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The potential for patient dose reduction in diagnostic radiology was investigated in five major Tanzanian hospitals. The aim of this study was to follow up previously reported suggestions for improved practices to achieve dose reductions. The suggestions were implemented and entrance surface dose measurement repeated by using well-calibrated LiF thermoluminescence dosemeters. The results show that dose reductions in chest PA X ray examinations ranged from 15% to 50%. For abdomen AP and pelvis AP X ray examinations, the dose reductions ranged from 24% to 73% and from 25% to 72%, respectively. The respective dose reductions for lumbar spine AP and LAT projections ranged from 4% to 58% and from 16% to 77%. Interestingly, the majority of radiographs obtained after the implementation of dose reduction measures were useful for intended diagnosis according to the opinion of radiologists. It is concluded that significant dose reductions can be achieved in the country without loss of diagnostic information. Such dose reductions also predict reductions of radiation risk to patients.

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Objective assessment of the quality of radiographic images is practically a difficult task and protocols that address this problem are few. In 1996, the European union published nearly objective image quality criteria to unify the practices in Europe. However, experience with these criteria in countries of lower health care levels is little documented. As a case study in Tanzania, we present the general performance of European guidelines in some Tanzanian hospitals to a total of 200 radiographs obtained from some common x‐ray examinations. The results show that more than 70% of chest (PA), lumbar spine (AP), and pelvis AP radiographs passed the quality criteria, while the performance of lumbar spine LAT x‐ray examinations was about 50% and therefore less satisfactory. The corresponding mean entrance dose to the patient for specified x‐ray techniques was of range 0.08–0.56 mGy, 3.1–7.7 mGy, 2.53–5.4 mGy, and 4.0–16.78 mGy for chest PA, lumbar spine AP, pelvis AP and lumbar spine LAT x‐ray examinations, respectively. Although a good number of observers were not well familiar to the guidelines, the quality criteria have been found useful and their adoption in the country recommended. The need to provide relevant education and training to staff in the radiology departments is of utmost importance.PACS number(s): 87.57.–s, 87.52.–g