Improved oxygen systems at hospitals in three Nigerian states: An implementation research study.

INTRODUCTION: Hypoxemia is a life-threatening condition and is commonly seen in children with severe pneumonia. A government-led, NGO-supported, multifaceted oxygen improvement program was implemented to increase access to oxygen therapy in 29 hospitals in Kaduna, Kano, and Niger states. The program installed pulse oximeters and oxygen concentrators, trained health care workers, and biomedical engineers (BMEs), and provided regular feedback to health care staff through quality improvement teams. OBJECTIVE: The aim of this study is to evaluate whether the program increased screening for hypoxemia with pulse oximetry and prescription of oxygen for patients with hypoxemia. METHODOLOGY: The study is an uncontrolled before-after interventional study implemented at the hospital level. Medical charts of patients under 5 admitted for pneumonia between January 2017 and August 2018 were reviewed and information on patient care was extracted using a standardized form. The preintervention period of this study was defined as 1 January to 31 October 2017 and the postintervention period as 1 February to 31 August 2018. The primary outcomes of the study were whether blood-oxygen saturation measurements (SpO2 ) were documented and whether children with hypoxemia were prescribed oxygen. RESULTS: A total of 3418 patient charts were reviewed (1601 during the preintervention period and 1817 during the postintervention period). There was a significant increase in the proportion of patients with SpO2 measurements after the interventions were conducted (adjusted odds ratio [aOR] 5.0; 4.3-5.7, P < .001). Before the interventions, only 13.7% (95% confidence interval [CI]: 12.2-15.3) of patients had SpO2 measurements and after the interventions, 82.4% (95% CI: 80.7-84.1) had SpO2 measurements. Oxygen administration for patients with clinical signs of hypoxemia also increased significantly (aOR 5.0; 4.2-5.9, P < .001)-from 22.8% (95% CI: 18.8-27.2) to 77.9% (95% CI: 73.9-81.5). CONCLUSION: Increasing pulse oximetry and oxygen therapy access and utilization in a low-resourced environment is achievable through a multifaceted program focused on strengthening government-owned systems.

Nutritional performance and antioxidant activities of roasted and unroasted sprouted sorghum-based weaning diets in Wistar rats.

The nutritional performance and antioxidant profile of sprouted sorghum-based weaning diets were evaluated in weaning wistar rats. Rats were fed basal diet, unroasted germinated sorghum-based diet, roasted germinated sorghum-based diet, or a commercial weaning feed (nutrend) for 28 days. Energy, carbohydrate, crude protein, lipids, crude fiber, and ash contents of the sorghum-based diets compared significantly with FAO/WHO recommendations. Contrastingly, moisture content of the germinated sorghum-based diet was higher than the recommendation. Weight gain, feed efficiency ratio, protein efficiency ratio, net protein utilization, biological value, and digestibility of unroasted germinated sorghum-based diet-fed rats compared significantly with Nutrend. Roasted germinated sorghum-based diet produced differential effects on these indices. The unroasted germinated sorghum-based diet significantly raised the antioxidant enzymes in the rat liver and kidney. Overall, evidence from the study indicates that unroasted germinated sorghum-based diet improves the nutritional performance and the antioxidants of weaning rats compared to the roasted germinated sorghum-based diet. PRACTICAL APPLICATIONS: The provision of nutritionally adequate food from local sources during the weaning period of infants continues to be a major source of concern in developing countries. The formulated unroasted sprouted sorghum-based diet can be adapted and used as weaning food. Furthermore, the diet can be processed and developed into a weaning food.