E-Posters

Abstract

Background: Uganda is a low-income country in East Africa with a population of 42.9 million. It is ranked 162nd out of 189 countries on the human development index. Annual health expenditure per capita is £352. Symptoms warranting investigation with upper gastrointestinal (UGI) endoscopy are common in Uganda however service availability is limited; meaning conditions such as peptic ulceration or even oesophageal malignancy are often treated empirically without formal diagnosis. This study aims to review all published literature on UGI endoscopy in Uganda, examining the findings and quality of research based in the country. Methods: A literature search of electronic databases PUBMED, MEDLINE and EMBASE was conducted. All articles published before August 2018 describing adult UGI endoscopy in Uganda were reviewed. Papers referring to investigations performed on patients under the age of 18 were excluded. The focus of each paper, methods and conclusions were tabulated. Papers looking at the range of diagnosis seen in consecutive endoscopy procedures were explored in greater depth, with raw data extracted and compared. Results: 15 papers published 1987 to 2016 from 8 different journals were reviewed. A total of 8043 endoscopies were performed, 88% of which were examined retrospectively. Of those papers that simply commented on the diagnoses identified within their cohort of procedures, 9%(287/3187) of endoscopy procedures identified oesophageal malignancy. Gastritis is the most common finding. The main focus (4 papers) was dyspepsia and H.Pylori prevalence. One study was conducted rurally, the rest were all based on populations from one of three cities. 5 papers investigated the prevalence ofHelicobacter pylori. Average prevalence was 46% (291/631), with a range of 25-76%. Conclusions: Despite being available in Uganda since the 1980s, there remains a paucity of prospective data on UGI endoscopy activity in Uganda. Almost all studies are from single centres serving urban populations. No data is available from the busiest endoscopy unit in Uganda or the eastern region unit. Oesophageal malignancy is prevalent and could be unevenly geographically distributed within Uganda. 46% of patients were diagnosed withH.Pylori, less than the average for Africa (70.1%). As endoscopy availability increases, future studies should aim to collaboratively collect larger prospective datasets and include rural populations. A national endoscopy society and registry could facilitate this.