Gastrointestinal endoscopy capacity in Eastern Africa

Background and study aims Limited evidence suggests that endoscopy capacity in sub-Saharan Africa is insufficient to meet the levels of gastrointestinal disease. We aimed to quantify the human and material resources for endoscopy services in eastern African countries, and to identify barriers to exp...

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Autores principales:	Michael Mwachiro, Hillary M. Topazian, Violet Kayamba, Gift Mulima, Elly Ogutu, Mengistu Erkie, Gome Lenga, Thomas Mutie, Eva Mukhwana, Hailemichael Desalegn, Rezene Berhe, Berhane Redae Meshesha, Bongani Kaimila, Paul Kelly, David Fleischer, Sanford M. Dawsey, Mark D. Topazian
Formato:	article
Lenguaje:	EN
Publicado:	Georg Thieme Verlag KG 2021
Materias:	Diseases of the digestive system. Gastroenterology RC799-869
Acceso en línea:	https://doaj.org/article/aed35a24b201441c9cb0548d2506dedd
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spelling	oai:doaj.org-article:aed35a24b201441c9cb0548d2506dedd2021-11-13T00:00:31ZGastrointestinal endoscopy capacity in Eastern Africa2364-37222196-973610.1055/a-1551-3343https://doaj.org/article/aed35a24b201441c9cb0548d2506dedd2021-11-01T00:00:00Zhttp://www.thieme-connect.de/DOI/DOI?10.1055/a-1551-3343https://doaj.org/toc/2364-3722https://doaj.org/toc/2196-9736Background and study aims Limited evidence suggests that endoscopy capacity in sub-Saharan Africa is insufficient to meet the levels of gastrointestinal disease. We aimed to quantify the human and material resources for endoscopy services in eastern African countries, and to identify barriers to expanding endoscopy capacity. Patients and methods In partnership with national professional societies, digestive healthcare professionals in participating countries were invited to complete an online survey between August 2018 and August 2020. Results Of 344 digestive healthcare professionals in Ethiopia, Kenya, Malawi, and Zambia, 87 (25.3 %) completed the survey, reporting data for 91 healthcare facilities and identifying 20 additional facilities. Most respondents (73.6 %) perform endoscopy and 59.8 % perform at least one therapeutic modality. Facilities have a median of two functioning gastroscopes and one functioning colonoscope each. Overall endoscopy capacity, adjusted for non-response and additional facilities, includes 0.12 endoscopists, 0.12 gastroscopes, and 0.09 colonoscopes per 100,000 population in the participating countries. Adjusted maximum upper gastrointestinal and lower gastrointestinal endoscopic capacity were 106 and 45 procedures per 100,000 persons per year, respectively. These values are 1 % to 10 % of those reported from resource-rich countries. Most respondents identified a lack of endoscopic equipment, lack of trained endoscopists and costs as barriers to provision of endoscopy services. Conclusions Endoscopy capacity is severely limited in eastern sub-Saharan Africa, despite a high burden of gastrointestinal disease. Expanding capacity requires investment in additional human and material resources, and technological innovations that improve the cost and sustainability of endoscopic services.Michael MwachiroHillary M. TopazianViolet KayambaGift MulimaElly OgutuMengistu ErkieGome LengaThomas MutieEva MukhwanaHailemichael DesalegnRezene BerheBerhane Redae MesheshaBongani KaimilaPaul KellyDavid FleischerSanford M. DawseyMark D. TopazianGeorg Thieme Verlag KGarticleDiseases of the digestive system. GastroenterologyRC799-869ENEndoscopy International Open, Vol 09, Iss 11, Pp E1827-E1836 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Diseases of the digestive system. Gastroenterology RC799-869
spellingShingle	Diseases of the digestive system. Gastroenterology RC799-869 Michael Mwachiro Hillary M. Topazian Violet Kayamba Gift Mulima Elly Ogutu Mengistu Erkie Gome Lenga Thomas Mutie Eva Mukhwana Hailemichael Desalegn Rezene Berhe Berhane Redae Meshesha Bongani Kaimila Paul Kelly David Fleischer Sanford M. Dawsey Mark D. Topazian Gastrointestinal endoscopy capacity in Eastern Africa
description	Background and study aims Limited evidence suggests that endoscopy capacity in sub-Saharan Africa is insufficient to meet the levels of gastrointestinal disease. We aimed to quantify the human and material resources for endoscopy services in eastern African countries, and to identify barriers to expanding endoscopy capacity. Patients and methods In partnership with national professional societies, digestive healthcare professionals in participating countries were invited to complete an online survey between August 2018 and August 2020. Results Of 344 digestive healthcare professionals in Ethiopia, Kenya, Malawi, and Zambia, 87 (25.3 %) completed the survey, reporting data for 91 healthcare facilities and identifying 20 additional facilities. Most respondents (73.6 %) perform endoscopy and 59.8 % perform at least one therapeutic modality. Facilities have a median of two functioning gastroscopes and one functioning colonoscope each. Overall endoscopy capacity, adjusted for non-response and additional facilities, includes 0.12 endoscopists, 0.12 gastroscopes, and 0.09 colonoscopes per 100,000 population in the participating countries. Adjusted maximum upper gastrointestinal and lower gastrointestinal endoscopic capacity were 106 and 45 procedures per 100,000 persons per year, respectively. These values are 1 % to 10 % of those reported from resource-rich countries. Most respondents identified a lack of endoscopic equipment, lack of trained endoscopists and costs as barriers to provision of endoscopy services. Conclusions Endoscopy capacity is severely limited in eastern sub-Saharan Africa, despite a high burden of gastrointestinal disease. Expanding capacity requires investment in additional human and material resources, and technological innovations that improve the cost and sustainability of endoscopic services.
format	article
author	Michael Mwachiro Hillary M. Topazian Violet Kayamba Gift Mulima Elly Ogutu Mengistu Erkie Gome Lenga Thomas Mutie Eva Mukhwana Hailemichael Desalegn Rezene Berhe Berhane Redae Meshesha Bongani Kaimila Paul Kelly David Fleischer Sanford M. Dawsey Mark D. Topazian
author_facet	Michael Mwachiro Hillary M. Topazian Violet Kayamba Gift Mulima Elly Ogutu Mengistu Erkie Gome Lenga Thomas Mutie Eva Mukhwana Hailemichael Desalegn Rezene Berhe Berhane Redae Meshesha Bongani Kaimila Paul Kelly David Fleischer Sanford M. Dawsey Mark D. Topazian
author_sort	Michael Mwachiro
title	Gastrointestinal endoscopy capacity in Eastern Africa
title_short	Gastrointestinal endoscopy capacity in Eastern Africa
title_full	Gastrointestinal endoscopy capacity in Eastern Africa
title_fullStr	Gastrointestinal endoscopy capacity in Eastern Africa
title_full_unstemmed	Gastrointestinal endoscopy capacity in Eastern Africa
title_sort	gastrointestinal endoscopy capacity in eastern africa
publisher	Georg Thieme Verlag KG
publishDate	2021
url	https://doaj.org/article/aed35a24b201441c9cb0548d2506dedd
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Gastrointestinal endoscopy capacity in Eastern Africa

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