A. Trilling

D. Opie

J. Bernstein

M. Shomali

T. Avasthi

Annals of Global Health

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188 I n n o v a t i o n s /New Te chn o l o g i e s / Imp r o v em en t S c i e n c emeasurements. But measuring boards are large and cumbersome touse in the field and children may be restless or afraid to use them.Alternative strategies that light, portable and provide accurate mea-surement under field conditions should be explored. Advances in lasermeasuring technology make the use of lasers one promising method.We tested the Leica Disto D2 Laser Distance Meter 763495 as a tool toquantify children’s’ height/length. The aim of the study was to deter-mine and evaluate the instrument’s accuracy and reliability withinanthropometric field studies. To determine the acceptability of thismethod, a qualitative investigation of the proposed technology andmeasuring boards was assessed among field researchers.Methods: This study was conducted in Western Kenya in primaryschools and clinical settings. The production laser model was modifiedto suit anthropometric requirements and was tested against a ShorrBoard. Two experiments were carried out to systematically pilot theLeica Disto D2 Laser tool. Experiment 1 focused on the assessment oftool accuracy tested by measuring the laser tool compared the Shorrboard differences. Study researcher measured (N¼62) children be-tween the ages of 0 months e 8 years old. Experiment 2 assessedreproducibility of results within trained field staff. Reproducibility wastested by field assistant (n¼6) measurements of children (n¼15) over 3days between the laser and measurement board tools. 77 study par-ticipants were recruited from schools and clinics within the ages of0 months to 8 years old. Experiment 1 differences in measurementsbetween tools were calculated and statistically analyzed for significance.Experiment 2 variance components, reliability coefficients (R) andcoefficients of variation (CV) were estimated and systematic differencesof measurements between field staff and study day were assessed.Findings: Preliminary statistical evaluations suggest that the LeicaDisto D2 Laser Distance Meter 763495 represents an adequatetechnical alternative to the standard methods currently used.Interpretation: This study demonstrates the importance of innova-tion within the field of anthropometrics. Current methods areoutdated, while technological advances are available and affordable.Leica Disto D2 Laser Distance Meter 763495 could be a viablealternative that can adequately measure height/length accurately andreliably, while being an affordable and portable alternative to currentmeasuring methods ideal for fieldwork in low-resourced countries.Funding: National Institutes of Health, R15 AI100118-01.Abstract #: 02ITIS003Adaptation of new sterilization technology to facilitatesterile surgical care in low-resource settingsJ. Bernstein1, M. Shomali1, D. Opie2, T. Avasthi1, A. Trilling1; 1EniwareLLC, Washington, DC/US, 2Noxilizer, Inc., Baltimore, MD/USBackground: A significant and growing portion of the globalburden of disease is attributable to conditions that can be treated withbasic surgical procedures. Poor infrastructure and resource limitationsin healthcare settings around the world present obstacles to the de-livery of this cost-effective care. To date, one of these obstacles hasbeen the sterilization of surgical instruments where availability ofelectricity and water is unreliable. Without sterilization capabilities,surgical care presents a high risk of infection, causing furthermorbidity and mortality. Innovation in sterilization technology hasbeen static, and established methods have not been successfullyadapted for use in low-resource settings on a large scale. The devel-opment of reliable, durable, affordable sterilization equipment thatcan operate independently of infrastructure would facilitate safe sur-gical care for the two billion people who currently lack access. Thisstudy was done to determine the appropriateness of a new sterilizationtechnology to meet this need. The authors believe that nitrogen di-oxide technology can be adapted for reliable sterilization in low-resource settings.Methods: Recently commercialized nitrogen dioxide sterilizationtechnology was adapted into a form suitable for use in low-resourceenvironments, which was then analyzed for sterilization efficacy,operator safety, and preservation of medical instrument functionality.Stainless steel surgical instruments were exposed to NO2 within arugged enclosure. Lab testing was conducted in microbiologicaltesting facilities simulating low-resource environments and in accor-dance with the requirements of the international sterilization standardANSI/AAMI/ISO. The hinges of the instruments, determined to bethe most challenging location for sterilization, and biological in-dicators (BIs) were evaluated for successful sterilization.Findings: Results of cycle efficacy testing showed that all hinges weresterile at the conclusion of the cycle. Cycle length depended on theamount of time needed for the sterilant gas to be absorbed by thescrubber medium to a safe level. This took between three to eighthours depending on cycle exposure requirements. A few of the cycleswith exposure to lower concentrations of NO2 had surviving BIs,which was attributed to the high density of spores on the BI.Interpretation: When deployed, NO2 sterilization technology willhave the twin benefits of reducing healthcare acquired infections andlimiting a major constraint for access to surgical care on a global scale.Additional benefits are achieved in reducing costs and bio-hazardwaste generated by current health care initiatives that rely primarily ondisposable kits, increasing the effectiveness and outreach of theseinitiatives. Next steps will involve testing of the adapted NO2 formfactor for ease of use in the field.Funding: Eniware, LLC.Abstract #: 02ITIS004Food fortification as a strategy for alleviatingmicronutrient deficiencies in low- and middle-incomecountries: A systematic reviewZ. Bhutta1, A.J. Prashad2, K. Wazny3, E. Keats4, A. Huynh4, D. A5,A. Parnia1, H. Pitchik6, J. Das7; 1Dalla Lana School of Public Health,University of Toronto, Toronto, ON/CA, 2Center for Global ChildHealth, Maple, ON/CA, 3Center for Global Child Health, Toronto,ON/CA, 4Dalla Lana Faculty of Public Health, Toronto, ON/CA,5Windsor University, Toronto, ON/CA, 6Harvard University, Toronto,ON/CA, 7Aga Khan University, Karachi, PKBackground: Currently, the World Health Organization (WHO)estimates that over 2 billion people are deficient in key vitamins andminerals. The majority of these individuals live in low and middle-income countries (LMICs), where resources are scarce and diets arenot diversified. Mass food fortification refers to the process wherebyone or more essential micronutrients are added during production to astaple food or condiment in order to improve its nutritional quality.This is a safe and effective strategy that has been used to preventmicronutrient deficiencies in developed countries for more than acentury. The objectives of the systematic review as a whole are toevaluate the effectiveness of mass food fortification efforts with keymicronutrients (iron, folic acid, iodine, vitamin A, calcium, vitamin Dor multiple micronutrients) in LMICs, and to describe the variouscontextual and design factors that contribute towards effective imple-mentation of food fortification programs. This abstract will pertainspecifically to the effects of folic acid fortification on neural tube defects.Methods: Study Design A comprehensive search strategy wasformulated and publications systematically retrieved from a total of 15

Adaptation of new sterilization technology to facilitate sterile surgical care in low-resource settings

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Adaptation of new sterilization technology to facilitate sterile surgical care in low-resource settings

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