Browsing by Author "Shapiro, Alyssa"

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    Avoid equipment graveyards: rigorous process to improve identification and procurement of effective, affordable, and usable newborn devices in low-resource hospital settings
    (Springer Nature, 2023) Asma, Elizabeth; Heenan, Megan; Banda, George; Kirby, Rebecca P.; Mangwiro, Lucky; Acemyan, Claudia Ziegler; Palamountain, Kara M.; Kortum, Philip; Kawaza, Kondwani; Oden, Z. Maria; Richards-Kortum, Rebecca; Brandt, Alexsandra; Kumara, Danica; Jin, Li; Khalid, Ali; Osoo, Cliff; Bisceglia, Nicki; Gate, Vince; Valle, Maureen; Mjumira, Rowland; Chapin, Abby; Shapiro, Alyssa; Samuel, Christina; Kimmey, David; Belton, M. Grant; Wang, Yifan Jack; Johnston, Jake; Anderson, Jessica; Bailey, Joseph; Coyle, Josh; Gordon, Kaede; Weld, Madeleine Tadros; Bond, Meaghan; Mitchell, Natalie; Mobarhan, Sara Liaghati; Salter, Sarah Elina; Matin, Shababa B.; Saenz, Sonia E. Sosa; Kalikoff, Sylvie; Boles, Taylor; Technical Collaborative Authorship Group; Rice360 Institute for Global Health Technologies
    Millions of newborns die annually from preventable causes, with the highest rates occurring in Africa. Reducing neonatal mortality requires investment to scale hospital care, which includes providing hospitals with appropriate technology to care for small and sick newborns. Expensive medical devices designed for high-resource settings often fail to withstand conditions in low-resource hospitals, including humidity, dust, frequent user turnover, complex maintenance, lack of stable power, or difficulty sourcing expensive consumables. Rigorous evaluation protocols are needed to identify effective, affordable, rugged, and easy-to-use medical devices appropriate for quality hospital-based newborn care in low-resource hospitals.
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    Evaluation of a Point-of-Care Test for Bilirubin in Malawi
    (American Academy of Pediatrics, 2022) Shapiro, Alyssa; Anderson, Jessica; Mtenthaonga, Prince; Kumwenda, Watson; Bond, Meaghan; Schwarz, Richard; Carns, Jennifer; Johnston, Ryan; Dube, Queen; Chiume, Msandeni; Richards-Kortum, Rebecca; Bioengineering; Rice 360 Institute for Global Health
    OBJECTIVES: BiliSpec is a low-cost spectrophotometric reader and disposable paper-based strip to quantify total serum bilirubin from several blood drops. This study was a prospective evaluation of BiliSpec in 2 neonatal wards in Malawi compared with a reference standard bilirubinometer over a large range of bilirubin and hematocrit levels. METHODS: The accuracy of BiliSpec and a transcutaneous bilirubinometer were compared with the reference standard of spectrophotometry for 475 blood samples collected from 375 subjects across a range of total serum bilirubin concentrations from 0.0 to 33.7 mg/dL. The development of error grids to assess the clinical effects of measurement differences is reported. RESULTS: BiliSpec was found to have a mean bias of −0.48 mg/dL and 95% limits of agreement of −5.09 mg/dL to +4.12 mg/dL. Results show 90.7% of BiliSpec measurements would have resulted in the same clinical decision as the reference standard, whereas 55.0% of transcutaneous bilirubin measurements would have resulted in the same clinical decision as the reference standard. CONCLUSIONS: This evaluation supports use of BiliSpec to provide accurate, low-cost, point-of-care bilirubin measurements in low-resource hospitals. Future work is needed to evaluate BiliSpec among a larger number of users.