A simple, low-cost bottle ‘spacer’ promises to save thousands of lives in South Africa by making the treatment of asthma more effective and safer. In a bid to improve the lives of people with asthma and prevent any possible unnecessary spread of the coronavirus, the Allergy Foundation South Africa (AFSA) is urgently rolling out the distribution of these plastic bottle spacers to public health facilities around the country.
Using plastic bottle spacers for the treatment of asthma has been pioneered by Red Cross War Memorial Children’s Hospital, Cape Town and used successfully for some time. With the COVID-19 pandemic, it became critical to fast-track wider distribution.
Traditionally, asthma medication is self-administered, pumped into the mouth using a small, hand-held inhaler. Inhalers are portable and convenient, but medication tends to mainly reach the back of the throat rather than the lungs, where it is most needed.
A nebuliser is more effective at pushing medication into the lungs and is often used in hospital and emergency situations. However, because a nebuliser sprays the patient’s breath into the air, it can potentially spread coronavirus and other germs, putting healthcare workers and fellow patients at risk.
A spacer attached to the patient’s inhaler is an efficient alternative. Medication is pumped from the inhaler into an empty chamber and the patient breathes it in, reaching the lungs without spraying micro-droplets into the air.
South Africa has one of the highest asthma death rates in the world, with around 15, 000 deaths each year. “It is conservatively estimated that 80% of asthma deaths could be prevented, especially with better treatment and access to medication,” says Professor Michael Levin, Head of Allergy at Red Cross War Memorial Children’s Hospital and CEO of Allergy Foundation South Africa.
“We’ve been using bottle spacers at Red Cross since Professor Heather Zar pioneered them in the late 1990s and know they work. The challenge was how to produce them cheaply in the quantities that would be required for the public health service” says Prof Levin.
“Thanks to modern technology we’ve been able to create an affordable and recyclable solution that works as well as commercial spacers.” The custom blow-mould base, produced by Polyoak Packaging and Habitat Industries, has an inhaler size attachment hole, making it simple to attach any inhaler.
AFSA is working to make the bottle spacers available throughout the country and the project has been enthusiastically supported by the Provincial Governments of the Western Cape, Gauteng and KwaZulu-Natal. So far 3, 000 bottle spacers have been distributed to public hospitals in Cape Town and a further 10 000 are available for Western Cape hospitals and clinics in preparation for the projected spike of respiratory infections in the winter months. In Gauteng, 20 000 spacers have been produced and a team of volunteers, organized by Professors Robin Green, Izelle Smuts and Ronel Herselman of the University of Pretoria Faculty of Health Sciences, are arranging distribution. Next, the moulds are going to KwaZulu-Natal for another batch to be produced.
Professor Andre Van Niekerk, head of the Allergy Society of South Africa, endorses the new device: “The bottle spacers will help make the treatment of acute and chronic asthma much more effective. Inhaled steroids are safe, even when people have coronavirus or other viral infections. Asthma sufferers should use their pumps daily to keep asthma well-controlled and prevent having to go to hospital during this time.”