Medics excited by revolutionary newborn treatment

By Richard Wetaya

60 clinicians and newborn care providers from across Africa Wednesday convened at Kiwoko hospital in Nakaseke district to deliberate and share experiences on the usage of the revolutionary treatment procedure called continuous positive airway pressure (CPAP).

The continuous positive airway procedure also refered to as the Kiwoko positive air pressure (KPAP) is a form of treatment that uses continuous mild air pressure to keep an infant’s airway open, thereby helping them to breath.

A newborn baby on bubble CPAP at Kiwoko Hospital NICU. Photo/Richard Wetaya

According to Dr Maneesh Batra of the Seattle Children’s hospital in the United States, the continuous positive airway pressure procedure can also be used to treat pre-term infants whose lungs have not fully developed and who are suffering from respiratory distress syndrome or bronchopulmonary dysplasia.

Respiratory distress syndrome is according to the World Health Organisation a leading cause of neonatal deaths in low income and middle income countries.

Debbie Lester of the Adara development group addresses participants at the workshop. Photo/Richard Wetaya

Complications from respiratory distress syndrome are responsible for deaths of approximately 1 million babies per year.

Respiratory distress syndrome is also associated with a high rate of morbidity.

The KPAP treatment procedure going by accounts has led to a remarkable reduction in Kiwoko hospital’s infant mortality rates.

50% of babies born before 32 weeks of gestational age at Kiwoko have survived respiratory distress syndrome as a result of the treatment in the past few years.

A doctor from Nigeria is taken through the mill of the CPAP procedure. Photo/Richard Wetaya

In 2013 and 2014, Kiwoko hospital in partnership with Adara, an international development organisation focused on perfecting KPAP delivery with air and oxygen blending as oxygen only (KPAP) can leave babies with damage to their retinas.

Dr James Nyonyintono, the deputy medical director at Kiwoko hospital, says plans are in high gear to design a new low cost bubble continuous positive airway pressure kit that will not require assembly at power source or a source of compressed air.

Participants at the workshop at Kiwoko Tuesday. Photo/Richard Wetaya

“Our team comprised of medical people from Uganda and the United states devised improvised bubble continuous positive airway pressure devices using tubes, connectors, nasal prongs and a water bottle as the bubbler. These devices provide lifesaving respiratory support to pre-term infants. These devices generally rely on a 100% source of oxygen,” Nyonyintono says.

This device, Nyonyintono adds targets babies who struggle to breath at birth.

“The continuous positive airway pressure procedure works well if you can deliver pressure to the lungs of the baby.
New solid and cheap devices are going to be incorporated onto what we are already using like for example the oxygen blenders.

The oxygen blender developed by (PATH) one of our partners entrains room air into the flowing oxygen in order to provide a safer gas for infants to breath using the bubble continuous positive airway pressure devices,” Nyonyintono adds.
 
The workshop organised under the theme “Expanding the reach of bubble CPAP devices” was co-hosted by Kiwoko Hospital, the Adara Group and PATH, an international nonprofit organisation.

It was funded through the Saving Lives at Birth partners, including the United States Agency for International Development (USAID), the Government of Norway, the Bill & Melinda Gates Foundation, Grand Challenges Canada, and the UK Government.