Assessing the utility of ultrasound in Liberia.

J Emerg Trauma Shock

Section of Emergency Medicine, Yale University School of Medicine, Department of Surgery, New Haven, CT, USA; John F. Kennedy Medical Center, Monrovia, Liberia.

Published: January 2008

AI Article Synopsis

  • Sub-Saharan Africa has limited ultrasound (US) capacity, leading to a study in Liberia that included 102 patients to evaluate the disease profile and US effectiveness.
  • The majority of US cases were for obstetrics/gynecology, with significant changes in management observed in 62% of patients, particularly in first trimester obstetrics and trauma assessments.
  • The curvilinear probe met over 80% of ultrasound needs, suggesting that training should primarily focus on obstetrics in developing countries.

Article Abstract

Sub-Saharan Africa has sparse imaging capacity, and data on ultrasound (US) use is limited. We collected prospective data on consecutive patients undergoing US to assess disease spectrum and US utility in Liberia. A total of 102 patients were prospectively enrolled. Average age was 33 years (0-84), 80% were female. US indications were: 53% Obstetrics/Gynecology (OB/GYN) (24% gynecologic, 17% second/third trimester, 12% first trimester), 14% hepatobiliary, 10% intraperitoneal/intrathoracic fluid, 8% cardiac, 5% focused assessment of sonography in trauma, and 4% renal. US changed management in 62% of cases. Greatest impact was in first trimester OB (86%), FAST (83%), ECHO (80%), and second/third trimester OB (77%). US changed management in 47% of right upper quadrant and 33% of gynecologic studies. Curvilinear probe addressed over 80% of need. The primary role for US in developing countries is in management of obstetrics, with a secondary role for traumatic and a-traumatic abdominal processes. Most needs can be met with the curvilinear probe. Training should begin with obstetrics and should be a primary focus for curriculum.

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Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2700563PMC
http://dx.doi.org/10.4103/0974-2700.41785DOI Listing

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