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Abstract
Background information The treatment of hyperbilirubinaemia in faraway remote locations of the world, where grid electricity and specialist doctors are unavailable, is hampered by a lack of appropriate technologies that could be operable by basic-trained healthcare workers. Hence the urgent need for the development of simplified low-cost medical devices that could be deployable to the hardest-to-reach remote locations of the world.
Methods Low-cost stable elements, components and workpieces were targeted and applied in design to develop an applicable intensive phototherapy machine. Materials were sourced from in-country local markets to prototype the resultant device for capacity tests and technical and safety assessments. The device was crafted to be solely solar energy dependent for power sustainability and climate-change mitigation in remote locations prior to ethical approval and commencement of clinical trialling at University of Calabar Teaching Hospital Nigeria, to determine its efficiency in rapid breakdown of ‘severe’ serum bilirubin to a ‘mild’ benchmark level.
Result The new device passed all technical safety assessments, delivering a total body irradiation treatment capacity of 45—158 µW/cm2/nm with 460 nm light wavelengths across various aspects of the body of a neonate. The device uses real-time solar power while self-banking its private reserve energy, which could last for over 27 hours when no real-time energy from the sun is available. All initial 11 patients enrolled during the first 3 months of trialling were safely and successfully treated within 17.8±8.7 irradiation-hours with stable vital signs and no injuries.
Conclusion The new device is a potentially sustainable low-income and middle-income country solution for severe jaundice management.
- Child Health
- Community Medicine
- Congenital, Hereditary, and Neonatal Diseases and Abnormalities
- Global Health
- Pediatrics
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Footnotes
Contributors HA conceptualised and designed this work. Details of all contributions: (1) Conceptualisation, product design and development, final device prototyping and facility installations: HA; (2) Initial device postinstallation assessment for clinical trialability: OEA-O, JJU, MMM, SOO, JMI, AJ and EBA; (3) Ethical clearance application and processing: HA, OEA-E, JMI, JJU, MMM, SOO and AJ; (4), Clinical trialling protocol design and subsequent reviews: HA, OEA-O, JJU, MMM, SOO, JMI, AJ, EBA, L-SCM, EUA and COA; (5) Clinical research management: HA, OEA-O, JJU, L-SCM and JMI; (6) Patient bench management and data supervision: L-SCM, EUA, COA, AJ and EBA; (7) Financial contribution/support for TcB device purchase and payment of hired junior health assistants (research data collectors): MMM, HA, L-SCM; (8) Data analyses: HA, OEA-O, JJU, MMM, SOO, JMI, AJ, EBA, L-SCM, EUA and COA; (9) Manuscript drafting: HA (10); Manuscript review, editing and readiness: HA, OEA-O, SOO, MMM, JJU, JMI, AJ, EBA, L-SCM, EUA, COA and (11) Manuscript Management: HA and OEA-O.
Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.
Competing interests None declared.
Provenance and peer review Not commissioned; externally peer reviewed.
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