Pediatric Radiology

, Volume 41, Issue 7, pp 811–825

Paediatric radiology seen from Africa. Part I: providing diagnostic imaging to a young population

  • Savvas Andronikou
  • Kieran McHugh
  • Nuraan Abdurahman
  • Bryan Khoury
  • Victor Mngomezulu
  • William E. Brant
  • Ian Cowan
  • Mignon McCulloch
  • Nathan Ford
Review

Abstract

Paediatric radiology requires dedicated equipment, specific precautions related to ionising radiation, and specialist knowledge. Developing countries face difficulties in providing adequate imaging services for children. In many African countries, children represent an increasing proportion of the population, and additional challenges follow from extreme living conditions, poverty, lack of parental care, and exposure to tuberculosis, HIV, pneumonia, diarrhoea and violent trauma. Imaging plays a critical role in the treatment of these children, but is expensive and difficult to provide. The World Health Organisation initiatives, of which the World Health Imaging System for Radiography (WHIS-RAD) unit is one result, needs to expand into other areas such as the provision of maintenance servicing. New initiatives by groups such as Rotary and the World Health Imaging Alliance to install WHIS-RAD units in developing countries and provide digital solutions, need support. Paediatric radiologists are needed to offer their services for reporting, consultation and quality assurance for free by way of teleradiology. Societies for paediatric radiology are needed to focus on providing a volunteer teleradiology reporting group, information on child safety for basic imaging, guidelines for investigations specific to the disease spectrum, and solutions for optimising imaging in children.

Keywords

Developing countries Radiographic equipment Non-governmental organisation Role extension 

References

  1. 1.
    Chen S, Ravallion M. The developing world is poorer than we thought, but no less successful in the fight against poverty, Policy Research Working Paper 4703, World Bank, August 2008. http://econ.worldbank.org/external/default/main?pagePK=64165259&piPK=64165421&theSitePK=469372&menuPK=64216926&entityID=000158349_20100121133109. Accessed 5 October 2010
  2. 2.
    2007 Human Development Report (HDR), United Nations Development Program, November 27, 2007 / 2008, p.25. http://hdr.undp.org/en/media/HDR_20072008_EN_Complete.pdf. Accessed 5 October 2010
  3. 3.
    State of the World’s Children, 2005, UNICEF. http://www.unicef.org/sowc05/english/sowc05.pdf. Accessed 5 October 2010
  4. 4.
    Patton GC, Coffey C, Sawyer SM, Viner RM, Haller DM, Bose K, Vos T, Ferguson J, Mathers CD (2009) Global patterns of mortality in young people: a systematic analysis of population health data. Lancet 374:881–892PubMedCrossRefGoogle Scholar
  5. 5.
  6. 6.
    World Health Organisation. http://www.who.int/countries/. Accessed 5 October 2010
  7. 7.
    Zanoni B (2005) Epidemiology of HIV in Southern Africa. Pediatr Radiol 39:538–540CrossRefGoogle Scholar
  8. 8.
    Bryce J, Boschi-Pinto C, Shibuya K, Black R (2005) WHO Child Health Epidemiology Reference Group. Lancet 365:1147–1152PubMedCrossRefGoogle Scholar
  9. 9.
    Zar HJ (2006) Global paediatric pulmonology: out of Africa. Paediatr Respir Rev 7:S226–S228PubMedCrossRefGoogle Scholar
  10. 10.
    WHO AIDS epidemic update UNAIDS/09.36E / JC1700E (English original, November 2009). http://data.unaids.org/pub/Report/2009/JC1700_Epi_Update_2009_en.pdf. Accessed 5 October 2010
  11. 11.
    Women and Children in South Africa. http://www.unicef.org/southafrica/children.html. Accessed 5 October 2010
  12. 12.
    Adams LV (2004) Childhood tuberculosis in the developing world. Pediatr Ann 33:685–690PubMedGoogle Scholar
  13. 13.
    WHO Report. Global tuberculosis control. http://www.who.int/tb/publications/global_report/2009/pdf/report_without_annexes.pdf. Accessed 5 October 2010
  14. 14.
    Ng’ambi TM, Borgstein ES (2005) Epidemiology of paediatric trauma admission at Queen Elizabeth Cebtral Hospital, Blantyre. Malawi Med J 17:5–6Google Scholar
  15. 15.
    Osinaike B, Amanor-Boadu S. Paediatric trauma admissions in a Nigerian ICU. Internet Journal of Emergency and Intensive Care Medicine. http://www.ispub.com/ostia/index.php?xmlPrinter=true&xmlFilePath=journals/ijeicm/vol9n2/icu.xml. Accessed 5 October 2010
  16. 16.
    Stuckler D, King L, Robinson H, McKee M (2008) WHO's budgetary allocations and burden of disease: a comparative analysis. Lancet 372:1563–1569PubMedCrossRefGoogle Scholar
  17. 17.
    Dept. of Int. devt.(2001) Access to water in developing countries. http://www.parliament.uk/documents/post/pn178.pdf. Accessed 19 December 2009
  18. 18.
  19. 19.
    Palmer PES (1985) The WHO basic radiological system. Radiography 53:170–178Google Scholar
  20. 20.
    Krupinski EA (1996) Clinical Assessment of dry laser-processed film versus traditional wet-processed film with computer tomography, magnetic resonance imaging, and ultrasound. Acad Radiol 3:855–858PubMedCrossRefGoogle Scholar
  21. 21.
    Kozilainin, H (2001) Rehabilitation of hospital infrastructure in a developing country. World Hospital Health Serv 37:28–8,34,36Google Scholar
  22. 22.
    US Army medical department centre and school. X-ray film processing.http://milmed.pmk.ac.th/MD0954%20X-RAY%20FILM%20PROCESSING.pdf. Accessed 3 January 2010
  23. 23.
    Korolev A I (1990) Equipment for fast radiography with diffusion-transfer photographic materials. (translated from Russian) Meditsinskaya Tekhnika1:25–27Google Scholar
  24. 24.
    McHugh K (2002) Essential imaging facilities. In: Southall DP, Coulter B, Ronald C, Nicholson S, Parke S (eds) International child health care: a practical manual for hospitals worldwide. Child Advocacy International. BMJ Books, LondonGoogle Scholar
  25. 25.
    Advice on Donating Equipment Overseas. http://idcsig.org/page6.html. Accessed 22 December 2009
  26. 26.
    Malkin AA (2007) Design of healthcare technologies for the developing world. Annu Rev Biomed Eng 9:567–587PubMedCrossRefGoogle Scholar
  27. 27.
    Kitonyi JM (1993) The basic radiological system experience in Kenya. East Afr Med J 70:793–796PubMedGoogle Scholar
  28. 28.
    The World Health Imaging System for Radiography—WHIS-RAD: simply perfect. World health Organisation, Geneva, 2004Google Scholar
  29. 29.
    What Is The Climate, Average Temperature/ Weather In Mozambique? http://www.climatetemp.info/mozambique/.Aceesed 21 December 2009
  30. 30.
    Brederhofs J, Raceveneau (1982) Radiological services throughout the world. Diagn Imaging 51:121–133Google Scholar
  31. 31.
    Health care in South Africa http://www.southafrica.info/about/health/health.htm Accessed: 3 January 2010
  32. 32.
    Urinary tract infection in children: diagnosis, treatment and long-term management. NICE clinical guideline 54. http://www.nice.org.uk/nicemedia/pdf/CG54NICEguideline. Accessed 5 October 2010
  33. 33.
    Frost and Sullivan (2008) Strategic Analysis of the Medical Imaging Market in Kenya. http://www.pharmaceutical-market-research.com/publications/medical_devices/strategic_analysis_medical_imaging_market_kenya.html. Accessed 5 October 2010
  34. 34.
    Kawooya M (2008) Role Extension for the Radiographer in the New Millennium. http://www.isrrt.org/images/isrrt/09H50%20DR%20M%20KAWOOYA%20RM%201A%20SESSION%201%20FRIDAY.pdf. Accessed 5 October 2010
  35. 35.
    www.medpages.co.za. Accessed 5 October 2010
  36. 36.
    Strachan M (2009) Imbalance between public and private radiological services in the Western Cape Of South Africa. Dissertation University of Stellenbosch, South AfricaGoogle Scholar
  37. 37.
    Hanson GP (1988) Essential X-ray services: the basic radiological system (BRS). Trop Geogr Med 40(4):s576–s578Google Scholar
  38. 38.
    Health systems http://www.who.int/topics/health_systems/en/.Accessed 5 January 2010
  39. 39.
    Simpson PD (1998) A study of chest radiography with mobile units. Br J Radiol 71:640–645PubMedGoogle Scholar
  40. 40.
    Wootton R (2001) Telemedicine and developing countries—successful implementation will require a shared approach. J Telemed Telecare S1:1–6CrossRefGoogle Scholar
  41. 41.
    http://www.swinfencharitabletrust.org/. Accessed 5 October 2010
  42. 42.
    http://www.healthnet.org/. Accessed 5 October 2010
  43. 43.
    Pyke J, Hart M, Popov V et al (2007) A tele-ultrasound system for real-time medical imaging in resource limited settings. In: Conference Proceedings of the IEEE 2007:3094–3097Google Scholar
  44. 44.
  45. 45.
    Szot A, Jacobson FL, Munn S, Jazayeri D, Nardell E, Harrison D, Drosten R, Ohno-Machado L, Smeaton LM, Fraser HS (2004) Diagnostic accuracy of chest X-rays acquired using a digital camera for low-cost teleradiology. Int J Med Inform 73:65–73Google Scholar
  46. 46.
    Corr P, Couper I, Beningfield SJ, Mars M (2000) A simple telemedicine system using a digital camera. J Telemed Telecare 6:233–236PubMedCrossRefGoogle Scholar
  47. 47.
    http://www.nighthawkradiology.net/. Accessed 5 October 2010
  48. 48.
  49. 49.
    Baylor College of Medicine. International Paediatric AIDS Initiative. http://www.Bayloraids.org/programs/Swaziland/outreach.php. Accessed 5 October 2010
  50. 50.
    Rotarians assess need for WHIS-RAD imaging system in Zimbabwe. http://www.auntminnie.com/index.asp?Sec=nws&sub=rad&pag=dis&ItemId=53004Accessed 3 January 2010
  51. 51.
    Rudd PD (2003) The development of radiographer reporting 1965–1999. Radiography 9:7–12CrossRefGoogle Scholar
  52. 52.
    Brandt A, Andronikou S, Wieselthaler N, Louw B, Kilborn T, Dekker G, Bertelsman J, Dreyer C (2007) Accuracy of radiographer reporting of paediatric brain CT. Pediatr Radiol 37:291–296PubMedCrossRefGoogle Scholar
  53. 53.
    Cowan I, Smith T, Nakabea P, Ajibulu O, Hennessy O (2007) WHO/RANZCR/ISRRT. Developing the image interpretation skills of South Pacific radiographers: a joint WHO/RANZCR/ISRRT project. Australas Radiol 51:527–531PubMedCrossRefGoogle Scholar
  54. 54.
    Andronikou S, Vanhoenacker FM, De Backer AI (2009) Advances in imaging chest tuberculosis: blurring of differences between children and adults. Clin Chest Med 30:717–744, viiiPubMedCrossRefGoogle Scholar
  55. 55.
    Williams JR (2000) Ethics and human rights in South African medicine. CMAJ 162:1167–1170PubMedGoogle Scholar
  56. 56.
    Sullivan P (1999) Canada a prime destination as MDs flee South Africa. CMAJ 160:1615–1616Google Scholar
  57. 57.
    Truth and Reconciliation Commission of South Africa Report. Cape Town: TRC/Juta; 1998. vol IV, chapt V. p. 120. www.polity.org.za/govdocs/commissions/1998/trc/index.htm. Accessed August 2010
  58. 58.
    Price M (1986) Health care as an instrument of apartheid policy in South Africa. Health Policy Plan 1:158–170CrossRefGoogle Scholar

Copyright information

© Springer-Verlag 2011

Authors and Affiliations

  • Savvas Andronikou
    • 1
  • Kieran McHugh
    • 2
  • Nuraan Abdurahman
    • 3
  • Bryan Khoury
    • 3
  • Victor Mngomezulu
    • 1
  • William E. Brant
    • 4
  • Ian Cowan
    • 5
  • Mignon McCulloch
    • 6
  • Nathan Ford
    • 7
  1. 1.Radiology DepartmentUniversity of WitwatersrandJohannesburg GautengSouth Africa
  2. 2.Radiology DepartmentGreat Ormond Street Hospital for ChildrenLondonUK
  3. 3.Radiology DepartmentUniversity of Cape TownCape TownSouth Africa
  4. 4.Radiology DepartmentUniversity of VirginiaCharlottesvilleUSA
  5. 5.Radiology DepartmentChristchurch HospitalChristchurchNew Zealand
  6. 6.Evelyna Children’s HospitalLondonUK
  7. 7.Public Health/AccessMédecins Sans FrontièresCape TownSouth Africa

Personalised recommendations