antivirals, future global influenza preparedness efforts should include investments in oxygen and associated equipment and infrastructure at first referral health facilities, to minimize morbidity and mortality from influenza in regions with limited medical resources.  Increasing oxygen delivery capacity in these areas may also provide long-term, post-pandemic benefits in the management of other medical conditions of significance, including trauma, neonatal pulmonary hypofunction, and HIV-related and childhood pneumonia.

Author Biographies

Janeil M Belle, Duke University School of Medicine

B.S/B.A, Duke University School of Medicine

(Medical student, candidate for MD May 2010)

Hillary J Cohen, Maimonides Medical Center
MD, Department of Emergency Medicine, Maimoides Medical Center
Nahoko Shindo, World Health Organization Headquarters
MD, Global Influenza Programme,  Department of Epidemic and Pandemic Alert and Response, World Health Organization
Matthew L Lim, World Health Organization Headquarters
MD, Department of Global Alert and
Response, World Health Organization
Adriana Velazquez-Berumen, World Health Organization Headquarters
MSc.,C.C.E, Diagnostic Imaging and Medical Devices, Department of Essential Health Technologies, World Health Organization
Jean-Bosco Ndihokubwayo, World Health Organization Regional Office for Africa
MD, Regional Office for Africa, World Health Organization 
Meena N Cherian, World Health Organization Headquarters
MD, Emergency and Essential Surgical Care program, Department of Health Technologies, World Health Organization


Published
2010-05-06
How to Cite
1.
Belle J, Cohen H, Shindo N, Lim M, Velazquez-Berumen A, Ndihokubwayo J-B, Cherian M (2010) Influenza preparedness in low-resource settings: a look at oxygen delivery in 12 African countries. J Infect Dev Ctries 4:419-424. doi: https://doi.org/10.3855/jidc.859
Section
Emerging Problems in Infectious Diseases