Underutilisation of nuclear medicine scans at a regional hospital in Nigeria: need for implementation research

Abstract

Background: Nuclear medicine needs better integration into the Nigerian health system. To understand the relevant public health initiatives that will be required, this study assessed the pattern of nuclear medicine imaging services at the first nuclear medicine centre in Nigeria from January 2010 to December 2018. Methods: The data of consecutive nuclear medicine (NM) scans performed between 1st January 2010 and 31st December 2018 at the NM department in a tertiary hospital in Nigeria were extracted from patient records and analysed using SAS version 9.4 (SAS Institute, Cary, NC). The National Cancer Institute's Joinpoint software and QCIS (QGIS project) were used to estimate imaging trends and geographical spread of patients. Results: An average of 486 scans per year was performed during the study period. Patients travelled from 32 of Nigeria's 36 states, and the majority (65%) travelled more than 100 km to obtain NM scans. Bone scans accounted for 88.1% of the studies. The remainder were renal scintigraphy (7.3%), thyroid scans (2.5%), whole-body iodine scans (1.7%) and others (0.4%). Conclusions: NM in Nigeria appears underutilised. Furthermore, the studies to characterise the access gaps and implementation needs will contribute to the design of practical strategies to strengthen NM services in Nigeria.

Maximal covering location problem for nuclear medicine clinics allocation in Nigeria

“…NM is vital to the detection and treatment of cancers, yet most sub-Saharan African countries face challenges with the provision of NM services [ 25 ]. Outside South Africa, NM is not readily available in sub-Saharan African countries [ 26 ]. The current availability of NM in sub-Sahara Africa has been the result of decades of coordination between the International Atomic Energy Agency (IAEA) and individual African governments and marks the proof of concept that NM is feasible, even profitable, in African developing countries.…”

Management of lung cancer in Africa: Underdiagnosis and poor access to treatment – A close look at Nigeria and West African Sub-region

“…There should be optimal utilization of nuclear medicine services as these seem to be presently underutilized. [81] With an average of one bone scan per year and <0.2% of total bone scans in an 11-year period, bone scintigraphy requested for lung cancer. [82] In the absence of PET/CT imaging, bone scintigraphy still has an important role to play in patients' management and referring physicians are encouraged to embrace this imaging modality.…”

Paediatric Nephrology in Africa

“…However, modalities such as urodynamics and nuclear medicine scans are still largely unavailable. For example, in Nigeria, there is only one functioning nuclear medicine centre for the country with a population of 211 million [ 1 , 50 •]. Medications for kidney diseases have become more available compared to several decades ago, largely as a result of cheaper and good-quality generics.…”