Interventional Radiology Awareness Among Clinicians at Muhimbili National Hospital, Tanzania

Kaur, Manpreet; Laage-Gaupp, Fabian; Rukundo, Ivan; Naif, Azza; Lwakatare, Flora; Mbuguje, Erick M.; Asch, Murray

doi:10.1007/s00270-020-02685-1

Cited by 3 publications

(2 citation statements)

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“…This demonstrates a promising trajectory of awareness with observed referral streams from both physicians specialized in the treatment of fibroids and satisfied patients by word-of-mouth. Due to the infancy of interventional radiology in SSA, it is important to continue to raise awareness among local clinicians and patients alike about the many benefits of procedures offered by the specialty [ 35 ]. This is especially important regarding symptomatic uterine fibroids, a condition in which women of color and those belonging to a lower socioeconomic bracket are often underdiagnosed and have a lower likelihood of receiving treatment [ 36 ] – an issue that can be mitigated through increased awareness and education.…”

Section: Discussionmentioning

confidence: 99%

Uterine artery embolization in Tanzania: a procedure with major public health implications

Musa,

Alswang,

Di Ioia

et al. 2023

CVIR Endovasc

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Background The burden of uterine fibroids is substantial in sub-Saharan Africa (SSA), with up to 80% of black women harboring them in their lifetime. While uterine artery embolization (UAE) has emerged as an effective alternative to surgery to manage this condition, the procedure is not available to the vast majority of women living in SSA due to limited access to interventional radiology (IR) in the region. One of the few countries in SSA now offering UAE in a public hospital setting is Tanzania. This study aims to assess the safety and effectiveness of UAE in this new environment. Methods From June 2019 to July 2022, a single-center, retrospective cohort study was conducted at Tanzania’s first IR service on all patients who underwent UAE for the management of symptomatic fibroids or adenomyosis. Patients were selected for the procedure based on symptom severity, imaging findings, and medical management failure. Procedural technical success and adverse events were recorded for all UAEs. Self-reported symptom severity and volumetric response on imaging were compared between baseline and six-months post-procedure using paired sample t-tests. Results During the study period, 92.1% (n = 35/38) of patients underwent UAE for the management of symptomatic fibroids and 7.9% (n = 3/38) for adenomyosis. All (n = 38/38) were considered technically successful and one minor adverse event occurred (2.7%). Self-reported symptom-severity scores at six-months post-procedure decreased in all categories: abnormal uterine bleeding from 8.8 to 3.1 (-5.7), pain from 6.7 to 3.2 (-3.5), and bulk symptoms from 2.8 to 1 (-1.8) (p < 0.01). 100% of patients reported satisfaction with outcomes. Among the nine patients with follow-up imaging, there was a mean volumetric decrease of 35.5% (p = 0.109). Conclusions UAE for fibroids and adenomyosis can be performed with high technical success and low complication rates in a low-resource setting like Tanzania, resulting in significant symptom relief for patients. Building capacity for UAE has major public health implications not only for fibroids and adenomyosis, but can help address the region’s leading cause of maternal mortality, postpartum hemorrhage.

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Section: Discussionmentioning

confidence: 99%

Uterine artery embolization in Tanzania: a procedure with major public health implications

Musa,

Alswang,

Di Ioia

et al. 2023

CVIR Endovasc

View full text Add to dashboard Cite

show abstract

“…This demonstrates a promising trajectory of awareness with observed referral streams from both physicians specialized in the treatment of broids and satis ed patients by word-of-mouth. Due to the infancy of interventional radiology in SSA, it is important to continue to raise awareness among local clinicians and patients alike about the many bene ts of procedures offered by the specialty [33]. This is especially important regarding symptomatic uterine broids, a condition in which women of color and those belonging to a lower socioeconomic bracket are often underdiagnosed and have a lower likelihood of receiving treatment [34] -an issue that can be mitigated through increased awareness and education.…”

Section: Uterine Fibroid Embolization Awarenessmentioning

confidence: 99%

Uterine Artery Embolization in Tanzania: A Procedure with Major Public Health Implications

Musa

Alswang

Ioia

et al. 2023

Preprint

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Background The burden of uterine fibroids is substantial in sub-Saharan Africa (SSA), with up to 80% of black women harboring them in their lifetime. While uterine artery embolization (UAE) has emerged as an effective alternative to surgery to manage this condition, the procedure is not available to the vast majority of women living in SSA due to limited access to interventional radiology (IR) in the region. One of the few countries in SSA now offering UAE in a public hospital setting is Tanzania. This study aims to assess the safety and effectiveness of UAE in this new environment.Methods From June 2019 to July 2022, a single-center, retrospective cohort study was conducted at Tanzania’s first IR service on all patients who underwent UAE for the management of symptomatic fibroids or adenomyosis. Patients were selected for the procedure based on symptom severity, imaging findings, and medical management failure. Procedural technical success and adverse events were recorded for all UAEs. Self-reported symptom severity and volumetric response on imaging were compared between baseline and six-months post-procedure using paired sample t-tests.Results During the study period, 92.1% (n = 35/38) of patients underwent UAE for the management of symptomatic fibroids and 7.9% (n = 3/38) for adenomyosis. 97.3% (n = 37/38) were considered technically successful and one minor adverse event occurred (2.7%). Self-reported symptom-severity scores at six-months post-procedure decreased in all categories: abnormal uterine bleeding from 8.8 to 3.1 (-5.7), pain from 6.7 to 3.2 (-3.5), and bulk symptoms from 2.8 to 1 (-1.8) (p < 0.01). 100% of patients reported satisfaction with outcomes. Among the nine patients with follow-up imaging, there was a mean volumetric decrease of 35.5% (p = 0.109).Conclusions UAE for fibroids and adenomyosis can be performed with high technical success and low complication rates in a low-resource setting like Tanzania, resulting in significant symptom relief for patients. Building capacity for UAE has major public health implications not only for fibroids and adenomyosis, but can help address the region’s leading cause of maternal mortality, postpartum hemorrhage.

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Comparative Analysis of Percutaneous Drainage versus Operative Drainage of Intra-Abdominal Abscesses in a Resource-Limited Setting: The Tanzanian Experience

Ukweh¹,

Alswang

Iya-Benson

et al. 2023

Annals of Global Health

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Background: Intra-abdominal abscesses (IAAs) are a major cause of morbidity and mortality worldwide. While image-guided percutaneous abscess drainage (PAD) has become the standard of care in many countries, over half of the global population does not have access to interventional radiology (IR) and are left with surgery as the only option for source control. Objective:The purpose of this study is to evaluate the development, implementation, and role of a PAD service in a resource-limited setting.Method: A retrospective cohort study was performed on all patients who underwent percutaneous or surgical abscess drainage (SAD) of IAAs at Tanzania's national referral hospital from 10/2018 to 4/2021. Patients were identified through a match case search of institutional records and inclusion was confirmed through manual chart review. Demographics, patient presentation, procedural data, and clinical outcomes were recorded in a password-encrypted database and compared between groups.Findings: Sixty-three patients underwent abscess drainage: 32 percutaneously and 31 surgically. In the PAD group, there was a 100% technical success rate and a 0% complication rate. In the SAD group, there was a 64.5% technical success rate and ten deaths within 30 days (32.3%), and one additional complication requiring major therapy (3.2%) (p < 0.001). Conclusion:Results from this study demonstrate that PAD can be performed with high technical success and without complication by trained IR physicians in Tanzania. The development of a successful PAD program exemplifies the drastic need to support the growth of IR services in this setting.

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Interventional Radiology Awareness Among Clinicians at Muhimbili National Hospital, Tanzania

Cited by 3 publications

References 1 publication

Uterine artery embolization in Tanzania: a procedure with major public health implications

Uterine artery embolization in Tanzania: a procedure with major public health implications

Uterine Artery Embolization in Tanzania: A Procedure with Major Public Health Implications

Comparative Analysis of Percutaneous Drainage versus Operative Drainage of Intra-Abdominal Abscesses in a Resource-Limited Setting: The Tanzanian Experience

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