Gastrointestinal endoscopy in Nigeria - a prospective two year audit

Abstract

IntroductionGastrointestinal (GI) endoscopy is currently performed by different specialties. Information on GI endoscopy resources in Nigeria is limited. Training, cost, availability and maintenance of equipment are some unique challenges. Despite these challenges, the quality and completion rates are important.MethodsProspective audit of endoscopic procedures by an endoscopist in a Nigerian hospital over a 24 month period.ResultsOne hundred and ninety endoscopic procedures were performed in 187 patients (109 male, 78 female) by a surgeon during this period. Mean age was 47.6 years (range 17 - 90 years). All patients were symptomatic. One hundred and twenty-two procedures (64.2%) were upper GI endoscopy, 52 (27.4%) colonoscopy and 16 (8.4%) sigmoidoscopy. Majority of endoscopies 182 (95.8%) were performed electively and only 7 (3.7%) were therapeutic. Upper GI endoscopy findings included 14 (11.5%) cases of peptic ulcer disease, 5 complicated by gastric outlet obstruction, and 21 (17.3%) cases of upper gastrointestinal cancer. Lower gastrointestinal endoscopy findings included 7 cases of polyps, 3 cases of colorectal cancer and 2 cases of diverticulosis. Commonest lesion on lower GI endoscopy was haemorrhoids (41.7%). Adjusted caecal intubation was 81.4% for colonoscopies performed. Overall adenoma detection rate for male and female patients were 18.2% and 5.3% respectively; in patients over 50 years these were 6.3% and 14.3%. Two complications, rupture of oesophageal varices, and respiratory arrest in bulbar palsy patient occurred.ConclusionAn endoscopist can perform GI endoscopy effectively in developing countries like Nigeria but attention to equipment need and training is important.

Upper Gastrointestinal Endoscopy at University Hospital Souro Sanou Bobo-Dioulasso (Burkina Faso), about 1022 Cases: Signs and Lesions Observed

“…This frequency is close to those of other authors [6] [8] [11] [19] who reported results varying between 8.9% and 9.8%. RGO in our study was 1.6 times higher than in Fasla H. [3] and Peghini [20] [12].…”

“…This predominance of gastric cancer among cancers of the upper digestive tract is also reported by many authors [4] [22] with prevalence included between 0.92% and 6.7%. Other authors reported rather, a predominance of esophageal cancer [6] [8]. These results show that upper gastrointestinal cancers and stomach cancer are no longer rare in Africa.…”

A Clinicopathological Review of Colonic Polyps in a Tertiary Hospital in North Central Nigeria

“…Nigeria and other sub-Saharan African countries suggest that they may not be as rare as previously reported though the prevalence rates are still relatively low when compared to the rates reported among Caucasians and Asians [10][11][12][13][14][15][16][17]. Over a period May, 2012 [14].…”

“…It was estimated that 30% of the Western population have colonic polyps, whereas lower rates (10-15%) were noted in Africa [8,9]. Recent studies in Nigeria and other sub-Saharan African countries have reported different prevalence rates of colonic polyps that appear to suggest that their occurrence in these countries may not be rare as previously noted [10][11][12][13][14][15][16][17]. Results from previous studies have also shown that colonic polyps are more common in men than in women and increase in frequency with increasing age in most of these studies.…”

WEO Newsletter

“…[1][2][3][4] However, in many countries, physicians who perform GI endoscopy as part of their medical practice are not required to be certified or acknowledged by a regulatory body. [5][6][7][8] Therefore, there is a need for training guidelines which define the minimum duration, procedural skills and competency that should be acquired by physicians during their endoscopy training.…”