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Establishment of an interdisciplinary vascular anomalies program in Tanzania, East Africa

PURPOSE: The aim of this project is the sustainable implementation of a vascular anomalies (VA) program in Tanzania. MATERIALS AND METHODS: In 2021 the first interdisciplinary VA program was initiated at Muhimbili National Hospital (MNH), Dar Es Salaam, Tanzania in a stepwise approach. During the pl...

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Autores principales: Puhr-Westerheide, Daniel, Masthoff, Max, Shah, Jay, Krechel, Alina, Shemwetta, Mwivano, Naif, Azza A., Ukweh, Ofonime N., Abdul, Ziad, Sarkar, Abizer, Baraka, Balowa Musa, Malecela, Furaha, Lekasio, Praygod Justin, Rajab, Latifa, Mungia, Abbas, Sianga, William, Manji, Karim P., Mbuguje, Eric M., Khoncarly, Sarah, Minja, Frank J., Laage Gaupp, Fabian M., Wildgruber, Moritz
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9871613/
https://www.ncbi.nlm.nih.gov/pubmed/36703894
http://dx.doi.org/10.3389/fmed.2022.1056539
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author Puhr-Westerheide, Daniel
Masthoff, Max
Shah, Jay
Krechel, Alina
Shemwetta, Mwivano
Naif, Azza A.
Ukweh, Ofonime N.
Abdul, Ziad
Sarkar, Abizer
Baraka, Balowa Musa
Malecela, Furaha
Lekasio, Praygod Justin
Rajab, Latifa
Mungia, Abbas
Sianga, William
Manji, Karim P.
Mbuguje, Eric M.
Khoncarly, Sarah
Minja, Frank J.
Laage Gaupp, Fabian M.
Wildgruber, Moritz
author_facet Puhr-Westerheide, Daniel
Masthoff, Max
Shah, Jay
Krechel, Alina
Shemwetta, Mwivano
Naif, Azza A.
Ukweh, Ofonime N.
Abdul, Ziad
Sarkar, Abizer
Baraka, Balowa Musa
Malecela, Furaha
Lekasio, Praygod Justin
Rajab, Latifa
Mungia, Abbas
Sianga, William
Manji, Karim P.
Mbuguje, Eric M.
Khoncarly, Sarah
Minja, Frank J.
Laage Gaupp, Fabian M.
Wildgruber, Moritz
author_sort Puhr-Westerheide, Daniel
collection PubMed
description PURPOSE: The aim of this project is the sustainable implementation of a vascular anomalies (VA) program in Tanzania. MATERIALS AND METHODS: In 2021 the first interdisciplinary VA program was initiated at Muhimbili National Hospital (MNH), Dar Es Salaam, Tanzania in a stepwise approach. During the planning phase the clinical need for minimally-invasive therapies of VAs and the preexisting structures were assessed by the local Interventional Radiology (IR) team at MNH. During the initiation phase, an IR team from two German VA centers joined the interdisciplinary team at MNH for clinical workup, image-guided procedures and follow-up. VA patients were recruited from existing patient records or seen at clinics as de novo presentations following nationwide advertisement. In the post-processing phase joined online conferences for follow-up and support in management of new patients were established. Further follow-up was supported by attending providers from other established VA centers, traveling to bolster the primary operators of MNH. RESULTS: The first interdisciplinary VA program was successfully launched in Tanzania. Minimally-invasive treatments were successfully trained, by performing ultrasound-guided sclerotherapy with polidocanol and bleomycin in twelve patients with slow-flow malformations, one endovascular embolization of a high-flow malformation, and medical treatment of an aggressive infantile hemangioma. Regular online follow-up presentations have been initiated. Follow-up evaluation and required treatment was sustained when appropriate. CONCLUSION: The presented “hands-on” training set the ground for the first interdisciplinary VA program in Tanzania. This framework is expected to establish comprehensive and sustainable care of patients with VAs in East Africa and can serve as a blueprint for other sites.
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spelling pubmed-98716132023-01-25 Establishment of an interdisciplinary vascular anomalies program in Tanzania, East Africa Puhr-Westerheide, Daniel Masthoff, Max Shah, Jay Krechel, Alina Shemwetta, Mwivano Naif, Azza A. Ukweh, Ofonime N. Abdul, Ziad Sarkar, Abizer Baraka, Balowa Musa Malecela, Furaha Lekasio, Praygod Justin Rajab, Latifa Mungia, Abbas Sianga, William Manji, Karim P. Mbuguje, Eric M. Khoncarly, Sarah Minja, Frank J. Laage Gaupp, Fabian M. Wildgruber, Moritz Front Med (Lausanne) Medicine PURPOSE: The aim of this project is the sustainable implementation of a vascular anomalies (VA) program in Tanzania. MATERIALS AND METHODS: In 2021 the first interdisciplinary VA program was initiated at Muhimbili National Hospital (MNH), Dar Es Salaam, Tanzania in a stepwise approach. During the planning phase the clinical need for minimally-invasive therapies of VAs and the preexisting structures were assessed by the local Interventional Radiology (IR) team at MNH. During the initiation phase, an IR team from two German VA centers joined the interdisciplinary team at MNH for clinical workup, image-guided procedures and follow-up. VA patients were recruited from existing patient records or seen at clinics as de novo presentations following nationwide advertisement. In the post-processing phase joined online conferences for follow-up and support in management of new patients were established. Further follow-up was supported by attending providers from other established VA centers, traveling to bolster the primary operators of MNH. RESULTS: The first interdisciplinary VA program was successfully launched in Tanzania. Minimally-invasive treatments were successfully trained, by performing ultrasound-guided sclerotherapy with polidocanol and bleomycin in twelve patients with slow-flow malformations, one endovascular embolization of a high-flow malformation, and medical treatment of an aggressive infantile hemangioma. Regular online follow-up presentations have been initiated. Follow-up evaluation and required treatment was sustained when appropriate. CONCLUSION: The presented “hands-on” training set the ground for the first interdisciplinary VA program in Tanzania. This framework is expected to establish comprehensive and sustainable care of patients with VAs in East Africa and can serve as a blueprint for other sites. Frontiers Media S.A. 2023-01-10 /pmc/articles/PMC9871613/ /pubmed/36703894 http://dx.doi.org/10.3389/fmed.2022.1056539 Text en Copyright © 2023 Puhr-Westerheide, Masthoff, Shah, Krechel, Shemwetta, Naif, Ukweh, Abdul, Sarkar, Baraka, Malecela, Lekasio, Rajab, Mungia, Sianga, Manji, Mbuguje, Khoncarly, Minja, Laage Gaupp and Wildgruber. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Medicine
Puhr-Westerheide, Daniel
Masthoff, Max
Shah, Jay
Krechel, Alina
Shemwetta, Mwivano
Naif, Azza A.
Ukweh, Ofonime N.
Abdul, Ziad
Sarkar, Abizer
Baraka, Balowa Musa
Malecela, Furaha
Lekasio, Praygod Justin
Rajab, Latifa
Mungia, Abbas
Sianga, William
Manji, Karim P.
Mbuguje, Eric M.
Khoncarly, Sarah
Minja, Frank J.
Laage Gaupp, Fabian M.
Wildgruber, Moritz
Establishment of an interdisciplinary vascular anomalies program in Tanzania, East Africa
title Establishment of an interdisciplinary vascular anomalies program in Tanzania, East Africa
title_full Establishment of an interdisciplinary vascular anomalies program in Tanzania, East Africa
title_fullStr Establishment of an interdisciplinary vascular anomalies program in Tanzania, East Africa
title_full_unstemmed Establishment of an interdisciplinary vascular anomalies program in Tanzania, East Africa
title_short Establishment of an interdisciplinary vascular anomalies program in Tanzania, East Africa
title_sort establishment of an interdisciplinary vascular anomalies program in tanzania, east africa
topic Medicine
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9871613/
https://www.ncbi.nlm.nih.gov/pubmed/36703894
http://dx.doi.org/10.3389/fmed.2022.1056539
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