ArticleBMJ open gastroenterology2025
Mobile endoscopy in rural South Africa: outcomes of a decentralised outreach programme to improve gastrointestinal healthcare access.
Article in BMJ open gastroenterology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
introductionGastrointestinal (GI) endoscopy is a valuable diagnostic tool for identifying upper and lower GI pathologies yet is rarely available in resource-limited settings. This project evaluates the impact of a mobile endoscopy outreach effort implemented across five district hospitals in the Western Cape of South Africa.
methodsA mobile endoscopy outreach programme was created and implemented at five district hospitals within the Western Cape of South Africa. Health records of patients who presented for endoscopy across these five hospitals were then retrospectively reviewed. Descriptive statistics were used as part of data analysis.
resultsA total of 515 procedures (486 oesophagogastroduodenoscopies (94%), 28 colonoscopies (5%) and one proctoscopy (0.2%)) were performed at five district hospitals between January and November of 2024 (323 female (63%), 192 male (37%); mean (SD) age 56 (14) years). The most common pathologies identified across all sites included gastritis (76%), hiatal hernia (70%) and oesophagitis (69%). For all patients, the average distance travelled to their nearest district hospital (Beaufort West, Oudtshoorn, Riversdale, Mossel Bay or Knysna) was 13.6 km (SD (26.6)), compared with the average distance they would have needed to travel to the regional referral centre (mean (SD) 102.1 (66.8) km) in George, South Africa, for the same endoscopy services.
conclusionImplementing a mobile, cost-conscious endoscopy outreach programme can offer diagnostic and therapeutic opportunities to patients in international resource-limited settings, while also alleviating resource strain on regional referral centres. This approach can improve healthcare access and can be replicated in other resource-limited settings.
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