4.6 Article

Establishment of an interdisciplinary vascular anomalies program in Tanzania, East Africa

Journal

FRONTIERS IN MEDICINE
Volume 9, Issue -, Pages -

Publisher

FRONTIERS MEDIA SA
DOI: 10.3389/fmed.2022.1056539

Keywords

radiology; interventional; education; health services needs and demand; developing countries; Tanzania; pediatrics; vascular malformations

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The purpose of this project is to implement a sustainable vascular anomalies (VA) program in Tanzania. Through a stepwise approach, the first interdisciplinary VA program was successfully launched at Muhimbili National Hospital. Minimally-invasive treatments were trained and implemented, and follow-up care was established through online conferences and support from other VA centers. This project sets a blueprint for comprehensive and sustainable care for VAs in Tanzania.
PurposeThe aim of this project is the sustainable implementation of a vascular anomalies (VA) program in Tanzania. Materials and methodsIn 2021 the first interdisciplinary VA program was initiated at Muhimbili National Hospital (MNH), Dar Es Salaam, Tanzania in a stepwise approach. During the planning phase the clinical need for minimally-invasive therapies of VAs and the preexisting structures were assessed by the local Interventional Radiology (IR) team at MNH. During the initiation phase, an IR team from two German VA centers joined the interdisciplinary team at MNH for clinical workup, image-guided procedures and follow-up. VA patients were recruited from existing patient records or seen at clinics as de novo presentations following nationwide advertisement. In the post-processing phase joined online conferences for follow-up and support in management of new patients were established. Further follow-up was supported by attending providers from other established VA centers, traveling to bolster the primary operators of MNH. ResultsThe first interdisciplinary VA program was successfully launched in Tanzania. Minimally-invasive treatments were successfully trained, by performing ultrasound-guided sclerotherapy with polidocanol and bleomycin in twelve patients with slow-flow malformations, one endovascular embolization of a high-flow malformation, and medical treatment of an aggressive infantile hemangioma. Regular online follow-up presentations have been initiated. Follow-up evaluation and required treatment was sustained when appropriate. ConclusionThe presented hands-on training set the ground for the first interdisciplinary VA program in Tanzania. This framework is expected to establish comprehensive and sustainable care of patients with VAs in East Africa and can serve as a blueprint for other sites.

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