Cargando…
Starting and Operating a Public Cardiac Catheterization Laboratory in a Low Resource Setting: The Eight-Year Story of the Uganda Heart Institute Catheter Laboratory
BACKGROUND: Low- and-middle-income-countries (LMICs) currently bear 80% of the world’s cardiovascular disease (CVD) mortality burden. The same countries are underequipped to handle the disease burden due to critical shortage of resources. Functional cardiac catheterization laboratories (cath labs) a...
Autores principales: | , , , , , , , , , , , , , , , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Ubiquity Press
2021
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7879993/ https://www.ncbi.nlm.nih.gov/pubmed/33598391 http://dx.doi.org/10.5334/gh.859 |
_version_ | 1783650624905150464 |
---|---|
author | Rwebembera, Joselyn Aliku, Twalib Kayima, James Lubega, Sulaiman Sebatta, Elias Kiggundu, Brian Kirenzi, Daudi Nyakoojo, Wilson Mondo, Charles Kumar, Krishna Ratnayaka, Kanishka Qureshi, Shakeel Daluvoy, Sanjay Lwabi, Peter Omagino, John Sable, Craig Longenecker, Chris Simon, Dan Costa, Marco Okello, Emmy |
author_facet | Rwebembera, Joselyn Aliku, Twalib Kayima, James Lubega, Sulaiman Sebatta, Elias Kiggundu, Brian Kirenzi, Daudi Nyakoojo, Wilson Mondo, Charles Kumar, Krishna Ratnayaka, Kanishka Qureshi, Shakeel Daluvoy, Sanjay Lwabi, Peter Omagino, John Sable, Craig Longenecker, Chris Simon, Dan Costa, Marco Okello, Emmy |
author_sort | Rwebembera, Joselyn |
collection | PubMed |
description | BACKGROUND: Low- and-middle-income-countries (LMICs) currently bear 80% of the world’s cardiovascular disease (CVD) mortality burden. The same countries are underequipped to handle the disease burden due to critical shortage of resources. Functional cardiac catheterization laboratories (cath labs) are central in the diagnosis and management of CVDs. Yet, most LMICs, including Uganda, fall remarkably below the minimum recommended standards of cath lab:population ratio due to a host of factors including the start-up and recurring costs. OBJECTIVES: To review the performance, challenges and solutions employed, lessons learned, and projections for the future for a single cath lab that has been serving the Ugandan population of 40 million people in the past eight years. METHODS: A retrospective review of the Uganda Heart Institute cath lab clinical database from 15 February 2012 to 31 December 2019 was performed. RESULTS: In the initial two years, this cath lab was dependent on skills transfer camps by visiting expert teams, but currently, Ugandan resident specialists independently operate this lab. 3,542 adult and pediatric procedures were conducted in 8 years, including coronary angiograms and percutaneous coronary interventions, device implantations, valvuloplasties, and cardiac defect closures, among others. There was a consistent expansion of the spectrum of procedures conducted in this cath lab each year. The initial lack of technical expertise and sourcing for equipment, as well as the continual need for sundries present(ed) major roadblocks. Government support and leveraging existing multi-level collaborations has provided a platform for several solutions. Sustainability of cath lab services remains a significant challenge especially in relation to the high cost of sundries and other consumables amidst a limited budget. CONCLUSION: A practical example of how centers in LMIC can set up and sustain a public cardiac catheterization laboratory is presented. Government support, research, and training collaborations, if present, become invaluable leverage opportunities. |
format | Online Article Text |
id | pubmed-7879993 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | Ubiquity Press |
record_format | MEDLINE/PubMed |
spelling | pubmed-78799932021-02-16 Starting and Operating a Public Cardiac Catheterization Laboratory in a Low Resource Setting: The Eight-Year Story of the Uganda Heart Institute Catheter Laboratory Rwebembera, Joselyn Aliku, Twalib Kayima, James Lubega, Sulaiman Sebatta, Elias Kiggundu, Brian Kirenzi, Daudi Nyakoojo, Wilson Mondo, Charles Kumar, Krishna Ratnayaka, Kanishka Qureshi, Shakeel Daluvoy, Sanjay Lwabi, Peter Omagino, John Sable, Craig Longenecker, Chris Simon, Dan Costa, Marco Okello, Emmy Glob Heart Original Research BACKGROUND: Low- and-middle-income-countries (LMICs) currently bear 80% of the world’s cardiovascular disease (CVD) mortality burden. The same countries are underequipped to handle the disease burden due to critical shortage of resources. Functional cardiac catheterization laboratories (cath labs) are central in the diagnosis and management of CVDs. Yet, most LMICs, including Uganda, fall remarkably below the minimum recommended standards of cath lab:population ratio due to a host of factors including the start-up and recurring costs. OBJECTIVES: To review the performance, challenges and solutions employed, lessons learned, and projections for the future for a single cath lab that has been serving the Ugandan population of 40 million people in the past eight years. METHODS: A retrospective review of the Uganda Heart Institute cath lab clinical database from 15 February 2012 to 31 December 2019 was performed. RESULTS: In the initial two years, this cath lab was dependent on skills transfer camps by visiting expert teams, but currently, Ugandan resident specialists independently operate this lab. 3,542 adult and pediatric procedures were conducted in 8 years, including coronary angiograms and percutaneous coronary interventions, device implantations, valvuloplasties, and cardiac defect closures, among others. There was a consistent expansion of the spectrum of procedures conducted in this cath lab each year. The initial lack of technical expertise and sourcing for equipment, as well as the continual need for sundries present(ed) major roadblocks. Government support and leveraging existing multi-level collaborations has provided a platform for several solutions. Sustainability of cath lab services remains a significant challenge especially in relation to the high cost of sundries and other consumables amidst a limited budget. CONCLUSION: A practical example of how centers in LMIC can set up and sustain a public cardiac catheterization laboratory is presented. Government support, research, and training collaborations, if present, become invaluable leverage opportunities. Ubiquity Press 2021-02-09 /pmc/articles/PMC7879993/ /pubmed/33598391 http://dx.doi.org/10.5334/gh.859 Text en Copyright: © 2021 The Author(s) http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution 4.0 International License (CC-BY 4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. See http://creativecommons.org/licenses/by/4.0/. |
spellingShingle | Original Research Rwebembera, Joselyn Aliku, Twalib Kayima, James Lubega, Sulaiman Sebatta, Elias Kiggundu, Brian Kirenzi, Daudi Nyakoojo, Wilson Mondo, Charles Kumar, Krishna Ratnayaka, Kanishka Qureshi, Shakeel Daluvoy, Sanjay Lwabi, Peter Omagino, John Sable, Craig Longenecker, Chris Simon, Dan Costa, Marco Okello, Emmy Starting and Operating a Public Cardiac Catheterization Laboratory in a Low Resource Setting: The Eight-Year Story of the Uganda Heart Institute Catheter Laboratory |
title | Starting and Operating a Public Cardiac Catheterization Laboratory in a Low Resource Setting: The Eight-Year Story of the Uganda Heart Institute Catheter Laboratory |
title_full | Starting and Operating a Public Cardiac Catheterization Laboratory in a Low Resource Setting: The Eight-Year Story of the Uganda Heart Institute Catheter Laboratory |
title_fullStr | Starting and Operating a Public Cardiac Catheterization Laboratory in a Low Resource Setting: The Eight-Year Story of the Uganda Heart Institute Catheter Laboratory |
title_full_unstemmed | Starting and Operating a Public Cardiac Catheterization Laboratory in a Low Resource Setting: The Eight-Year Story of the Uganda Heart Institute Catheter Laboratory |
title_short | Starting and Operating a Public Cardiac Catheterization Laboratory in a Low Resource Setting: The Eight-Year Story of the Uganda Heart Institute Catheter Laboratory |
title_sort | starting and operating a public cardiac catheterization laboratory in a low resource setting: the eight-year story of the uganda heart institute catheter laboratory |
topic | Original Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7879993/ https://www.ncbi.nlm.nih.gov/pubmed/33598391 http://dx.doi.org/10.5334/gh.859 |
work_keys_str_mv | AT rwebemberajoselyn startingandoperatingapubliccardiaccatheterizationlaboratoryinalowresourcesettingtheeightyearstoryoftheugandaheartinstitutecatheterlaboratory AT alikutwalib startingandoperatingapubliccardiaccatheterizationlaboratoryinalowresourcesettingtheeightyearstoryoftheugandaheartinstitutecatheterlaboratory AT kayimajames startingandoperatingapubliccardiaccatheterizationlaboratoryinalowresourcesettingtheeightyearstoryoftheugandaheartinstitutecatheterlaboratory AT lubegasulaiman startingandoperatingapubliccardiaccatheterizationlaboratoryinalowresourcesettingtheeightyearstoryoftheugandaheartinstitutecatheterlaboratory AT sebattaelias startingandoperatingapubliccardiaccatheterizationlaboratoryinalowresourcesettingtheeightyearstoryoftheugandaheartinstitutecatheterlaboratory AT kiggundubrian startingandoperatingapubliccardiaccatheterizationlaboratoryinalowresourcesettingtheeightyearstoryoftheugandaheartinstitutecatheterlaboratory AT kirenzidaudi startingandoperatingapubliccardiaccatheterizationlaboratoryinalowresourcesettingtheeightyearstoryoftheugandaheartinstitutecatheterlaboratory AT nyakoojowilson startingandoperatingapubliccardiaccatheterizationlaboratoryinalowresourcesettingtheeightyearstoryoftheugandaheartinstitutecatheterlaboratory AT mondocharles startingandoperatingapubliccardiaccatheterizationlaboratoryinalowresourcesettingtheeightyearstoryoftheugandaheartinstitutecatheterlaboratory AT kumarkrishna startingandoperatingapubliccardiaccatheterizationlaboratoryinalowresourcesettingtheeightyearstoryoftheugandaheartinstitutecatheterlaboratory AT ratnayakakanishka startingandoperatingapubliccardiaccatheterizationlaboratoryinalowresourcesettingtheeightyearstoryoftheugandaheartinstitutecatheterlaboratory AT qureshishakeel startingandoperatingapubliccardiaccatheterizationlaboratoryinalowresourcesettingtheeightyearstoryoftheugandaheartinstitutecatheterlaboratory AT daluvoysanjay startingandoperatingapubliccardiaccatheterizationlaboratoryinalowresourcesettingtheeightyearstoryoftheugandaheartinstitutecatheterlaboratory AT lwabipeter startingandoperatingapubliccardiaccatheterizationlaboratoryinalowresourcesettingtheeightyearstoryoftheugandaheartinstitutecatheterlaboratory AT omaginojohn startingandoperatingapubliccardiaccatheterizationlaboratoryinalowresourcesettingtheeightyearstoryoftheugandaheartinstitutecatheterlaboratory AT sablecraig startingandoperatingapubliccardiaccatheterizationlaboratoryinalowresourcesettingtheeightyearstoryoftheugandaheartinstitutecatheterlaboratory AT longeneckerchris startingandoperatingapubliccardiaccatheterizationlaboratoryinalowresourcesettingtheeightyearstoryoftheugandaheartinstitutecatheterlaboratory AT simondan startingandoperatingapubliccardiaccatheterizationlaboratoryinalowresourcesettingtheeightyearstoryoftheugandaheartinstitutecatheterlaboratory AT costamarco startingandoperatingapubliccardiaccatheterizationlaboratoryinalowresourcesettingtheeightyearstoryoftheugandaheartinstitutecatheterlaboratory AT okelloemmy startingandoperatingapubliccardiaccatheterizationlaboratoryinalowresourcesettingtheeightyearstoryoftheugandaheartinstitutecatheterlaboratory |