Occupational exposure to radiation in medical practice in Ghana has been analysed for a 10-y period between 2000 and 2009. Monitored dose data in the medical institution in Ghana from the Radiation Protection Institute's database were extracted and analysed in terms of three categories: diagnostic radiology, radiotherapy and nuclear medicine. One hundred and eighty medical facilities were monitored for the 10-y period, out of which ~98% were diagnostic radiology facilities. Only one nuclear medicine and two radiotherapy facilities have been operational in the country since 2000. During the 10-y study period, monitored medical facilities increased by 18.8%, while the exposed workers decreased by 23.0%. Average exposed worker per entire medical institution for the 10-y study period was 4.3. Annual collective dose received by all the exposed workers reduced by a factor of 4 between 2000 and 2009. This is seen as reduction in annual collective doses in diagnostic radiology, radiotherapy and nuclear medicine facilities by ~76, ~72 and ~55%, respectively, for the 10-y period. Highest annual collective dose of 601.2 man mSv was recorded in 2002 and the least of 142.6 man mSv was recorded in 2009. Annual average values for dose per institution and dose per exposed worker decreased by 79 and 67.6%, respectively between 2000 and 2009. Average dose per exposed worker for the 10-y period was least in radiotherapy and highest in diagnostic radiology with values 0.14 and 1.05 mSv, respectively. Nuclear medicine however recorded average dose per worker of 0.72 mSv. Correspondingly, range of average effective doses within the diagnostic radiology, radiotherapy and nuclear medicine facilities were 0.328-2.614, 0.383-0.728 and 0.448-0.695 mSv, respectively. Throughout the study period, an average dose per medical institution of 3 mSv and an average dose per exposed worker of 0.69 mSv were realised. Exposed workers in diagnostic radiology primarily received most of the individual annual doses >1 mSv. The entire study period had 705 instances in which exposed workers received individual annual doses >1 mSv. On thermoluminescent dosemeter (TLD) return rates, facilities in Volta and Eastern Regions recorded highest return rates of 94.3% each. Ashanti Region recorded the least TLD return rate with 76.7%.
a b s t r a c tPatients usually undergo repeated X-ray examinations after their initial X-ray radiographs are rejected due to poor image quality. This subjects the patients to an excess radiation exposure and extra cost and necessitates the need to investigate the causes of reject. The use of reject analysis as part of the overall quality assurance programs in clinical radiography and radiology services is vital in the evaluation of image quality of a well-established practice. It is shown that, in spite of good quality control maintained by the Radiology Department of a Teaching hospital in Ghana, reject analysis performed on a number of radiographic films developed indicated 14.1% reject rate against 85.9% accepted films. The highest reject rate was 57.1 ± 0.7% which occurs in cervical spine and the lowest was7.7 ± 0.5% for lumbar spine. The major factors contributing to film rejection were found to be over exposure and patient positioning in cervical spine examinations. The most frequent examination was chest X-ray which accounts for about 42.2% of the total examinations. The results show low reject rates by considering the factors for radiographic rejection analysis in relation to both equipment functionality and film development in the facility.
Africa has seen an upsurge in diagnostic imaging utilization, with benefits of efficient and accurate diagnosis, but these could easily be offset by undesirable effects attributed to unjustified, unoptimized imaging and poor quality examinations. This paper aims to present Africa’s position regarding quality and safety in imaging, give reasons for the rising interest in quality and safety, define quality and safety from an African context, list drivers for quality and safety in Africa, discuss the impact of COVID-19 on quality and safety, and review Africa’s progress using the Bonn Call for Action framework while proposing a way forward for imaging quality and safety in Africa. In spite of a healthcare setting characterized by meagre financial, human and technology resources, a rapidly widening disease-burden spectrum, growing proportion of non-communicable diseases and resurgence of tropical and global infections, Africa has over the last ten years made significant strides in quality and safety for imaging. These include raising radiation-safety awareness, interest and application of evidence-based radiation safety recommendations and guidance tools, establishing facility and national diagnostic reference levels (DRLs) and strengthening end-user education and training. Major challenges are: limited human resource, low prioritization of imaging in relation to other health services, low level of integration of imaging into the entire health service delivery, insufficient awareness for radiation safety awareness, a radiation safety culture which is emerging, insufficient facilities and opportunities for education and training. Solutions to these challenges should target the entire hierarchy of health service delivery from prioritization, policy, planning, processes to procedures.
Radiotherapy is life-saving treatment which ought to be guaranteed for all cancer patients who are indicated. While this is so, it is incumbent on the management of radiotherapy centres to ensure that patients, patient care-givers and radiotherapy personnel are at all times safe within the radiotherapy facility. Cancer patients are known to have increased risk for respiratory viruses like Covid-19 due to the compromised immune state of such persons. It is thus important to institute adequate safety measures in radiotherapy centres to prevent infection of cancer patients during the global Covid-19 pandemic. A survey conducted in 12 radiotherapy centres in 8 African countries has highlighted key measures needing implementation to ensure safety against Covid-19 infections. The safety measures were indexed on a 16-point questionnaire covering 5 main areas of staffing, radiotherapy environment, equipment and treatment protocols, patient condition and scheduling, and education/sensitization. The study shows that use of personal protective equipment, provision of hand washing and sanitizing facilities, social distance observance, restrictions for patient care-givers, provision of isolation unit meant for holding suspected Covid-19 cases, existence of working protocols, and Covid-19 safety education for staff are fully complied with by the surveyed radiotherapy centres. A greater portion of the centres, are however, without radiotherapy facilities solely dedicated for suspicious and confirmed Covid-19 cases. Strict adherence of the safety measures is highly essential to contain the spread and prevent infection of the disease to patients, caregivers and staff of the radiotherapy departments.
Knowledge and perception on transmission and control of SARS-COV-2 infection are key to preventing outbreak of the disease in healthcare settings and in dealing with the COVID-19 pandemic. This study assessed the level of knowledge on SARS-COV-2 infection prevention, transmission and symptoms of COVID-19, as well as perceptions regarding prevention of SARS-COV-2 infection among allied radiation medicine professionals. Cross-sectional descriptive survey was carried out among 145 radiation medicine professionals in Ghana using facts on COVID-19 as presented on the website of the World Health Organization and data was analyzed based on weighted average indices. Overall, the extent of knowledge among allied radiation medicine professionals on the symptoms of COVID-19, transmission and control of SARS-COV-2 infection in radiation medicine facilities were all adequate, with weighted average indices of 3.8, 4.1 and 4.4 respectively. However, overall perception of the respondents regarding the use of radiation medicine procedures in management of COVID-19 was diverse, with weighted index of 3.5. The facts about COVID-19 that were identified to be most known were shortness of breath being a serious symptom of the disease and fever being a common symptom. The extent of knowledge on the fact that "SARS-COV-2 infection can be transmitted through small droplets from the nose or mouth of an infected person" was almost excellent, with weighted average index of 4.9. Also, the thinking that provision of hand washing and sanitizing facilities is a measure for controlling the infection was almost perfectly shared among the respondents. Computed tomography was perceived by majority of the respondents as the most preferred imaging modality for screening patients for COVID-19. The study shows that some aspects of the awareness of radiation medicine professionals on COVID-19 pandemic are adequate and others need critical improvement to help reduce spread of the disease.
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