Utility of Point-of-Care Ultrasound in A Resource-Limited Health Care Setting in Southeast Ghana: A Needs Assessment

Abstract

Background: Many proven benefits of point-of-care ultrasound (POCUS) are increasingly recognized, including being non-invasive, cost-effective, and of significant diagnostic value. Evidence for these benefits has been replicated in variable settings. However, little is known about the utilization of POCUS in the developing world and in an out-of-hospital, resource-limited setting. This needs assessment study describes utilization of POCUS in rural Ghana. Methods: We performed retrospective analysis of data from medical missions to Southeast Ghana, evaluating the utilization of POCUS in a rural resource-limited health setting. The first mission trip took place in the Oti region between January 25th, 2023, and February 1st, 2023. The second was in the Volta region between February 19th, 2023, and February 24th, 2023. These missions established out-of-hospital remote clinics for walk in patients who are informed about the clinic by the word of mouth by their community leaders and neighbors. We included all POCUS scans performed as part of those missions. Findings: A total of 128 POCUS studies were performed and included in this analysis. Studies were performed for 111 patients (median age 23 years; 49.9% male). Twelve distinct types of sonographic studies were performed. Notably, 48.4% revealed significant findings that helped to confirm a working diagnosis and subsequently formulate or optimize plan of management. A therapeutic intervention was made based on US findings in 16.4% of encounters, while a referral to higher level of care was recommended in 27.3% of cases. Reassurance with ruling out a main differential diagnosis was the case in 7% of encounters. Conclusion: POCUS is effective and can be utilized for a wide range of types of scans effectively in out-of-hospital resource-limited settings in rural Ghana with significant impact on clinical decision-making process.