Caffeine for the care of preterm infants in sub-Saharan Africa: a missed opportunity?

Abstract

In 2019, 2.4 million neonates (infants< 28 days of age) died globally. Of these, over 80% were preterm infants (< 37 weeks gestation), with the majority born in low-income and middle-income countries. 1 Complications of preterm birth, largely from respiratory distress syndrome due to surfactant deficiency, pneumonia or apnoea of prematurity (AOP), are now the leading cause of under 5 mortality globally. 1 These conditions are frequently fatal in the absence of effective ventilatory support which is commonplace in neonatal units across sub-Saharan Africa. Although the global neonatal mortality rate (NMR) has halved over the past three decades, significant regional disparities remain. These correlate with World Bank and International Monetary Fund estimates of the proportion of the population living on less than US $1.90 a day, with the majority of poorer countries being in sub-Saharan Africa. 1 2 As the …