NIHR Global Health Research Unit on Respiratory Health (RESPIRE)

Bubble CPAP for treatment of Bangladeshi children with severe pneumonia

This project is based at icddr,b in Bangladesh

Overview

  • Project title:  Feasibility and acceptability followed by effectiveness of bubble continuous positive airway pressure for treatment of Bangladeshi children with severe pneumonia
  • Acute or chronic:  Acute
  • Based at:  icddr,b
  • Start date:  01 September 2018
  • End date:  31 December 2020
  • Principal investigator:  Mohammod Jobayer Chisti
  • Project team:  Mohammod Jobayer Chisti, John D. Clemens, Shams El Arifeen, Tahmeed Ahmed, Trevor Duke, Harry Campbell, Harish Nair, Steve Cunningham, Kathrin Cresswell, KM Shahunja, Ahmed Ehsanur Rahman, ASG Faruque, Fakhar Uddin, Abu SMSB Shahid, Aziz Sheikh

Background

Hypoxaemia, a low level of oxygen in the blood, is one of the main risk factors for death due to pneumonia among children.

District hospitals in Bangladesh are considered as secondary level referral hospitals and usually provide care of paediatric patients in paediatric wards, including children with pneumonia and severe pneumonia.

District hospitals do not have additional respiratory support available to children who are failing to improve following treatment with low-flow oxygen supplementation, the World Health Organization standard. As a result, these children may die due to lack of availability of additional respiratory support.

Bubble CPAP (a low-cost, locally made device to deliver oxygen) improved survival rates when provided to treat severe pneumonia in tertiary hospitals. This study will explore whether the same technology made available in district hospitals could provide the same patient benefit.

Aim and impact

This study aims to explore whether bubble CPAP is able to improve outcomes of children with severe pneumonia and hypoxaemia who receive care in non-tertiary, district hospitals. We also aim to understand the feasibility and acceptability of introducing and using locally made innovative low-cost bubble CPAP in these real-life settings in two selected district hospitals, prior to commencing our multicentre trial.

The results of this study will provide cohesive support to deliver a trial of bubble CPAP as an intervention for acute lower respiratory tract infection with hypoxaemia in children attending district hospitals. The next step is to aid the scale up of this low-cost intervention, to reduce pneumonia-related deaths in low- and middle-income countries across the globe.

Key developments