title: Endoscopic capacity in West Africa.
abstract: BACKGROUND
  Levels of endoscopic demand and capacity in West Africa are unclear.
  
  
  OBJECTIVE
  This paper aims to: 1. describe the current labor and endoscopic capacity, 2. quantify the impact of a mixed-methods endoscopy course on healthcare professionals in West Africa, and 3. quantify the types of diagnoses encountered.
  
  
  METHODS
  In a three-day course, healthcare professionals were surveyed on endoscopic resources and capacity and were taught through active observation of live cases, case discussion, simulator experience and didactics. Before and after didactics, multiple-choice exams as well as questionnaires were administered to assess for course efficacy. Also, a case series of 23 patients needing upper GI endoscopy was done.
  
  
  RESULTS
  In surveying physicians, less than half had resources to perform an EGD and none could perform an ERCP, while waiting time for emergency endoscopy in urban populations was at least one day. In assessing improvement in medical knowledge among participants after didactics, objective data paired with subjective responses was more useful than either alone. Of 23 patients who received endoscopy, 7 required endoscopic intervention with 6 having gastric or esophageal varices. Currently the endoscopic capacity in West Africa is not sufficient. A formal GI course with simulation and didactics improves gastrointestinal knowledge amongst participants.
authors.affiliation: Gastroenterology, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
authors.forename: Daniel
authors.initials: D
authors.lastname: Perl
authors.affiliation: Gastroenterology, Dalhousie University, Halifax, Nova Scotia, Canada.
authors.forename: Desmond
authors.initials: D
authors.lastname: Leddin
authors.affiliation: Department of Surgery, University of the Witwatersrand, Johannesburg, South Africa.
authors.forename: Damon
authors.initials: D
authors.lastname: Bizos
authors.affiliation: Gastroenterology, New Cross Hospital, Wolverhampton, England.
authors.forename: Andrew
authors.initials: A
authors.lastname: Veitch
authors.affiliation: Urological Surgery, University of Aberdeen, Aberdeen, Scotland.
authors.forename: James
authors.initials: J
authors.lastname: N'Dow
authors.affiliation: Horizon's Clinic and Foundation, The Gambia.
authors.forename: Stephanie
authors.initials: S
authors.lastname: Bush-Goddard
authors.affiliation: Hepatology, Medical Research Council Unit, The Gambia.
authors.forename: Ramou
authors.initials: R
authors.lastname: Njie
authors.affiliation: Hepatology, Medical Research Council Unit, The Gambia.
authors.forename: Maud
authors.initials: M
authors.lastname: Lemoine
authors.affiliation: Clinical Services Department, Medical Research Council Unit, The Gambia.
authors.forename: Suzanne T
authors.initials: ST
authors.lastname: Anderson
authors.affiliation: Gastroenterology, Dalhousie University, Halifax, Nova Scotia, Canada.
authors.forename: John
authors.initials: J
authors.lastname: Igoe
authors.affiliation: Gastroenterology, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
authors.forename: Sharmila
authors.initials: S
authors.lastname: Anandasabapathy
authors.affiliation: Gastroenterology, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
authors.forename: Brijen
authors.initials: B
authors.lastname: Shah
mesh_terms: D000354:Africa, Western; D002983:Clinical Competence; D018450:Disease Progression; D004501:Education, Medical / Q000379:methods; D004506:Education, Nursing / Q000379:methods; D004638:Emergency Treatment / Q000379:methods / Q000706:statistics & numerical data; D016099:Endoscopy, Gastrointestinal / Q000193:education* / Q000706:statistics & numerical data*; D006801:Humans; D014850:Waiting Lists
keywords: Endoscopic capacity; West Africa; endoscopic demand; training course