Utilization of modern imaging in a referral paediatric surgical centre

Abstract

Modern radiological imaging have significantly improved the standard of medical practice. This study reports the extent and challenges faced with the utilization of modern imaging facilities in a Nigerian referral paediatric surgical centre. A retrospective study on children with surgical pathology who required the use of modern imaging facilities between January-December 2008 at the University of Benin Teaching Hospital, Nigeria. Of 1401 children seen with surgical pathology, 603 (43.1%) aged between 1 day and 16 years (mean 5 ± 4.7 years) comprising 391 males and 212 females (ratio1.8:1) had radiological imaging investigations during the period. Utilizations were investigative as no interventional radiological imaging procedure was done owing to lack of facilities and manpower. Single investigative radiological procedure such as ultrasound scan, plain radiographs, contrast study, CT scan and MRI were done in 396 (65.7%) and in different combinations in 207 (34.3%) children, with plain radiograph/USS as the most commonly performed imaging. Although clinical diagnosis influenced requests for investigations, lack of manpower/facilities, accessibility, affordability, availability, safety, invasiveness, emergency conditions, need for special preparation, unstable electricity, and industrial actions were noted as challenges that influenced utilization. With the exemption of ultrasound scan that had 100% compliance to 196 requests others were influenced. Consequently, whereas 291 (144%) children did plain radiographs against initial 202 requested, 76 (69.7%) of 109 contrast study, 5 (22.7%) of 22 CT, and one (14.3%) of 7 MRI were done. Utilizations of modern imaging in managing children with surgical pathology were for basic investigative purposes owing to lack of facilities and manpower. Training of manpower and provision of affordable imaging facilities may result in therapeutic and sophisticated investigative uses of modern imaging in this centre.

Key words: Modern imaging, Utilization, Challenges, Influencing factors.