Impact of the COVID-19 pandemic on gastrointestinal endoscopy in Africa

Abstract

Background and study aims As with all other fields of medical practice, gastrointestinal endoscopy has been impacted by the COVID-19 pandemic. However, data on the impact of the pandemic in Africa, especially sub-Saharan Africa are lacking. Methods A web-based survey was conducted by the International Working Group of the European Society for Gastrointestinal Endoscopy and the World Endoscopy Organization to determine the impact and effects the COVID-19 pandemic has had on endoscopists in African countries. Results Thirty-one gastroenterologists from 14 countries in north, central, and sub-Saharan Africa responded to the survey. The majority of respondents reduced their endoscopy volume considerably. Personal protective equipment including FFP-2 masks were available in almost all participating centers. Pre-endoscopy screening was performed as well. Conclusion The COVID-19 pandemic has had a substantial impact on gastrointestinal endoscopy in most African countries; however, the impact may not have been as devastating as expected.

Resuming endoscopy during COVID-19 pandemic: ESGE, WEO and WGO Joint Cascade Guideline for Resource Limited Settings

“…The cascade adaptations presented here are in conjunction with return strategies reported previously, and which mainly included pre-screening and risk stratification based on questionnaires and temperature measurement 8 . Strategies for multiple use of PPE, especially N95 masks and water-resistant long-sleeved gowns, have also been described, and may form an important part of return strategies in resource-poor regions.…”

“…Resumption of partial or full endoscopy capacity depends on implementation of several interventions, such as availability of Personal Protective Equipment (PPE), COVID-19 testing, distancing and separation according to the level of infection, use of telemedicine, availability of vaccines and others. At least some of these interventions are resource-consuming, representing a limitation in developing countries 8 .…”

“…The majority of recommendations in the position papers are based on expert opinions and early survey-based or observational evidence. Many recommendations are resource-sensitive and may be unavailable in low-resource settings due to issues such as extensive costs, personnel unavailability, lack of sufficient healthcare professional training and logistical limitations 8 11 .…”

Adherence to recommendations for endoscopy practice during COVID-19 pandemic in Latin America: how are we doing it?

“…A survey conducted in Africa reported a PPE reuse rate of 43%. 26 Although certain PPE components were originally designed for single use (eg, N95 respirator or higher), a shortage of resources has forced its reutilisation. Methods that have been shown to be effective in decontaminating a high-efficiency respirator without affecting its filtering capacity are ultraviolet light, vaporised hydrogen peroxide and dry heat.…”

National survey regarding the timing of endoscopic procedures during the COVID-19 pandemic

“…In addition, in developing countries not all endoscopy units have access to adequate protective equipment, so it is possible that this leads to a reduction in the care of urgent pathologies in patients with COVID-19. This was demonstrated by Ebigbo et al where only 2 of the respondents in Africa regions attended urgent procedures in patients with COVID-19 [ 12 ], an important difference compared to centres in developed countries [ 13 ]. It is important to note that our survey was carried out during the worst moment of the COVID-19 pandemic in our country, so it is possible that application of the same survey at a different time could lead to variations in the answers.…”