Malawi Study Confirms Lasting Impact of CPAP Life-Saving Technology
A study in Malawi confirms CPAP "continuous positive airway pressure"lasting impact of life –saving technology. Malawi's national adoption of affordable, rugged, neonatal CPAP technology as a part of routine hospital care resulted in sustained improvements in the survival of babies with respiratory illness, according to a new study in the journal Pediatrics.
southeast Africa, has the world's highest preterm birth rate, with almost 1 in
5 babies born prematurely. A study conducted at 26 Malawi government hospitals
found that the national adoption of rugged, low-cost, neonatal "continuous
positive airway pressure" (CPAP) devices improved survival rates from 49%
to 55% for newborns admitted with breathing problems. For newborns with severe
breathing problems, survival improved from 40% to 48%.
"For babies that had
respiratory distress syndrome -- these are the tiniest babies that have some of
the biggest challenges with breathing -- we saw a nearly a 10% improvement in
survival after CPAP was available," said Rice University engineering
professor Rebecca Richards-Kortum, the study's corresponding author and
co-director of the Rice 360° Institute for Global Health.
involved 2,457 babies born at government hospitals from 2013 to 2016 and was
conducted by researchers from the Malawi Ministry of Health, Malawi's leading
medical school and its teaching hospital, and Rice 360°.
Rice 360° developed the
Pumani CPAP machine used in the study and supported the national rollout via a
transition-to-scale grant from Saving Lives at Birth, a joint undertaking by
the U.S. Agency for International Development (USAID), the Bill & Melinda
Gates Foundation and the governments of Norway, the United Kingdom, Canada and
co-director Maria Oden said most sub-Saharan hospitals can't afford to bring on
extra nurses or technicians, so it was important to monitor patient outcomes
and see if CPAP gains were sustained over years as part of routine hospital
Malawi rollout was a nurse-led, quality improvement initiative that was
directed and sustained by the Malawi Ministry of Health," Oden said.
"They have shown that a low-income country can scale CPAP nationally and
see dramatic and lasting improvements in newborn outcomes."
Jennifer Carns, a Rice 360° bioengineer and research scientist at Rice's Brown
School of Engineering, said the study also found that babies did not get the
full benefit of CPAP if they were too cold.
infants with normal body temperatures, survival rates were 66% -- more than 25%
higher than those who were too cold," Carns said. While respiratory
distress is common among premature babies, so are other conditions like
more work to be done," Richards-Kortum said. "We know for CPAP to
have its full potential, it needs to be introduced as part of a quality program
that focuses on improving essential newborn care."
is Rice's Malcolm Gillis University Professor and a 2018 State Department U.S.
science envoy for health security. Oden is the director of Rice's award-winning
Oshman Engineering Design Kitchen. Richards-Kortum and Oden are each
bioengineering professors in Rice's Brown School of Engineering and co-founders
of NEST360°, an international campaign to end preventable newborn deaths in