Table 3.
Studies included in the review
| Reference | Research design | Sample | Location | Facility level | Device used | Quality assessment |
|---|---|---|---|---|---|---|
| Abdulkadir et al. [19] | Descriptive case study | Male newborn (1 h old) with idiopathic respiratory distress syndrome | Ahmadu Bello University Teaching Hospital (ABUTH), Nigeria | Tertiary | Bubble CPAP system not described | Poor quality |
| Abdulkadir et al. [20] | Descriptive case series of neonates who received nasal bubble CPAP | 20 spontaneously breathing newborns with respiratory distress over 1-year period from 1 June 2012 to 31 May 2013 | Ahmadu Bello University Teaching Hospital (ABUTH), Nigeria | Tertiary | Improvised water bottle system | Fair quality |
| Amadi et al. [21] | Quasi-experimental study comparing politeCPAP outcomes with standard care (improvised bubble CPAP system) | 57 neonates with RDS who met eligibility from three hospitals, dates unknown | Multiple locations, Nigeria | Tertiary | Low-cost standalone system—politeCPAP | Poor quality |
| Audu et al. [22] | Descriptive case series of neonates who received nasal bubble CPAP | 48 babies admitted into newborn unit with respiratory distress over a 6-month period, dates unknown | National Hospital Abuja, Nigeria | Tertiary | Improvised water bottle system | Fair quality |
| Brown et al. [23] | Descriptive case study | A full-term neonate with respiratory distress caused by congenital pneumonia | Queen Elizabeth Central Hospital, Malawi | Tertiary | Low-cost standalone system—Pumani | Poor quality |
| Crehan et al. [24] | Quasi-experimental study comparing nurses’ assessments with new decision-aid with a paediatrician’s assessment | 57 neonates who received joint assessments by nurses and paediatrician, 27 April to 15 June 2015 | Zomba District Hospital, Malawi | Secondary | Low-cost standalone system—Pumani | Poor quality |
| Fulton and Lavalette [25] | Pre and post study with follow-up 6 months after interventions introduced | 58 neonates in October 2012 and 55 neonates in February 2013 | Felege Hiwot Referral Hospital, Ethiopia | Tertiary | Improvised water bottle system | Poor quality |
| Gondwe et al. [26] | Observational phenomenological study with in-depth semi-structured interviews | 12 caregivers of infants in Chatinkha nursery (0–28 days) and paediatric nursery (0–6 months) that improved on bCPAP January to February 2015 | Queen Elizabeth Central Hospital, Malawi | Tertiary | Low-cost standalone system—Pumani | Poor quality |
| Kawaza et al. [5], Chen et al. [27] | Quasi-experimental study with allocation to CPAP based on availability of equipment [5] with an economic evaluation [28] | 87 neonates (62 bCPAP and 25 nasal oxygen) over a 10 month period from January 2012 to October 2012 | Queen Elizabeth Central Hospital, Malawi | Tertiary | Low-cost standalone system—Pumani | Fair quality |
| McAdams et al. [29] | Descriptive case series of neonates who received nasal bubble CPAP | 21 neonates starting < 3 days of age in NICU from January to June 2012 | Kiwoko Hospital, Uganda | Secondary (rural referral hospital) | Improvised water bottle system | Fair quality |
| Myhre et al. [12] | Pre and post introduction of bCPAP retrospective chart review | All preterm infants diagnosed with RDS consisting of 46 infants enrolled from 1 November 2007 to 30 April 2009 before and 72 infants enrolled from 1 November 2009 to 30 April 2011 after introduction of bCPAP | AIC Kijabe Hospital, Kenya | Secondary (rural referral hospital) | Improvised water bottle system | Fair quality |
| Nabwera et al. [30] | Observational cross-sectional survey with a structured assessment tool and qualitative key informant interviews and focus group discussions | 39 neonates who received bubble CPAP between March and May 2017; 19 (of 23) tertiary level hospitals in Kenya surveyed | Multiple locations, Kenya | Tertiary level hospitals | Majority (93%) used commercial bubble CPAP systems | Fair quality |
| Nahimana et al. [31] | Observational retrospective chart review of all newborns admitted to neonatal units in three rural hospitals | 43 infants initiated on bubble CPAP admitted between 1 February to 31 October 2013 (136 preterm and very low birthweight admitted overall) | Butaro, Kirehe and Rwinkwavu District Hospitals, Rwanda | Secondary (rural district hospitals) | Bubble CPAP system not described | Fair quality |
| Ntigurirwa et al. [32] | Pre and post clinical audits with follow-up 18 months after interventions introduced | 365 infants in the first 18 months of introduction between February 2012 and January 2014 | Two university hospitals and two district hospitals, Rwanda | Tertiary and secondary | Commercial bubble CPAP system—Fisher Paykel | Fair quality |
| Okonkwo and Okolo [33] | Observational cross-sectional survey administered to attendees during the 2015 Paediatric Association of Nigeria Conference (PANCONF) | 237 questionnaires returned by doctors and nurses | 54 health facilities from six geopolitical regions of Nigeria | Mostly public (87%) tertiary hospitals (76%) | Improvised water bottle system vs commercial bubble CPAP system—Fisher Paykel | Poor quality |
| Olayo et al. [28] | Quasi-experimental study that compared knowledge and skill of first and second-generation health professionals trained | 37 (16 nurses, 21 physicians, medical/clinical officers) first-generation trained July 2014 to August 2015 and 40 (19 nurses, 21 physicians, medical/clinical officers) second generation | Multiple locations, Kenya | Tertiary | Commercial bubble CPAP system—DeVilbiss IntelliPAP | Poor quality |
| van den Heuvel et al. [34] | Descriptive case series of neonates who received nasal bubble CPAP | 11 neonates during a 7-week introduction period from 11 March to 27 April 2008 | Queen Elizabeth Central Hospital, Malawi | Tertiary | Improvised water bottle system | Fair quality |