Groote Schuur Hospital, Cape Town, South Africa.
Department of Paediatrics, University of Cape Town, South Africa.
Acta Paediatr. 2022 Feb;111(2):275-283. doi: 10.1111/apa.16050. Epub 2021 Aug 4.
Over two thirds of newborn deaths occur in Africa and South Asia, and respiratory failure is a major contributor of these deaths. The exact availability of continuous positive airway pressure (CPAP) and surfactant in Africa is unknown. The aim of this study was to describe the availability of newborn respiratory care treatments in the countries of Africa.
Surveys, in English, French and Portuguese, were sent to neonatal leaders in all 48 continental countries and the two islands with populations over 1 million.
Forty-nine (98%) countries responded. Twenty-one countries reported less than 50 paediatricians, and 12 countries had no neonatologists. Speciality neonatal nursing was recognised in 57% of countries. Most units were able to provide supplemental oxygen. CPAP was available in 63% and 67% of the most well-equipped government and private hospitals. Surfactant was available in 33% and 39% of the most well-equipped public and private hospitals, respectively. Availability of CPAP and surfactant was greatly reduced in smaller cities. Continuous oxygen saturation monitoring was only available in 33% of countries.
The availability of proven life-saving interventions in Africa is inadequate. There is a need to sustainably improve availability and use of these interventions.
超过三分之二的新生儿死亡发生在非洲和南亚,而呼吸衰竭是这些死亡的主要原因之一。在非洲,持续气道正压通气(CPAP)和表面活性剂的确切供应情况尚不清楚。本研究旨在描述非洲国家新生儿呼吸治疗的供应情况。
向非洲大陆所有 48 个国家和两个人口超过 100 万的岛屿的新生儿专家发送了英语、法语和葡萄牙语的调查。
49 个(98%)国家作出回应。21 个国家报告称儿科医生人数少于 50 人,12 个国家没有新生儿科医生。57%的国家承认有专门的新生儿护理。大多数单位都能够提供补充氧气。63%和 67%的装备最精良的政府和私立医院可以提供 CPAP。33%和 39%的装备最精良的公立医院和私立医院分别可以提供表面活性剂。在较小的城市,CPAP 和表面活性剂的供应大大减少。只有 33%的国家能够进行连续血氧饱和度监测。
非洲提供的经过验证的救生干预措施供应不足。需要可持续地提高这些干预措施的供应和使用。