Authors: Duke, T.¹; Graham, S.M.²; Cherian, M.N.³; Ginsburg, A.S.⁴; English, M.⁵; Howie, S.⁶; Peel, D.⁷; Enarson, P.M.⁸; Wilson, I.H.⁹; Were, W.¹⁰; the Union Oxygen Systems Working Group,

Source: The International Journal of Tuberculosis and Lung Disease, Volume 14, Number 11, November 2010 , pp. 1362-1368(7)

Publisher: International Union Against Tuberculosis and Lung Disease

Abstract:

Hypoxaemia is commonly associated with mortality in developing countries, yet feasible and cost-effective ways to address hypoxaemia receive little or no attention in current global health strategies. Oxygen treatment has been used in medicine for almost 100 years, but in developing countries most seriously ill newborns, children and adults do not have access to oxygen or the simple test that can detect hypoxaemia. Improving access to oxygen and pulse oximetry has demonstrated a reduction in mortality from childhood pneumonia by up to 35% in high-burden child pneumonia settings. The cost-effectiveness of an oxygen systems strategy compares favourably with other higher profile child survival interventions, such as new vaccines. In addition to its use in treating acute respiratory illness, oxygen treatment is required for the optimal management of many other conditions in adults and children, and is essential for safe surgery, anaesthesia and obstetric care. Oxygen concentrators provide the most consistent and least expensive source of oxygen in health facilities where power supplies are reliable. Oxygen concentrators are sustainable in developing country settings if a systematic approach involving nurses, doctors, technicians and administrators is adopted. Improving oxygen systems is an entry point for improving the quality of care. For these broad reasons, and for its vital importance in reducing deaths due to lung disease in 2010: Year of the Lung, oxygen deserves a higher priority on the global health agenda.

Keywords: oxygen; hypoxaemia; pneumonia; lung disease; health systems

Document Type: Invited paper

Affiliations: 1: Centre for International Child Health, Department of Paediatrics, University of Melbourne and Murdoch Children's Research Institute, Royal Children's Hospital, Melbourne, Australia 2: Centre for International Child Health, Department of Paediatrics, University of Melbourne and Murdoch Children's Research Institute, Royal Children's Hospital, Melbourne, Australia; and Lung Health Division, International Union Against Tuberculosis and Lung Disease, Paris, France 3: Department of Essential Health Technologies, World Health Organization, Geneva, Switzerland 4: PATH, Seattle, WA, USA 5: Kenya Medical Research Institute/Wellcome Trust Research Programme, Nairobi, Kenya 6: Medical Research Council, Banjul, The Gambia 7: Ashdown Consultants, Hartfield, UK 8: Lung Health Division, International Union Against Tuberculosis and Lung Disease, Paris, France 9: World Federation of Societies of Anaesthesiologists, London, UK 10: Department of Child and Adolescent Health, World Health Organization, Geneva, Switzerland

Publication date: 2010-11-01

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• The International Journal of Tuberculosis and Lung Disease publishes articles on all aspects of lung health, including public health-related issues such as training programmes, cost-benefit analysis, legislation, epidemiology, intervention studies and health systems research. The IJTLD is dedicated to the continuing education of physicians and health personnel and the dissemination of information on tuberculosis and lung health world-wide.

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