Paediatric radiology seen from Africa. Part I: providing diagnostic imaging to a young population

Abstract

Paediatric radiology requires dedicated equipment, specific precautions related to ionising radiation, and specialist knowledge. Developing countries face difficulties in providing adequate imaging services for children. In many African countries, children represent an increasing proportion of the population, and additional challenges follow from extreme living conditions, poverty, lack of parental care, and exposure to tuberculosis, HIV, pneumonia, diarrhoea and violent trauma. Imaging plays a critical role in the treatment of these children, but is expensive and difficult to provide. The World Health Organisation initiatives, of which the World Health Imaging System for Radiography (WHIS-RAD) unit is one result, needs to expand into other areas such as the provision of maintenance servicing. New initiatives by groups such as Rotary and the World Health Imaging Alliance to install WHIS-RAD units in developing countries and provide digital solutions, need support. Paediatric radiologists are needed to offer their services for reporting, consultation and quality assurance for free by way of teleradiology. Societies for paediatric radiology are needed to focus on providing a volunteer teleradiology reporting group, information on child safety for basic imaging, guidelines for investigations specific to the disease spectrum, and solutions for optimising imaging in children.

Feasibility of using teleradiology to improve tuberculosis screening and case management in a district hospital in Malawi

“…Notably, several studies have demonstrated that JPEGs obtained by digital photography of film radiographs using limited image compression are sufficient for diagnosis in most instances; additionally, rates of discrepancy between radiologists are the same whether teleradiology images or regular X-ray images are being interpreted. 10,12,15 In our experience, most images were classified as good and conclusive. Importantly, final diagnoses and case management were not based solely on the radiologist's report.…”

“…Our findings are consistent with those of other studies in resource-limited settings. [10][11][12]14 Our study has several limitations. We established no specific criteria for requesting teleradiology.…”

Implementing Diagnostic Imaging Services in a Rural Setting of Extreme Poverty: Five Years of X-ray and Ultrasound Service Delivery in Achham, Nepal

“…Previous success with the WHIS-RAD, the same system purchased by Possible, has been described by researchers in South Africa (5). Current literature and WHO guidelines emphasize the importance of maintaining an independent power supply for X-ray and ultrasound devices (20), but the process of implementing solar power to increase the capacity to provide reliable power after battery failure has yet to be described.…”

“…Currently, there is only sparse literature on the difficulties of implementing diagnostic radiology services in low-and middle-income countries (5)(6)(7). In this paper, we will review Possible's responses to the challenges faced over the last five years of the implementation of diagnostic imaging in Achham, Nepal.…”

Saving the starfish: World Federation of Pediatric Imaging (WFPI) development, work to date, and membership feedback on international outreach

“…We must make purposeful choices in how we get involved (which means, at times, consciously saying "no") in fulfilling our mission to serve children. radiologists, and 14 have none [21]. Zambia, for example, offers four public-sector radiologists for an estimated population of more than 14.4 million (of which 47% is younger than 15 years) [22].…”