Kawooya Michael G, Kisembo Harriet Nalubega, Remedios Denis, Malumba Richard, Del Rosario Perez Maria, Ige Taofeeq, Hasford Francis, Brown Joanna Kasznia, Lette Miriam Mikhail, Mansouri Boudjema, Salama Dina H, Peer Fozy, Nyabanda Rose
Ernest Cook Ultrasound Research and Education Institute, Kampala, Uganda.
Department of Radiology, Mulago National Referral Hospital, Kampala, Uganda.
Insights Imaging. 2022 Mar 26;13(1):58. doi: 10.1186/s13244-022-01203-w.
Africa has seen an upsurge in diagnostic imaging utilization, with benefits of efficient and accurate diagnosis, but these could easily be offset by undesirable effects attributed to unjustified, unoptimized imaging and poor quality examinations. This paper aims to present Africa's position regarding quality and safety in imaging, give reasons for the rising interest in quality and safety, define quality and safety from an African context, list drivers for quality and safety in Africa, discuss the impact of COVID-19 on quality and safety, and review Africa's progress using the Bonn Call for Action framework while proposing a way forward for imaging quality and safety in Africa. In spite of a healthcare setting characterized by meagre financial, human and technology resources, a rapidly widening disease-burden spectrum, growing proportion of non-communicable diseases and resurgence of tropical and global infections, Africa has over the last ten years made significant strides in quality and safety for imaging. These include raising radiation-safety awareness, interest and application of evidence-based radiation safety recommendations and guidance tools, establishing facility and national diagnostic reference levels (DRLs) and strengthening end-user education and training. Major challenges are: limited human resource, low prioritization of imaging in relation to other health services, low level of integration of imaging into the entire health service delivery, insufficient awareness for radiation safety awareness, a radiation safety culture which is emerging, insufficient facilities and opportunities for education and training. Solutions to these challenges should target the entire hierarchy of health service delivery from prioritization, policy, planning, processes to procedures.
非洲的诊断成像利用率呈上升趋势，带来了高效准确诊断的好处，但这些好处可能很容易被不合理、未优化的成像以及质量不佳的检查所带来的不良影响抵消。本文旨在阐述非洲在成像质量与安全方面的立场，说明对质量与安全兴趣上升的原因，从非洲背景定义质量与安全，列出非洲质量与安全的驱动因素，讨论新冠疫情对质量与安全的影响，利用《波恩行动呼吁》框架审视非洲的进展，同时为非洲成像质量与安全提出前进方向。尽管医疗环境面临资金、人力和技术资源匮乏、疾病负担谱迅速扩大、非传染性疾病比例不断上升以及热带和全球感染卷土重来等问题，但在过去十年里，非洲在成像质量与安全方面仍取得了重大进展。这些进展包括提高辐射安全意识、对基于证据的辐射安全建议和指导工具的兴趣及应用、建立机构和国家诊断参考水平（DRLs）以及加强终端用户教育和培训。主要挑战包括：人力资源有限、相对于其他卫生服务而言成像的优先级较低、成像与整个卫生服务提供的整合程度较低、辐射安全意识不足、正在形成的辐射安全文化、教育和培训的设施及机会不足。应对这些挑战的解决方案应针对卫生服务提供的整个层级，从优先级、政策、规划、流程到程序。
