Outcomes of Patients with Respiratory Distress Treated with Bubble CPAP on a Pediatric Ward in Malawi

J Trop Pediatr. 2015 Dec;61(6):421-7. doi: 10.1093/tropej/fmv052. Epub 2015 Sep 11.


Objective: To describe the outcomes of infants and young children with respiratory distress when treated with a novel, low-cost, stand-alone bubble Continuous Positive Airway Pressure (bCPAP) system in a resource-limited setting.

Methods: A non-randomized, convenience sample study in a pediatric unit in Blantyre, Malawi, 2013. Patients weighing ≤10 kg with respiratory distress were eligible. We compared outcomes for patients with bronchiolitis, pneumonia and Pneumocystis jiroveci pneumonia (PJP) after treatment with bCPAP.

Results: Seventy percent of patients treated with bCPAP survived. Outcomes were best for patients with bronchiolitis and worst for those with PJP. Most survivors (80%) showed improvement within 24 h. All treating physicians found bCPAP useful, leading to a change in practice.

Conclusions: Bubble CPAP was most beneficial to patients with bronchiolitis. Children, who were going to get well, tended to get well quickly. Physicians believed the bCPAP system provided a higher level of care than nasal oxygen.

Keywords: bubble CPAP; low cost device; pediatric; resource limited setting; respiratory distress.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Bronchiolitis / pathology
  • Bronchiolitis / therapy*
  • Continuous Positive Airway Pressure / economics
  • Continuous Positive Airway Pressure / instrumentation*
  • Continuous Positive Airway Pressure / methods*
  • Cost-Benefit Analysis
  • Female
  • Humans
  • Infant
  • Infant, Newborn
  • Malawi / epidemiology
  • Male
  • Oxygen Inhalation Therapy
  • Pneumocystis carinii
  • Pneumonia / pathology
  • Pneumonia / therapy*
  • Respiratory Distress Syndrome, Newborn / mortality
  • Respiratory Distress Syndrome, Newborn / pathology
  • Respiratory Distress Syndrome, Newborn / therapy*
  • Survival Analysis
  • Survival Rate / trends
  • Treatment Outcome