Background: In Zambia, Computed Tomography (CT) has been available since 1994 as part of the healthcare delivery pathway. Radiographers undertake CT examinations of the body to diagnose diseases, injuries and to plan for radiotherapy.  Objective: The aim of this study was to audit CT services in Zambia.  Methodology: The study used a convergent parallel design in which quantitative and qualitative data were collected concurrently using an online questionnaire. Quantitative data were analysed using descriptive statistics, whilst qualitative data were analysed by themes.  Results: Out of the 23 facilities, a total of 22 responded. Results indicated that Western and Central provinces did not have CT scanners. Most CT facilities are in the Lusaka province. 59% (N=13) and 41% (N=9) were from the public and private sectors, respectively. In public hospitals, 46% (N=6) of CT scanners were functional with service contracts and 89% (N=8) were functional in the private hospitals with service contracts. 61.5 % (N=8) of public hospitals had maintenance schedules while 89% (N=8) of private hospitals had maintenance schedules. A total of 7 facilities reported having radiographers with a qualification in CT. 12 out of 22 facilities indicated having a radiologist with average patient waiting times for CT reports being 76 hours and 24 hours in public and private facilities, respectively.  Conclusion: This audit revealed an unequal distribution of CT scanners characterised by poor maintenance and lack of service contracts, especially in public hospitals. The audit also revealed longer waiting times for CT reports in public than in private hospitals.

Background: Globally, breast cancer among females is the number one cause of morbidity at 11.6% and is the leading cause of mortality at 6.6%. In Zambia, it is the most common malignancy among women. However, the demographic characteristics of suspected breast cancer female patients accessing ultrasound breast cancer services in Zambia are still unclear. Objective: This study aimed to determine the demographic characteristics of suspected female breast cancer patients. The demographic characteristics may then be used by responsible authorities such as the Ministry of Health (MoH) in Zambia and aligned Non-governmental organisations (NGOs) such as the Zambia cancer association in concentrating their efforts to curtail the scourge. Methods: Systematic random sampling was used for the selection of participants in this study. The selected participant’s demographic information was obtained from their medical records such as the medical files, Cancer Diseases Hospital (CDH) ultrasound register and University Teaching Hospital (UTH) histology registers. Further, the researcher personally interviewed the selected participants to obtain the demographic information required for the study. Results: The median age for the study participants was 43, with the interquartile range (IQR)=36-50. The median parity status was 3, with IQR=1-5. The majority of breast cancer patients were married (57) (55.9%) and employed (80) (78.4%). There was no significant difference in education level and classification of residence for study participants between participants with a histology-positive and histology-negative result, P greater than 0.05. Conclusion: This study has found evidence that the reproductive age group, low to no parity status, married marital status and employed employment status are associated with breast cancer. Education level and classification of residence did not show any association with breast cancer in this study.

Background: Breast cancer is the most common malignancy among women in Zambia. Ultrasound can be a useful tool for early diagnosis of breast cancer based on the breast lesions’ features. However, an overlap in the ultrasound features of malignant and benign breast tumours has been noticed together with a paucity of information on the ultrasound features that are more suggestive of breast cancer. Objective: The purpose of this study was to identify ultrasound features of suspected breast cancer lesions which may assist in ascertaining a high breast cancer or benign breast disease suspicion index, that may be used to prioritise patients requiring further and urgent management for breast cancer. Methods: Systematic random sampling was used for the selection of participants in this study. The selected patients first underwent an ultrasound scan in the Ultrasound department to obtain the breast lesion ultrasound features. The histology results for the same patients were then obtained from the University Teaching Hospital (UTH) histology laboratory or the histology report filed in the patient’s medical file. Results: Irregular shape of breast lesions, vertical orientation of breast lesions, hypoechogenicity of breast lesions, complex echo pattern of breast lesions, irregular or spiculated margin contours of breast lesions, compression of breast lesion surrounding tissue, absence of hyperechogenic spots in breast lesions and a breast lesion boundary with neither a hyperechoic halo nor thin capsule (None) were found to be associated with breast cancer. No breast lesion showed less than 3 ultrasound features suspicious for breast cancer. Hyperechoic spots in breast lesions were found to be associated with non-cancerous breast lesions. Conclusion: Low-resource countries, such as Zambia, where access to imaging diagnostic equipment such as Mammography and Magnetic Resonance Imaging machines (MRI), and histology examinations are scarce, the preceding ultrasound findings .......

Background: There is a critical shortage of radiologists in Zambia to report on all imaging examinations. Radiologists have concentrated on specialised imaging examinations, thereby leaving the interpretation of general radiography examinations to the referring medical practitioners, whose competence in image interpretation is not at the same level as radiologists. This can lead to misdiagnosis and mismanagement of patients.  Objective: This study aimed at determining the opinions of Zambian radiographers on extending their role in the interpretation and reporting of general radiographic images.  Methodology: This study was conducted using a cross-sectional survey approach. Data were collected using an online questionnaire. Radiographers with a minimum of two years’ work experience were invited to participate in the study. Both quantitative and qualitative data were collected. Descriptive statistics were used to analyse quantitative data, while thematic analysis was used for qualitative data.  Results: A total of 81 participants responded to the survey. A major finding showed that most radiographers (N=78, 95%) had a positive attitude towards image reporting because it improves the delivery of imaging services. Most of the radiographers were also willing to be trained at a postgraduate level (93%, N=76), and indicated the need to extend the scope of practice to include image reporting (N=78, 95%). The main challenges identified were inadequate advocacy and possible resistance from medical professions. Conclusion:  Radiographers are prepared to venture into image reporting. It is anticipated that this role extension can supplement radiologists in providing diagnostic reports and ensure that all patients have access to this service.