{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T20:51:10Z","timestamp":1790887870616,"version":"4.1.0"},"reference-count":32,"publisher":"Public Library of Science (PLoS)","issue":"12","license":[{"start":{"date-parts":[[2022,12,30]],"date-time":"2022-12-30T00:00:00Z","timestamp":1672358400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"UNITAID Explore"},{"name":"Harvard College, Sheldon Fellowship Grant"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\">\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Continuous Positive Airway Pressure (CPAP) is recommended in the treatment of respiratory distress syndrome of premature newborns, however there are significant barriers to its implementation in low-resource settings. The objective of this study was to evaluate the feasibility of use and integration of Vayu bCPAP Systems into the newborn unit at Muhimbili National Hospital in Tanzania.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec002\">\n                    <jats:title>Study design<\/jats:title>\n                    <jats:p>A prospective qualitative study was conducted from April 6 to October 6 2021. Demographic and clinical characteristics of patients treated with Vayu bCPAP Systems were collected and analyzed. Healthcare workers were interviewed until thematic saturation. Interviews were transcribed, coded, and analyzed using a framework analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec003\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>370 patients were treated with Vayu bCPAP Systems during the study period. Mean birth weight was 1522 g (500\u20133800), mean duration of bCPAP treatment was 7.2 days (&lt;1\u201339 d), and survival to wean was 81.4%. Twenty-four healthcare workers were interviewed and perceived Vayu bCPAP Systems as having become essential for treating neonatal respiratory distress at MNH. Key reasons were that Vayu bCPAP Systems improve patient outcomes, are easy to use, and more patients are now able to receive quality care. Barriers to integration included durability of oxygen tubing material and training.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec004\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>It was feasible to implement and integrate Vayu bCPAP Systems into the care of neonates at Muhimbili National Hospital.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1371\/journal.pone.0269147","type":"journal-article","created":{"date-parts":[[2022,12,30]],"date-time":"2022-12-30T14:11:39Z","timestamp":1672409499000},"page":"e0269147","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":13,"title":["Feasibility of a novel ultra-low-cost bubble CPAP (bCPAP) System for neonatal respiratory support at Muhimbili National Hospital, Tanzania"],"prefix":"10.1371","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5045-521X","authenticated-orcid":true,"given":"Ashtyn","family":"Tayler","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8989-8560","authenticated-orcid":true,"given":"Henry","family":"Ashworth","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ghassan","family":"Bou Saba","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hena","family":"Wadhwa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michelle","family":"Dundek","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ellie","family":"Ng","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kennedy","family":"Opondo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martha","family":"Mkony","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert","family":"Moshiro","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas","family":"Burke","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2022,12,30]]},"reference":[{"key":"pone.0269147.ref001","unstructured":"Newborns: reducing mortality. World Health Organization. Updated 19 September 2019. https:\/\/www.who.int\/news-room\/fact-sheets\/detail\/newborns-reducing-mortality"},{"issue":"10063","key":"pone.0269147.ref002","doi-asserted-by":"crossref","first-page":"3027","DOI":"10.1016\/S0140-6736(16)31593-8","article-title":"Global, regional, and national causes of under-5 mortality in 2000\u201315: an updated systematic analysis with implications for the Sustainable Development Goals","volume":"388","author":"L Liu","year":"2016","journal-title":"Lancet. Dec 17"},{"issue":"1","key":"pone.0269147.ref003","first-page":"12","article-title":"Neonatal Respiratory Distress Syndrome: Tackling A Worldwide Problem.","volume":"44","author":"J. Dyer","year":"2019","journal-title":"P & T: a peer-reviewed journal for formulary management"},{"key":"pone.0269147.ref004","doi-asserted-by":"crossref","first-page":"667404","DOI":"10.3389\/fped.2021.667404","article-title":"Critical Breaths in Transit: A Review of Non-invasive Ventilation (NIV) for Neonatal and Pediatric Patients During Transportation.","volume":"9","author":"N Ide","year":"2021","journal-title":"Front Pediatr"},{"key":"pone.0269147.ref005","doi-asserted-by":"crossref","first-page":"709","DOI":"10.2147\/JMDH.S260058","article-title":"Neonatal Survival in Sub-Sahara: A Review of Kenya and South Africa.","volume":"13","author":"BB Masaba","year":"2020","journal-title":"J Multidiscip Healthc."},{"issue":"8","key":"pone.0269147.ref006","doi-asserted-by":"crossref","first-page":"649","DOI":"10.1055\/s-0032-1314885","article-title":"Neonatal death in low- to middle-income countries: a global network study.","volume":"29","author":"JM Beliz\u00e1n","year":"2012","journal-title":"Am J Perinatol"},{"key":"pone.0269147.ref007","doi-asserted-by":"crossref","first-page":"e006964","DOI":"10.1136\/bmjgh-2021-006964","article-title":"Brantuo NABarriers to decolonising educational partnerships in global health","volume":"6","author":"J Kulesa","year":"2021","journal-title":"BMJ Global Health"},{"issue":"6","key":"pone.0269147.ref008","doi-asserted-by":"crossref","first-page":"e710","DOI":"10.1016\/S2214-109X(19)30163-9","article-title":"National, regional, and global levels and trends in neonatal mortality between 1990 and 2017, with scenario-based projections to 2030: a systematic analysis","volume":"7","author":"L Hug","year":"2019","journal-title":"The Lancet Global Health"},{"issue":"6","key":"pone.0269147.ref009","doi-asserted-by":"crossref","first-page":"1139","DOI":"10.1542\/peds.2010-3212","article-title":"Neonatal mortality from respiratory distress syndrome: lessons for low-resource countries","volume":"127","author":"BD Kamath","year":"2011","journal-title":"Pediatrics"},{"issue":"5","key":"pone.0269147.ref010","first-page":"409","article-title":"Bubble CPAP\u2014A primary respiratory support for respiratory distress syndrome in newborns","volume":"46","author":"PS Urs","year":"2009","journal-title":"Article. Indian Pediatrics"},{"key":"pone.0269147.ref011","volume-title":"WHO recommendation on continuous positive airway pressure therapy for the treatment of preterm newborns with respiratory distress syndrome","author":"World Health Organization","year":"2015"},{"issue":"6","key":"pone.0269147.ref012","doi-asserted-by":"crossref","first-page":"F495","DOI":"10.1136\/archdischild-2013-305519","article-title":"Efficacy and safety of bubble CPAP in neonatal care in low and middle income countries: a systematic review","volume":"99","author":"S Martin","year":"2014","journal-title":"Arch Dis Child Fetal Neonatal Ed"},{"issue":"6","key":"pone.0269147.ref013","doi-asserted-by":"crossref","first-page":"e0252718","DOI":"10.1371\/journal.pone.0252718","article-title":"Experiences with implementation of continuous positive airway pressure for neonates and infants in low-resource settings: A scoping review.","volume":"16","author":"S Dada","year":"2021","journal-title":"PLoS One"},{"issue":"1","key":"pone.0269147.ref014","doi-asserted-by":"crossref","first-page":"311","DOI":"10.1186\/s12887-019-1698-x","article-title":"Reducing preterm mortality in eastern Uganda: the impact of introducing low-cost bubble CPAP on neonates <1500\u2009g","volume":"19","author":"F Okello","year":"2019","journal-title":"BMC Pediatr"},{"issue":"5","key":"pone.0269147.ref015","doi-asserted-by":"crossref","first-page":"385","DOI":"10.1093\/tropej\/fmw023","article-title":"Effect of Treatment of Premature Infants with Respiratory Distress Using Low-cost Bubble CPAP in a Rural African Hospital","volume":"62","author":"J Myhre","year":"2016","journal-title":"J Trop Pediatr."},{"key":"pone.0269147.ref016","doi-asserted-by":"crossref","first-page":"S21","DOI":"10.1038\/jp.2016.29","article-title":"Efficacy and safety of CPAP in low- and middle-income countries","volume":"36","author":"A Thukral","year":"2016","journal-title":"Journal of Perinatology"},{"key":"pone.0269147.ref017","doi-asserted-by":"crossref","first-page":"31","DOI":"10.1016\/j.prrv.2018.04.004","article-title":"Risk and benefits of Bubble Continuous Positive Airway Pressure for neonatal and childhood respiratory diseases in Low- and Middle-Income countries.","volume":"29","author":"OA Ekhaguere","year":"2019","journal-title":"Paediatric Respiratory Reviews"},{"key":"pone.0269147.ref018","first-page":"10","article-title":"To Bubble or Not? A Systematic Review of Bubble Continuous Positive Airway Pressure in Children in Low- and Middle-Income Countries.","volume":"10","author":"M Norgaard","year":"2019","journal-title":"Journal of Tropical Pediatrics"},{"key":"pone.0269147.ref019","article-title":"Barriers and facilitators to implementing bubble CPAP to improve neonatal health in sub-Saharan Africa: a systematic review.","author":"M-LW Kinshella","journal-title":"Public Health Reviews."},{"key":"pone.0269147.ref020","unstructured":"Secretary-General U. Special Edition: Progress Towards the Sustainable Development Goals. 2019."},{"issue":"10","key":"pone.0269147.ref021","first-page":"1572","article-title":"Evaluation of a Bubble CPAP System for Low Resource Settings","volume":"66","author":"M L Dundek","journal-title":"Respir Care. 2021 Oct"},{"issue":"3","key":"pone.0269147.ref022","doi-asserted-by":"crossref","first-page":"184","DOI":"10.1080\/20469047.2019.1598125","article-title":"A new low-cost commercial bubble CPAP (bCPAP) machine compared with a traditional bCPAP device in Nigeria.","volume":"39","author":"HO Amadi","year":"2019","journal-title":"Paediatrics & international Child Health."},{"issue":"1","key":"pone.0269147.ref023","doi-asserted-by":"crossref","first-page":"347","DOI":"10.1186\/s12887-018-1311-8","article-title":"Healthcare workers\u2019 views on the use of continuous positive airway pressure (CPAP) in neonates: a qualitative study in Andhra Pradesh, India.","volume":"18","author":"JE Dewez","year":"2018","journal-title":"BMC Pediatrics"},{"issue":"5","key":"pone.0269147.ref024","doi-asserted-by":"crossref","first-page":"348","DOI":"10.1093\/tropej\/fmu025","article-title":"Is continuous positive airway pressure a feasible treatment modality for neonates with respiratory distress syndrome in a rural district hospital?","volume":"60","author":"H Hendriks","year":"2014","journal-title":"Journal of Tropical Pediatrics"},{"issue":"4","key":"pone.0269147.ref025","doi-asserted-by":"crossref","first-page":"10","DOI":"10.1542\/peds.2019-0668","article-title":"Neonatal CPAP for Respiratory Distress Across Malawi and Mortality","volume":"144","author":"J Carns","year":"2019","journal-title":"Pediatrics"},{"key":"pone.0269147.ref026","doi-asserted-by":"crossref","first-page":"533","DOI":"10.1186\/s12913-019-4364-y","article-title":"Bubble CPAP and oxygen for child pneumonia care in Malawi: a CPAP IMPACT time motion study.","volume":"19","author":"K.L. Sessions","year":"2019","journal-title":"BMC Health Serv Res"},{"issue":"11","key":"pone.0269147.ref027","doi-asserted-by":"crossref","first-page":"964","DOI":"10.1016\/S2213-2600(19)30243-7","article-title":"Bubble continuous positive airway pressure for children with high-risk conditions and severe pneumonia in Malawi: an open label, randomised, controlled trial","volume":"7","author":"ED McCollum","year":"2019","journal-title":"Lancet Respir Med"},{"issue":"11","key":"pone.0269147.ref028","doi-asserted-by":"crossref","first-page":"923","DOI":"10.1016\/S2213-2600(19)30261-9","article-title":"Bubble CPAP in resource-poor settings: friend or foe?","volume":"7","author":"PT Wilson","year":"2019","journal-title":"Lancet Respir Med"},{"issue":"4","key":"pone.0269147.ref029","doi-asserted-by":"crossref","first-page":"249","DOI":"10.1093\/tropej\/fmi109","article-title":"An evaluation of bubble-CPAP in a neonatal unit in a developing country: effective respiratory support that can be applied by nurses","volume":"52","author":"L Koyamaibole","year":"2006","journal-title":"Journal of Tropical Pediatrics"},{"issue":"3","key":"pone.0269147.ref030","doi-asserted-by":"crossref","first-page":"155","DOI":"10.1080\/20469047.2019.1613782","article-title":"CPAP and high-flow oxygen to address high mortality of very severe pneumonia in low-income countries\u2014keeping it in perspective","volume":"39","author":"T. Duke","year":"2019","journal-title":"Paediatr Int Child Health"},{"issue":"1","key":"pone.0269147.ref031","doi-asserted-by":"crossref","first-page":"33","DOI":"10.1093\/tropej\/fmt074","article-title":"Aftermath of a clinical trial: evaluating the sustainability of a medical device intervention","volume":"60","author":"PT Wilson","year":"2014","journal-title":"Ghana. Journal of Tropical Pediatrics"},{"key":"pone.0269147.ref032","first-page":"19","article-title":"Using a peer mentorship approach improved the use of neonatal continuous positive airway pressure and related outcomes in Malawi","volume":"19","author":"A Asibon","year":"2019","journal-title":"Acta Paediatrica"}],"container-title":["PLOS ONE"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0269147","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,12,30]],"date-time":"2022-12-30T14:12:07Z","timestamp":1672409527000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0269147"}},"subtitle":[],"editor":[{"given":"Orvalho","family":"Augusto","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2022,12,30]]},"references-count":32,"journal-issue":{"issue":"12","published-online":{"date-parts":[[2022,12,30]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pone.0269147","relation":{"has-preprint":[{"id-type":"doi","id":"10.1101\/2022.05.16.22275176","asserted-by":"object"}]},"ISSN":["1932-6203"],"issn-type":[{"value":"1932-6203","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,12,30]]}}}