P2383 - Rwanda Endoscopy Week: A Success Story of Endoscopic Practice in Sub-Saharan Africa

Prosper Ingabire, MD¹, Gordon P Bensen, BA², Eric Rutaganda, MD¹, Felicien Shikama, MD¹, Robert Giraneza, MD¹, Benoit Seminega, MD¹, Florence Masaisa, MD¹, Steve Bensen, MD³, Vincent Dusabejambo, MD^1
1University of Rwanda, Kigali, Kigali, Rwanda; ²Harvard Medical School, Jamaica Plain, MA; ³Dartmouth Hitchcock Medical Center, Norwich, VT

Introduction: Since 2017, the Rwanda Society for Endoscopy in partnership with the Rwandan Ministry of Health and GI Rising Inc. – an International non-profit dedicated to advancing GI care in Rwanda – has conducted an annual Endoscopy week (REW) to: 1) offer comprehensive training in GI disorders and endoscopy to local personnel, 2) provide outreach to remote communities delivering quality care to patients in need, and 3) build the capacity of local health facilities to advance and sustain GI care in Rwanda.

Methods: During week one, Rwandan GI fellows presented research projects and the GI core curriculum was delivered to Rwandan residents. Workshops were held on endoscopic nursing technique as well as conscious sedation. During week two, integrated teams of Rwandan and international personnel were deployed to hospitals located in the capital as well as the periphery of the country to deliver high-level GI care and to train local providers.

Results: The 6th REW expanded to 10 hospitals, which included remote district hospitals where endoscopy had not previously been performed. 1069 Procedures were performed: 962 Esophago-gastroduodenoscopies (EGD), 96 colonoscopies and 11 ERCPS. All Colonoscopies and ERCPs received sedation (MAC) while 40% of EGDs were sedated. 888 of the procedures performed were documented in a survey collection tool. 64.9% of patients were male; 95.9% were outpatients. Major presenting symptoms for EGD included chronic dyspepsia, heartburn, emesis, weight loss and early satiety. For colonoscopy, symptoms were constipation, hematochezia, weight loss and abdominal pain. Approximately 75% of procedures were abnormal (Figure 1). A total of 3941 procedures have been conducted over the 6 successive years of REW with annual increases in case number and local facility capacity (Table 1).

Discussion: REW has expanded in scope and impact, treating more patients locally, reducing consultation wait lists, training local professionals (endoscopists, nurses, anesthetists) and sustaining the recently implemented Rwandan GI fellowship. During REW 6, we identified a significant burden of GI pathology including peptic ulcer disease, gastric malignancy, and colorectal malignancy. These findings reflect the high burden of GI disease and current delay in access to care in Rwanda, highlighting the value of continued efforts to expand training and remote site development. Finally, it remains important to improve access to anesthesia for all procedures.



Disclosures:


Prosper Ingabire, MD¹, Gordon P Bensen, BA², Eric Rutaganda, MD¹, Felicien Shikama, MD¹, Robert Giraneza, MD¹, Benoit Seminega, MD¹, Florence Masaisa, MD¹, Steve Bensen, MD³, Vincent Dusabejambo, MD¹. P2383 - Rwanda Endoscopy Week: A Success Story of Endoscopic Practice in Sub-Saharan Africa, ACG 2024 Annual Scientific Meeting Abstracts. Philadelphia, PA: American College of Gastroenterology.