To strengthen patient radiation protection and control of medical exposure, in the Haute Matsiatra region, Fianarantsoa District, Madagascar, we have carried out a study to develop a protocol for dose assessment in diagnostic radiology in order to ensure good radiological practice. In this region, no studies have ever been done in their radiology department. The patient entrance dose (D e ) is one of the basic dosimetric quantities for measuring the dose delivered to the patients. Therefore, to assess the patient entrance dose (D e ), we have chosen two hospitals such as the Andrainjato University Hospital Center (CHUA) and the Tambavao University Hospital Center (CHUT). We have chosen four most requested radilogicals examinations (Skull, Thorax, abdomen and pelvis) and we have evaluated the entrance doses of patient and we have compared the result found to the Diagnostic Reference Levels (DRL) recommended by the IAEA for each examination. We found that, the average doses delivered to the patients during their radiographic examinations, were below the reference doses recommended by the IAEA. For this comparison carried out in these two hospitals, we can be confirmed that the values obtained can be useful for the application of regulations on the patient radiation protection and the control of medical exposure in Fianarantsoa.

The medical use of ionizing radiation is the largest and a growing man-made source of radiation exposure. The aim of this study is to assess the doses received by patients during radiological examinations in order to standardize the examination procedures and optimize the patient dose. Four most frequented hospitals, located in the Vakinankaratra and Haute Matsiatra regions of Madagascar, were investigated. Patients dose undergoing chest posterior-anterior (PA) and lateral (LAT), skull (PA, LAT), lumbar spine (PA, LAT), spine cervical (PA, LAT), abdomen (AP, LAT) and members (AP, PA, LAT) X-ray examinations were involved in this study. Entrance Skin Dose (ESD) was calculated using the X-ray radiation output and the exposure parameters (high voltage, tube loading, focus-patient distance). Thermoluminescent dosimeters were used to measure the X-rays radiation output. Conversion coefficients were used to relate ESD to the effective dose (ED). A total of 302 radiographic examinations were collected from the four hospitals during two months of 2019. The highest ESD (mGy) was found for the lumbar spine lateral projection, with an average value of 2.66 mGy. The highest value of ED was observed for the abdomen lateral projection with an average of 0.174 mSv. The ESDs and EDs reported in this study are generally lower than reference dose values published by the IAEA. This trend is an indication that the patient radiation protection practices in these four hospitals are already acceptable. The results of this study showed that there is a need to improve the radiodiagnostic procedures for reducing patient radiation dose without affecting the quality of the radiography image. The data of this work will be useful in contributing to the formulation of regional guidance levels.