Tropical Health Matters

NCDs are increasingly being recognized as health problems in Nigeria and other LMICs.  Here, Bolanle Akinyele, Olufunso Odunukan, Oluwaseyi Bolorunduro, and William Brieger describe a Pilot project to help high school students learn to perform CPR through a Combination Virtual and In-person Learning. This is being presented at the 2021 American Society of Tropical Medicine and Hygiene Annual Meeting.

Out-of-hospital cardiac arrest (OHCA) is estimated to have an average global incidence of 55 adults per 100,000 person-years. However, despite advances in medical care and technology, survival to hospital discharge remains abysmally low at 8-10%. In low to middle income countries like Nigeria, where cardiovascular disease is rising but emergency response systems are poor, the rate of survival after OHCA is lower.

Interventions such as bystander cardiopulmonary resuscitation (CPR) training and automated external defibrillator (AED) use are effective, scalable, and low-cost interventions that can reduce the OHCA mortality. Training schoolchildren to perform Hands-only CPR has been shown to increase bystander CPR.

Cardiopulmonary Resuscitation Peer Educator’s Program (CPEP) is a community-based program in Ibadan, Nigeria, designed enhance understanding of CPR in secondary school students. The American Heart Association’s school health module was adapted. The training was run jointly by staff of the four pilot schools, a Nigerian NGO, and the Revolving Hearts Foundation, Atlanta.

The training had both in-person and virtual components due to COVID-19 travel restrictions on Atlanta based partners. Here we present the results of training on knowledge, comfort level and perceived barriers of performing hands-only CPR.

A pre-training survey was conducted in February 2021 using convenience sampling that also was used to recruit participants. Pre- and post- training responses were matched by participants to assess the changes. Data were analyzed using Stata 16.1 software. A paired t-test analysis was conducted. The primary outcome was a percentage change in mean knowledge scores and secondary outcome was a change in comfort level and perceived barriers pre- and post- training.

A total of 45 secondary school students from 4 schools completed the tests. Females comprised 31.1% of students and the average age was 15.02 + 0.18 years. Paired t-test showed a significant change of 44.6% (p <0.0001) in the mean knowledge score. There was also an increase in comfort level in performing hands-only CPR, and a decrease in perceived barriers.

Trainees have started sharing what they learned through skits at school assemblies. Planning is underway to follow-up on training and to expand to other schools and states.

PS: as a followup another training session with a new group of 45 students and 15 teachers was conducted. The students made videos of their understanding of CPR from the program so it could be used for peer education, and most of them were pretty good and creative.

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