Vesicoureteric reflux is an important association of paediatric urinary tract infection. Fluoroscopic micturating cystourethrography and radionuclide cystography have been employed for detecting and grading vesicoureteric reflux. However, both modalities involve ionising radiation, which can pose significant radiation risk to growing children. They also have a lower detection rate due to intermittent fluoroscopic technique in micturating cystourethrography, and lower spatial resolution in radionuclide cystography. Therefore, newer radiation-free ultrasound-based contrast-enhanced voiding urosonography has been developed in Europe for 15 years. This article aimed to summarise the current literature and discuss the first local pilot study in our institution on detection of vesicoureteric reflux by contrast-enhanced voiding urosonography. Contrast-enhanced voiding urosonography is a valid alternative to micturating cystourethrography in assessing vesicoureteric reflux, based on its superior diagnostic performance, reliability, safety, feasibility, and radiation safety for children. Therefore, it should be incorporated in the guideline for investigating paediatric urinary tract infection.

Objectives: Reduction of child mortality rates, to improve maternal health, to sustain post millennium goals 2015, to revitalize Kenya"s health infrastructure as part of Kenya"s Vision 2030. Methods: Ultrasound services were introduced at Elgeyo. Data sheets for each ultrasound scan performed during routine clinical care were collected and analyzed to determine patient demographics, which ultrasound applications were most frequently used, and whether the use of the ultrasound changed patient management plans. Ultrasound scans performed by the Sono Imaging Kenya during the period were reviewed for accuracy of interpretation and image quality by a specialist. Results: Adult women appeared to benefit most from the presence of ultrasound services. During these outreaches a total of 247 women were scanned. Twenty percent of these scans showed abnormalities. These woman were referred to the nearest health center or hospital where they received more check-ups. Conclusions: We suggest ultrasound is a useful modality that particularly benefits women's health and obstetrical care in the developing world, it appears that an ultrasound program led by Sono Imaging Kenya is sustainable and lead to accurate diagnoses in a rural international setting. Ultrasound training in a rural setting supported remotely is feasible, efficient, and sustainable. It can help local healthcare workers and therefore has the potential to improve outcomes at delivery and provide site-specific epidemiologic data that can be used to develop new healthcare provision strategies.