Evidence map›Paper›PMID 37548779›Full record

ArticleCVIR endovascular2023

Uterine artery embolization in Tanzania: a procedure with major public health implications.

Balowa Musa, Jared Mark Alswang, Rose Di Ioia, Lydia Grubic, Azza Naif, Erick Michael Mbuguje, Victoria Vuong, Janice Newsome, Behnam Shaygi, Vijay Ramalingam and 1 more

Open access · goldAbstract read
In one paragraph

Article in CVIR endovascular, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
1.2field-weighted citation impact, top 20% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed, 4 citations in OpenAlex.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors at 10 institutions in 4 countries.

Balowa Musa *Radiology and Imaging Department, School of Medicine, Muhimbili University of Health and Allied Sciences, P.O. Box 65001, Dar Es Salaam, Tanzania.
Jared Mark Alswang *Harvard Medical School, Harvard University, 25 Shattuck Street, Boston, MA, 02115, USA. Jared_alswang@hms.harvard.edu.ORCID http://orcid.org/0000-0002-1839-5712
Rose Di IoiaFaculty of Medicine and Health Sciences, McGill University, 2001 McGill College Avenue, Montreal, QC, H3A 1A3, Canada.
Lydia GrubicMarian University College of Osteopathic Medicine, 3200 Cold Spring Rd, Indianapolis, IN, 46222, USA.
Azza NaifDepartment of Radiology and Imaging, Muhimbili National Hospital, P.O. Box 65000, Dar Es Salaam, Tanzania.
Erick Michael MbugujeDepartment of Radiology and Imaging, Muhimbili National Hospital, P.O. Box 65000, Dar Es Salaam, Tanzania.
Victoria VuongDepartment of Radiology, University of California San Diego Medical Center, 200 W. Arbor Drive, San Diego, CA, 92103, USA.
Janice NewsomeDepartment of Radiology, Emory University School of Medicine, 1364 Clifton Rd, NE, Atlanta, GA, 30322, USA.
Behnam ShaygiDepartment of Radiology, London North West University Healthcare NHS Trust, A404 Watford Rd, Harrow, HA1 3UJ, UK.
Vijay RamalingamDivision of Interventional Radiology, Department of Radiology, Beth Israel Deaconess Medical Center, Harvard Medical School, 1 Deaconess Road, Boston, MA, 02215, USA.
Fabian Max Laage GauppSection of Interventional Radiology, Department of Radiology and Biomedical Imaging, Yale School of Medicine, 333 Cedar St, New Haven, CT, 06510, USA.
Muhimbili National Hospital · TZBeth Israel Deaconess Medical Center · USEmory University · USHarvard University · USLondon North West Healthcare NHS Trust · GBMarian University - Indiana · USMcGill University · CAMuhimbili University of Health and Allied Sciences · TZUniversity of California San Diego Medical Center · USYale University · US

Funding

RSNA Research and Education Foundation 6614
6 · The paper itself

Abstract

backgroundThe burden of uterine fibroids is substantial in sub-Saharan Africa (SSA), with up to 80% of black women harboring them in their lifetime. While uterine artery embolization (UAE) has emerged as an effective alternative to surgery to manage this condition, the procedure is not available to the vast majority of women living in SSA due to limited access to interventional radiology (IR) in the region. One of the few countries in SSA now offering UAE in a public hospital setting is Tanzania. This study aims to assess the safety and effectiveness of UAE in this new environment.

methodsFrom June 2019 to July 2022, a single-center, retrospective cohort study was conducted at Tanzania's first IR service on all patients who underwent UAE for the management of symptomatic fibroids or adenomyosis. Patients were selected for the procedure based on symptom severity, imaging findings, and medical management failure. Procedural technical success and adverse events were recorded for all UAEs. Self-reported symptom severity and volumetric response on imaging were compared between baseline and six-months post-procedure using paired sample t-tests.

resultsDuring the study period, 92.1% (n = 35/38) of patients underwent UAE for the management of symptomatic fibroids and 7.9% (n = 3/38) for adenomyosis. All (n = 38/38) were considered technically successful and one minor adverse event occurred (2.7%). Self-reported symptom-severity scores at six-months post-procedure decreased in all categories: abnormal uterine bleeding from 8.8 to 3.1 (-5.7), pain from 6.7 to 3.2 (-3.5), and bulk symptoms from 2.8 to 1 (-1.8) (p < 0.01). 100% of patients reported satisfaction with outcomes. Among the nine patients with follow-up imaging, there was a mean volumetric decrease of 35.5% (p = 0.109).

conclusionsUAE for fibroids and adenomyosis can be performed with high technical success and low complication rates in a low-resource setting like Tanzania, resulting in significant symptom relief for patients. Building capacity for UAE has major public health implications not only for fibroids and adenomyosis, but can help address the region's leading cause of maternal mortality, postpartum hemorrhage.

Indexed as

AdenomyosisInterventional radiologyPostpartum hemorrhageReproductive healthSub-Saharan AfricaTanzaniaUterine artery embolizationUterine fibroid embolizationUterine fibroids

Identifiers

PMID37548779
PMCPMC10406993
OpenAlexW4385621020

What Socratic holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.