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Usability of pulse oximeters used by community health and primary care workers as screening tools for severe illness in children under five in low resource settings: A cross-sectional study in Cambodia, Ethiopia, South Sudan, and Uganda

Timely recognition and referral of severely ill children is especially critical in low-resource health systems. Pulse-oximeters can improve health outcomes of children by detecting hypoxaemia, a severity indicator of the most common causes of death in children. Cost-effectiveness of pulse-oximeters...

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Autores principales: Pfurtscheller, Theresa, Baker, Kevin, Habte, Tedila, Lasmi, Kévin, Matata, Lena, Mucunguzi, Akasiima, Nicholson, Jill, Nuwa, Anthony, Petzold, Max, Posada González, Mónica, Sebsibe, Anteneh, Alfvén, Tobias, Källander, Karin
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10353789/
https://www.ncbi.nlm.nih.gov/pubmed/37463164
http://dx.doi.org/10.1371/journal.pgph.0001800
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author Pfurtscheller, Theresa
Baker, Kevin
Habte, Tedila
Lasmi, Kévin
Matata, Lena
Mucunguzi, Akasiima
Nicholson, Jill
Nuwa, Anthony
Petzold, Max
Posada González, Mónica
Sebsibe, Anteneh
Alfvén, Tobias
Källander, Karin
author_facet Pfurtscheller, Theresa
Baker, Kevin
Habte, Tedila
Lasmi, Kévin
Matata, Lena
Mucunguzi, Akasiima
Nicholson, Jill
Nuwa, Anthony
Petzold, Max
Posada González, Mónica
Sebsibe, Anteneh
Alfvén, Tobias
Källander, Karin
author_sort Pfurtscheller, Theresa
collection PubMed
description Timely recognition and referral of severely ill children is especially critical in low-resource health systems. Pulse-oximeters can improve health outcomes of children by detecting hypoxaemia, a severity indicator of the most common causes of death in children. Cost-effectiveness of pulse-oximeters has been proven in low-income settings. However, evidence on their usability in community health settings is scarce.This study explores the usability of pulse-oximeters for community health and primary care workers in Cambodia, Ethiopia, South Sudan, and Uganda. We collected observational data, through a nine-task checklist, and survey data, using a five-point Likert scale questionnaire, capturing three usability aspects (effectiveness, efficiency, and satisfaction) of single-probe fingertip and multi-probe handheld devices. Effectiveness was determined by checklist completion rates and task completion rates per checklist item. Efficiency was reported as proportion of successful assessments within three attempts. Standardized summated questionnaire scores (min = 0, max = 100) determined health worker’s satisfaction. Influencing factors on effectiveness and satisfaction were explored through hypothesis tests between independent groups (device type, cadre of health worker, country). Checklist completion rate was 78.3% [CI 72.6–83.0]. Choosing probes according to child age showed the lowest task completion rate of 68.7% [CI 60.3%-76.0%]. In 95.6% [CI 92.7%-97.4%] of assessments a reading was obtained within three attempts. The median satisfaction score was 95.6 [IQR = 92.2–99.0]. Significantly higher checklist completion rates were observed with single-probe fingertip devices (p<0.001) and children 12–59 months (p<0.001). We found higher satisfaction scores in South Sudan (p<0.001) and satisfaction varied slightly between devices. From a usability perspective single-probe devices for all age groups should be prioritized for scaled implementation. Further research on easy to use and accurate devices for infants is much needed.
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spelling pubmed-103537892023-07-19 Usability of pulse oximeters used by community health and primary care workers as screening tools for severe illness in children under five in low resource settings: A cross-sectional study in Cambodia, Ethiopia, South Sudan, and Uganda Pfurtscheller, Theresa Baker, Kevin Habte, Tedila Lasmi, Kévin Matata, Lena Mucunguzi, Akasiima Nicholson, Jill Nuwa, Anthony Petzold, Max Posada González, Mónica Sebsibe, Anteneh Alfvén, Tobias Källander, Karin PLOS Glob Public Health Research Article Timely recognition and referral of severely ill children is especially critical in low-resource health systems. Pulse-oximeters can improve health outcomes of children by detecting hypoxaemia, a severity indicator of the most common causes of death in children. Cost-effectiveness of pulse-oximeters has been proven in low-income settings. However, evidence on their usability in community health settings is scarce.This study explores the usability of pulse-oximeters for community health and primary care workers in Cambodia, Ethiopia, South Sudan, and Uganda. We collected observational data, through a nine-task checklist, and survey data, using a five-point Likert scale questionnaire, capturing three usability aspects (effectiveness, efficiency, and satisfaction) of single-probe fingertip and multi-probe handheld devices. Effectiveness was determined by checklist completion rates and task completion rates per checklist item. Efficiency was reported as proportion of successful assessments within three attempts. Standardized summated questionnaire scores (min = 0, max = 100) determined health worker’s satisfaction. Influencing factors on effectiveness and satisfaction were explored through hypothesis tests between independent groups (device type, cadre of health worker, country). Checklist completion rate was 78.3% [CI 72.6–83.0]. Choosing probes according to child age showed the lowest task completion rate of 68.7% [CI 60.3%-76.0%]. In 95.6% [CI 92.7%-97.4%] of assessments a reading was obtained within three attempts. The median satisfaction score was 95.6 [IQR = 92.2–99.0]. Significantly higher checklist completion rates were observed with single-probe fingertip devices (p<0.001) and children 12–59 months (p<0.001). We found higher satisfaction scores in South Sudan (p<0.001) and satisfaction varied slightly between devices. From a usability perspective single-probe devices for all age groups should be prioritized for scaled implementation. Further research on easy to use and accurate devices for infants is much needed. Public Library of Science 2023-07-18 /pmc/articles/PMC10353789/ /pubmed/37463164 http://dx.doi.org/10.1371/journal.pgph.0001800 Text en © 2023 Pfurtscheller et al https://creativecommons.org/licenses/by/4.0/This is an open access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Research Article
Pfurtscheller, Theresa
Baker, Kevin
Habte, Tedila
Lasmi, Kévin
Matata, Lena
Mucunguzi, Akasiima
Nicholson, Jill
Nuwa, Anthony
Petzold, Max
Posada González, Mónica
Sebsibe, Anteneh
Alfvén, Tobias
Källander, Karin
Usability of pulse oximeters used by community health and primary care workers as screening tools for severe illness in children under five in low resource settings: A cross-sectional study in Cambodia, Ethiopia, South Sudan, and Uganda
title Usability of pulse oximeters used by community health and primary care workers as screening tools for severe illness in children under five in low resource settings: A cross-sectional study in Cambodia, Ethiopia, South Sudan, and Uganda
title_full Usability of pulse oximeters used by community health and primary care workers as screening tools for severe illness in children under five in low resource settings: A cross-sectional study in Cambodia, Ethiopia, South Sudan, and Uganda
title_fullStr Usability of pulse oximeters used by community health and primary care workers as screening tools for severe illness in children under five in low resource settings: A cross-sectional study in Cambodia, Ethiopia, South Sudan, and Uganda
title_full_unstemmed Usability of pulse oximeters used by community health and primary care workers as screening tools for severe illness in children under five in low resource settings: A cross-sectional study in Cambodia, Ethiopia, South Sudan, and Uganda
title_short Usability of pulse oximeters used by community health and primary care workers as screening tools for severe illness in children under five in low resource settings: A cross-sectional study in Cambodia, Ethiopia, South Sudan, and Uganda
title_sort usability of pulse oximeters used by community health and primary care workers as screening tools for severe illness in children under five in low resource settings: a cross-sectional study in cambodia, ethiopia, south sudan, and uganda
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10353789/
https://www.ncbi.nlm.nih.gov/pubmed/37463164
http://dx.doi.org/10.1371/journal.pgph.0001800
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