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DOI: 10.1055/s-0038-1669064
Obstacles facing gastrointestinal endoscopy in a resource-limited setting
Publication History
Publication Date:
13 August 2018 (online)
Introduction:
Gastrointestinal endoscopy is becoming more available in resource-limited settings. A team of doctors and nurses from the endoscopy unit of the Department of Gastroenterology in Augsburg performed four endoscopy training workshops in Enugu, southeastern Nigeria. Highlights of the training workshops and challenges facing the proper implementation of endoscopy in a resource-limited setting are demonstrated.
Methods:
Four training workshops were held in two tertiary care institutions in Enugu: Enugu State University Teaching Hospital (ESUTH) and University of Nigeria Teaching Hospital (UNTH). Endoscopists and nurses were trained in a hands-on manner. Major obstacles facing the implementation and development of GI-endoscopy in a resource-limited setting in Africa were identified.
Results:
A total of 100 examinations were performed together with the endoscopists and nurses of the endoscopy units of both institutions. Endoscopists and nurses were trained in basic gastroscopy and colonoscopy as well as in manual cleaning and desinfection/sterilization of endoscopes with Natriumpercarbonat. Manual cleaning and sterilisation were based on recommendations of the „Robert Koch Institut“. The most common endoscopic findings were esophageal varices and peptic ulcer disease due to the high incidence of Hepatitis B and Helicobacter pylori infections respectively. Major obstacles facing endoscopy were scarcity of clean drinking water, erratic electric power supply, lack of equipment for cardiorespiratory patient monitoring and lack of equipment and expertise for therapeutic procedures. Finally, lack of immunhistochemistry led to insufficient work-up of biopsy samples.
Conclusion:
Gastrointestinal endoscopy is not just feasible but also necessary in resource-limited settings in African countries. However, economic factors, especially lack of equipment and infrastructure, are still limiting the further development of endoscopy in these countries.