Paediatric endoscopy in Nigeria humble beginning

Abstract

Introduction: Paediatric gastroenterology has become an established subspecialty in the last five decades in developed and some developing countries. Endoscopy is the cornerstone of this sub-specialty. In Nigeria, it is still at its infancy stage, though with increasing local interest. This is a report of the first Paediatric Endoscopy Workshop in Nigeria organized as a pre -conference by the Paediatric Association of Nigeria (PAN) and the Nigerian Society of Paediatric Gastroenterology, Hepatology and Nutrition (NISPGHAN).Aim: The aim of the conference was to promote and create awareness on paediatric gastroenterology as a subspecialty and introduce participants to the practice of paediatric endoscopy.Method: This was a two day preconference workshop. Paediatricians, paediatric resisdents and nurses were in attendance. One International and three National resource persons were on ground to impart the needed knowledge and skills. Training involved didactic lectures, hands-on sessions using manikins and three live sessions involving the upper gastrointestinal tract.Results: There were 40 attendees on day 1: 22 (55%) paediatric residents, 12 (30%) consultant paediatricians and six (15%) nurses. Day 2: 22 (52%) paediatric residents, 12 (29%) consultant paediatricians and eight (19%) nurses. Three children (two females and one male) had upper GI endoscopy (with biopsy done in two cases) during the pre-conference workshop as live sessions. They were aged eight, nine and 16 years. Indications for endoscopy were recurrent haematemesis in an eight year old female patient and recurrent upper abdominal pain in the other two patients (a male and a female). Gastritis was found in the two patients and this was confirmed histologically in one of the patients.Conclusion: The training stirred up participant’s interest in this subspecialty of paediatrics. It brought to fore the need for paediatric endoscopy to be developed in Nigeria. The procedure should be performed at tertiary centres at this stage of our development and the cost of it covered by the National Health Insurance Scheme. Four training centres to aid interested paediatricians and paediatric trained nurses acquire the needed skills are recommended.Keywords: Paediatric endoscopy, Calabar, Nigeria.

Paediatric Gastrointestinal Endoscopy in a Nigerian Tertiary Hospital

“…Cost constitutes another limitation to the practice of paediatric endoscopy in Nigeria. The cost of upper GI endoscopy as reported by Ikobah et al [6] ranges from 200 to 250 USD while lower GI endoscopy may cost between 250 and 300 USD. These are far beyond the reach of most Nigerian families.…”

“…[5] Although pockets of training in paediatric endoscopy take place in selected tertiary health facilities in Nigeria, the first documented report on training of paediatric endoscopists in Nigeria was at a pre-conference workshop organized by the Nigerian Society of Paediatric Gastroenterology, Hepatology and Nutrition (NISPGHAN) in collaboration with the Paediatric Association of Nigeria in 2014, hosted by the University of Calabar Teaching Hospital, Calabar. [6] Paediatric endoscopy provides diagnostic and therapeutic benefits in the management of gastrointestinal disorders in children. Endoscopy is superior to other radiographic studies in the diagnosis of peptic ulcers, polyps and mucosal abnormalities while offering opportunity for tissue biopsy and therapeutic procedures such as banding, dilatation and polypectomy.…”