Abstract
Levels of endoscopic demand and capacity in West Africa are unclear. This paper aims to: 1. describe the current labor and endoscopic capacity, 2. quantify the impact of a mixed-methods endoscopy course on healthcare professionals in West Africa, and 3. quantify the types of diagnoses encountered. In a three-day course, healthcare professionals were surveyed on endoscopic resources and capacity and were taught through active observation of live cases, case discussion, simulator experience and didactics. Before and after didactics, multiple-choice exams as well as questionnaires were administered to assess for course efficacy. Also, a case series of 23 patients needing upper GI endoscopy was done. In surveying physicians, less than half had resources to perform an EGD and none could perform an ERCP, while waiting time for emergency endoscopy in urban populations was at least one day. In assessing improvement in medical knowledge among participants after didactics, objective data paired with subjective responses was more useful than either alone. Of 23 patients who received endoscopy, 7 required endoscopic intervention with 6 having gastric or esophageal varices. Currently the endoscopic capacity in West Africa is not sufficient. A formal GI course with simulation and didactics improves gastrointestinal knowledge amongst participants.
Highlights
Though the burden of common gastrointestinal (GI) conditions such as diarrhea continues in Africa[1], the landscape of GI illness in the region is changing to one of African Health Sciences Vol 16 Issue 1, March 2016Each of the aforementioned chronic conditions requires endoscopy for the diagnosis, emergency treatment or chronic monitoring of disease progression
This paper aims to: 1. describe the current labor and endoscopic capacity, 2. quantify the impact of a mixed-methods endoscopy course on healthcare professionals in West Africa, and 3. quantify the types of diagnoses encountered
The United States has 3.9 gastroenterologists per 100,000 people, most of whom have regular access to endoscopy suites[6], whereas the Gambia has 3.8 medical doctors per 100,000 people, few of whom are trained in formal gastroenterology, including basic upper endoscopy[7]; and in Nigeria there are just 60 registered gastroenterologists for a nation of 140 million people[8]
Summary
Though the burden of common gastrointestinal (GI) conditions such as diarrhea continues in Africa[1], the landscape of GI illness in the region is changing to one of African Health Sciences Vol 16 Issue 1, March 2016Each of the aforementioned chronic conditions requires endoscopy for the diagnosis, emergency treatment or chronic monitoring of disease progression. The demand for endoscopy in West Africa is likely to be similar to that of the United States, the endoscopic capacity lags far behind. Little is known about how great the endoscopic shortage truly is, except that it exists[8] In light of this shortage, various attempts have been made to train the current healthcare professionals[11,12]. Levels of endoscopic demand and capacity in West Africa are unclear. Quantify the impact of a mixed-methods endoscopy course on healthcare professionals in West Africa, and 3. Methods: In a three-day course, healthcare professionals were surveyed on endoscopic resources and capacity and were taught through active observation of live cases, case discussion, simulator experience and didactics.
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