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Hawkes MT, Conroy AL, Namasopo S, et al. Solar-Powered Oxygen Delivery in Low-Resource Settings: A Randomized Clinical Noninferiority Trial. JAMA Pediatr. 2018;172(7):694–696. doi:10.1001/jamapediatrics.2018.0228
Oxygen is an essential medicine for life-threatening hypoxemic illnesses, including pneumonia, which is currently the leading cause of childhood mortality worldwide.1,2 However, oxygen is not available in many pediatric wards in low-income countries. In a survey of 12 African countries, only 44% of 231 health centers, district hospitals, and provincial or general hospitals had access to oxygen on a continuous basis.3 Pragmatic solutions are needed to improve access to oxygen in low-resource settings.
In resource-constrained settings, compressed oxygen cylinders and oxygen concentrators are commonly used. Oxygen cylinders are ready to use and do not require any electricity; however, their availability may be compromised by weak stock management, the need for transportation from supplier to hospital, and leakage from ill-fitting regulators. Oxygen concentrators generate oxygen on site from ambient air through selective adsorption of nitrogen using aluminum silicate sieve beds. Concentrators overcome the logistical supply barriers of cylinder oxygen, require minimal service and maintenance, and are more user-friendly than cylinders. However, oxygen concentrators require a continuous and reliable source of electricity. A systematic review found that only 34% of hospitals in sub-Saharan Africa have reliable access to electricity.4 Interruptions in oxygen therapy owing to power outages are therefore frequent and potentially fatal in the settings in which most deaths from pneumonia occur.4
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