Assessing the Diagnostic Imaging needs for Five Selected Hospitals in Uganda

Abstract

Introduction:Uganda has limited health resources. It is important to measure the need for imaging in order to set policy and plan for imaging services.Objectives:The first specific objective was to develop and apply four imaging needs indices on a case study basis, in five selected Ugandan hospitals. The indices were: Imaging Load (IL), Imaging Burden (IB), Type Specific Imaging Burden (TSIB), and Disease Specific Imaging Burden (DSIB). The second objective was to explore the perceptions of the patient, referring clinician, and radiologist regarding the values, meaning, and objective of imaging in patient care.Materials and Methods:This was a cross-sectional survey employing triangulation methodology, conducted in 5 Ugandan hospitals over a period of 3 years during 2005 - 2008. The subjects were divided into four clusters: Obstetrics and gynecology (obs/gynae), surgery, internal medicine, and pediatrics. For the quantitative component of the study, data from case notes was used to calculate the indices. The qualitative component explored the non-measurable aspects of imaging needs from the clinician's, radiologist's, and patient's perspective.Results:A total of 1961 patient case notes were studied. The IB was 460 per 1000 hospital patients per year. The highest TSIB was for ultrasound at 232 per 1000 hospital patients per year, followed by 191 patients for general X-ray. The majority of the patients interviewed had special desires, expectations, and misconceptions.Conclusions:There is a high IB of 460 per thousand patient populations per year, mainly due to ultrasound. The majority of the patients have perceptions, misconceptions, beliefs, and values which influence the need for imaging. There is a need to address the medical and non-tangible imaging needs of the patient and to counteract imaging-related misconceptions and over-expectations. Public awareness of the value, capabilities, limitations, and adverse effects of various imaging modalities need to be addressed to ensure that the patients make informed imaging choices and readily avail themselves of interventions in situations when imaging is crucial, for example in suspected high-risk pregnancy.

Clinical and cranial computed tomography scan findings in adults following road traffic accidents in Kampala, Uganda

“…This is in keeping with previous studies conducted in 2009 by Galukande and Naddumba 7,8 . Furthermore, the results indicate a male preponderance of 4.2:1, this is also similar to previous studies done in 1998 and 2004 in Uganda 7,8,10 . The typical cyclists who use bicycles and motorcycles in Kampala and surrounding areas were young adult males.…”

“…The occipital lobe and the cerebellum were the least injured areas of the brain. This distribution of the intra-parenchymal haemorrhage is consistent with studies done locally and internationally [8][9][10] . This could partly be explained by the mechanism of impact in boda boda cyclists who were the most common group involved in RTAs, they usually fall forwards or sideways.…”

“…These findings differ from previous studies where brain oedema and sub-dural haematoma were the most common CT findings 10 . This difference could probably be due to the change in motorisation pattern since the last study was done about 10 years ago in Uganda.…”

Training for Rural Radiology and Imaging in Sub-Saharan Africa: Addressing the Mismatch Between Services and Population

“…[8] The need for ultrasound and plain radiography in rural communities has been noted in other publications. [917–23]…”

Implementing a mobile diagnostic unit to increase access to imaging and laboratory services in western Kenya

“…In Uganda, for example, 56% of patients requiring imaging receive such services in urban areas compared with 10%–13% of patients in rural areas, and an estimated 90% of radiographs performed do not have an accompanying imaging report. 3 The optimal strategy to increase access to radiographic imaging in these settings is not well understood.…”