The low cost lifesaver

Ahmed Shatil Alam writes about the innovation which is cutting costs and saving lives

icddr b treatment of pneumonia

The disease affects the lungs after the bacterial and virus related infections. Therefore, the physicians usually apply low-flow oxygen therapy to infants to tackle the oxygen crisis in their lungs.

But this high-cost therapy is given to the infants through a ventilator in developed countries, while often the infants from poor countries cannot get the facility leading to their deaths. A pediatrician from Bangladesh has researched and come up with a breakthrough low-cost technology for treating infants suffering from acute severe pneumonia.

Dr Mohammod Jobayer Chisti, who is currently leading the pediatric department of International Centre for Diarrhoeal Disease Research, Bangladesh (ICDDRB) is the person who came up with the technology following a decade-long research that started officially in 2008 with the support of researchers from ICDDR,B and University of Melbourne.

Calling his new method ‘Bubble continuous positive airway pressure (Bubble CPAP)’, Chisti said that the procedure requires a water-filled bottle with a pipe going through a nasal hole in addition to the oxygen flow, while in the traditional low-flow oxygen therapy, patients receive only oxygen.

Bubbles are created in the bottle, which then exerts pressure on lungs, thus creating continuous positive airway pressure, said Chisti who started his career at Sylhet Medical College in 1996.

With continuous bubble pressure, a child’s chances of survival increases as Bubble CPAP opens patient’s lungs and his/her collapsed tissues becomes active again, he shared.

Christi was inspired after seeing a machine when he was doing his research in Melbourne, Australia. By using CPAP, the highly expensive machine as it costs around 150 USD, prevents the lungs from collapsing, helping the body to absorb enough oxygen.

After returning home and starting his job at ICDDR,B, he started work on a simpler and cheaper bubble CPAP device. One day, along with his colleague, Chisti took a discarded plastic shampoo bottle from the intensive care unit. ‘We filled it with water and inserted one end of some plastic supply tubing and tested it on four or five patients at random. We saw a significant improvement among them within a few hours,’ he recalled.

Chisti, after two years of study and trials on 225 infants from August 2011 till June 2013, published the results in The Lancet magazine. The study showed that infant treated with the bubble CPAP device had much lower death rates compared against those treated with low-flow oxygen and high-flow oxygen therapy. The 100 Taka worth locally made device appeared to reduce mortality rates by 75 percent.

‘During our trial we found only six per cent treatment failure while mortality rate was four per cent among the children treated with the device… the rates were high in low-flow oxygen therapy cases,’ he said.

He shared that since then his department at ICDDR,B has been using this low-cost life saver method and treated 650 children. The device also makes efficient use of oxygen, as it reduces the hospital’s annual oxygen bill by around five times and the expense has been brought down to Taka 4,80,000 from Taka 24,00,000.

Chisti also said that for applying Bubble CPAP no highly qualified medical personnel or doctors are needed. But for applying conventional low-flow oxygen therapy, highly trained medical personnel and doctors are needed.

‘Bubble CPAP method can be applied by anybody from a medical personnel to any random person with some training,’ he says.

Because the method is easy and cost-effective, it may soon be used in all other hospitals in Bangladesh. ‘My method was also applauded by the WHO and they are thinking if this can be applied in the developing and under developed countries where thousands of infants die every year after not receiving expensive low-flow oxygen therapy through ventilator,’ he said.