The drivers of migration of Ghanaian radiographers to high-income countries.

Background: The brain drain of Ghanaian radiographers is a growing concern for the Ghana Health Service and patient care in the country. Unfortunately, this is affecting the quality of radiology services in Ghana. This study investigated the determinants of radiographers' brain drain from Ghana and identified potential mitigating factors. Methods: A cross-sectional survey was conducted using a semi-structured questionnaire which was administered online to Ghanaian radiographers. The questionnaire gathered data on push and pull factors that influenced brain drain. Statistical analysis was performed using SPSS version 29. Results: A total of 128 radiographers participated in the study. The findings indicated that 92.2 % of Ghanaian radiographers expressed intentions to work abroad. The estimated means and standard deviations on a five-point Likert Scale demonstrated that poor salary (4.47 ± 0.1) and poor working conditions (4.17 ± 1.1) were the main push factors, while improved living conditions (4.62 ± 0.9) and better health infrastructure (4.55 ± 0.9) were the influential pull/attractive factors. Although there are variations in participants' demographics, comparative analyses of push and pull factors indicated that respondents did not significantly differ in their migration decisions intentions (p < 0.05). To mitigate brain drain, respondents emphasised the need for better salaries (97.7 %) and comprehensive health insurance for radiographers and their families (92.2 %) among other factors. Conclusion: This study highlights the multifaceted factors that drive Ghanaian radiographers abroad and their consequences on the healthcare system. A comprehensive strategy encompassing financial incentives, career development, improved working conditions, and personal satisfaction was identified as a mitigating approach to addressing these challenges. Implementation of these recommendations by policymakers is necessary to create an environment that retains and empowers radiographers and ultimately enhances patient care and healthcare advancement in Ghana.

Assessment of average glandular dose in mammography practice of a teaching hospital in Ghana.

Introduction: above the age of 40, women are advised to begin breast examinations and screenings for early detection of breast cancer. The average glandular dose (AGD) provides dosimetric information about the quantity of radiation received by the mammary glands during mammographic exposures. There is, therefore, the need to analyse the radiation dose received by patients presenting for mammography examinations. Methods: a retrospective cross-sectional design was carried out on the data of 663 participants, conveniently sampled between the months of July 2021 and June 2022. Paired T-test was used to compare imaging parameters for cranio-caudal (CC), medio-lateral (ML), automatic exposure control (AEC), manual exposure control (MEC), and left and right breast. Pearson´s correlation was used to test for relationship between imaging parameters and AGD. Results: the mean AGD per exposure was 1.9 ± 0.7 mGy for CC projections and 2.3 ± 1.2 mGy for ML projections. The mean AGD per examination for the study was 4.1 ± 1.4 mGy. A positive correlation was found between AGD per examination and exposure factors (tube loading and tube voltage), compressed breast thickness, and compression force. Patient age had no statistically significant relationship with the AGD per examination. Conclusion: average glandular dose (AGD) was consistent with other findings in literature studies. It was also observed that MEC yielded lower AGD per exposure values than AEC. There was no significant difference in the mean AGD per exposure for left and right breasts.

Psychometrically Equivalent Fante Speech Recognition Threshold Materials by a Female Talker.

PURPOSE: This study aimed to create and evaluate digitally recorded speech materials for speech recognition threshold (SRT) testing among children and adults in Fante. Fifty-one (51) familiar trisyllabic words were chosen from a list of 107 widely used trisyllabic Fante words. They were digitally captured and edited to create the same root mean square as a 1-kHz calibration tone. METHOD: The study used a three-phase cross-sectional study method. Twenty native Fante speakers with normal hearing thresholds were selected at random for listener evaluation. For each of the words, the researchers used logistic regression to measure the slope, intercepts, and psychometric function slope at 50% and from 20% to 80%. In the study, the intensity of each word was modified digitally, so that the threshold at 50% of each word was equal to the mean pure-tone average (PTA) of the participants to increase the homogeneity of the thresholds of the selected words. RESULTS: A final list of 25 familiar homogenous words with the same tone patterns of slopes greater than 7%/dB was finally selected and recorded for speech audiometry in Fante. CONCLUSIONS: Psychometrically equivalent trisyllabic words in Fante were successfully developed and evaluated for SRT testing in Ghana. There is a need for the development of speech audiometry materials in other Ghanaian languages.

Patient radiation dose during diagnostic and interventional cardiology procedures: A study in a tertiary hospital.

BACKGROUND: Fluoroscopy-guided diagnostic and interventional cardiology (IC) procedures help to identify and treat several problems associated with the heart. However, these procedures expose patients, cardiologists, radiographers, and nurses to radiation doses. Due to the risk that ionizing radiation poses, concerns have been raised and studies are continually being done to ensure that optimization is achieved during such procedures. This study assessed patient radiation dose during diagnostic and interventional cardiology procedures as well as right heart studies at a tertiary hospital in Ghana to formulate the facility's diagnostic reference levels (DRLs) for optimization purposes. As this study was the first of its kind in Ghana, it was a vital step towards dose optimization within the local department, as well as contributing to future DRLs in Ghana. METHODS: The study collected dose (air kerma, and kerma area product (KAP) and procedural data, and assessed any correlation between parameters such as fluoroscopy time and KAP, and between body mass index (BMI) and KAP. The DRL values were determined as the 75th percentile level for the dose distribution for the various IC procedures including percutaneous coronary interventions (PCI), coronary angiography (CA), and right heart catheterization (RHC). Data were analyzed using SPSS version 23. RESULTS: CA was the most frequently performed IC procedure (77.3%), while RHC was the least recorded (3.3%). The highest mean KAP was observed during the PCI procedure. The proposed diagnostic reference levels (DRLs) were 162.0 Gy.cm2 (PCI), 69.4 Gy.cm2 (CA), 39.8 Gy.cm2 (RHC) and 159.9 Gy.cm2 (CA+PCI). Patients who presented for the CA+PCI and RHC procedures received the highest and lowest mean KAP of 159.9 Gy.cm2 and 39.8 Gy.cm2 of radiation respectively. CONCLUSION: This study, therefore, concludes that there is a need for dose optimization of radiation exposures for IC procedures at the cardiothoracic center in Ghana.

Development of size-specific dose estimates for common computed tomography examinations: a study in Ghana.

This study determined the size-specific dose estimate (SSDE) of computed tomography (CT) examinations and derived mathematical expressions for dose output estimation and optimization in a teaching hospital in Ghana. Demographic and scanner output indices, including CT dose index (CTDIvol) and dose length product for adult head, chest and abdominopelvic (ABP) CT examinations carried out at the hospital from 2018 to 2020, were retrieved from the picture archiving and communication system of the CT scanner machine. Other indices such as the antero-posterior diameter (DAP), lateral diameter (DL) and diagonal diameter (Ddia) of the patients' bodies were measured on the mid-slice axial image using a digital caliper. The effective diameter (Deff) was then calculated as the square root of the product of theDAPandDL. The SSDEs were calculated as the product of the CTDIvoland the size-specific conversion factors obtained from Report 204 of the American Association of Physicists in Medicine. Regression analyses were performed to find the relationship between SSDE and the various parameters to derive mathematical equations for the dose estimations. There were more female samples (n= 468, 56.3%) than male samples (n= 364, 43.7%) for each CT procedure. The SSDEs and size-specific diagnostic reference levels (SSDRLs) were: head (83.9 mGy; 86.9 mGy), chest (8.1 mGy; 8.7 mGy) and ABP (8.4 mGy; 9.2 mGy). The variations between CTDIvoland SSDEs for head (2.50%), chest (25.9%), and ABP (26.2%) showed an underestimation of radiation dose to patients, especially in chest and ABP examinations, if CTDIvolis used to report patient doses. The SSDEs of the chest and ABP CT examinations showed linear correlations with the CTDIvol. The estimated values could be used to optimize radiation doses in the CT facility. The SSDE and SSDRLs for head, chest and ABP CT examinations have been developed at a teaching hospital in Ghana. The SSDEs of chest and ABP examinations showed linear correlations with the CTDIvoland hence can be calculated using the mathematically derived equations in the study.

Biochemical outcome after curative treatment for localized prostate cancer with external beam radiotherapy: a cross-sectional study.

Although many patients who receive definitive radiotherapy (RT) for localised prostate cancer (CaP) experience long-term disease-free survival and better quality of life, some also have biochemical progression during follow-up. Oftentimes this implies additional treatment for patients with the accompanying challenges of cumulative treatment side effects, inconvenience and financial toxicity. This study retrospectively assessed the clinicopathological characteristics and biochemical outcomes of patients treated for localised CaP with external beam radiotherapy (EBRT) between 2015 and 2020 at a major cancer treatment centre in Accra, Ghana. Patients' socio-demographic and clinical data were collected from their hospital records and analysed with the Statistical Package for Social Sciences version 26. Biochemical failure (BCF) was defined as an increase in the level of serum prostate-specific antigen (PSA) >2 ng/mL above the nadir after curative therapy based on the Phoenix definition. The mean age was 67.6 years (SD ± 6.2). The majority of the study participants (n = 79, 64.8%) had initial PSA >20 ng/mL, with the highest recorded value of 705 ng/mL. All the patients had biopsy-proven adenocarcinoma of the prostate gland. Some patients received 3-dimensional conformal radiotherapy (3DCRT) on a cobalt-60 teletherapy machine whereas others were treated with either 3DCRT or intensity-modulated radiotherapy (IMRT) on a 6 MV Linac. In all, 13.1% of the patients experienced BCF after receiving EBRT after an average follow-up of 31.3 months. This study demonstrated a low rate of BCF among patients treated with EBRT for localised CaP in Ghana. Strong prognostic factors of biochemical outcome demonstrated in this study were the percentage of cores positive, grade group, and risk stratification. Diarrhaea and desquamation experienced by treated CaP patients were exclusively attributable to EBRT. RT produced a complete resolution of symptoms in some of the patients.

The assertiveness of final year student radiographers during their clinical practice: A study in Ghana.

INTRODUCTION: Speaking up by health professionals is essential for patient safety. To ensure that student radiographers are well equipped in professional practice at the time of graduation, their capacity to speak up openly in the clinical setting is very important. This study assessed student radiographers' ability to speak up in the face of patient safety compromises during their clinical rotation and how it impacts their learning. METHODS: Twenty-four (24) final-year radiography students at the University of Ghana, who were then the only final years in the country, were recruited for the study. Questionnaires about assertive communication using a harm index score were given to the students who consented to participate in the study. The data were analysed using Microsoft Excel version 13 and SPSS version 20. RESULTS: The study recorded a response rate of 96% of which the majority (66.7%) were males. The majority (75%) of the participants would not speak up about patient safety issues for reasons. Moreover, 95.8% of the participants got confused when they observed a disparity between clinical practice and lessons taught in the lecture room. CONCLUSION: The ability of students to speak up is dependent on several factors encountered in the clinical area. For students to be able to function well in a clinical team, they need to be competent to speak up to ensure patient safety irrespective of who they work with. This study identified that students preferred to express themselves non-verbally in some situations that deal with patient safety compromises, instead of speaking up. Improving a culture of respect and freedom to speak up in healthcare settings would ensure patient wellbeing.

Financial toxicity of cancer care in low- and middle-income countries: a systematic review and meta-analysis.

INTRODUCTION: The costs associated with cancer diagnosis, treatment and care present enormous financial toxicity. However, evidence of financial toxicity associated with cancer in low- and middle-income countries (LMICs) is scarce. AIM: To determine the prevalence, determinants and how financial toxicity has been measured among cancer patients in LMICs. METHODS: Four electronic databases were searched to identify studies of any design that reported financial toxicity among cancer patients in LMICs. Random-effects meta-analysis was used to derive the pooled prevalence of financial toxicity. Sub-group analyses were performed according to costs and determinants of financial toxicity. RESULTS: A total of 31 studies were included in this systematic review and meta-analysis. The pooled prevalence of objective financial toxicity was 56.96% (95% CI, 30.51, 106.32). In sub-group meta-analyses, the objective financial toxicity was higher among cancer patients with household size of more than four (1.17% [95% CI, 1.03, 1.32]; p = 0.02; I2 = 0%), multiple cycles of chemotherapy (1.94% [95% CI, 1.00, 3.75]; p = 0.05; I2 = 43%) and private health facilities (2.87% [95% CI, 1.89, 4.35]; p < 0.00001; I2 = 26%). Included studies hardly focused primarily on subjective measures of financial toxicity, such as material, behavioural and psychosocial. One study reported that 35.4% (n = 152 of 429) of cancer patients experienced high subjective financial toxicity. CONCLUSIONS: This study indicates that cancer diagnosis, treatment and care impose high financial toxicity on cancer patients in LMICs. Further rigorous research on cancer-related financial toxicity is needed.

STATUS OF RADIATION DOSE LEVELS IN PAEDIATRIC CHEST RADIOGRAPHY IN A TERTIARY HOSPITAL IN GHANA.

Determination of appropriate radiation doses to paediatric patients in accordance with the as low as reasonably achievable (ALARA) principle is important, as it allows for effective optimization of imaging techniques. This study assessed the status of radiation dose levels in paediatric patients undergoing chest X-ray examinations at a tertiary hospital in Ghana. A population encompassing 86 paediatric patients categorised as infants (<1 y), young children (1-5 y) and older children (6-12 y) was selected using a quasi-experimental study design. The patients' anatomical data and X-ray beam exposure parameters were used to indirectly calculate the entrance surface doses (ESDs) received during the examinations. The infants received the highest mean ESD of 196 µGy (uncertainty = 0.37) compared to 158 µGy (uncertainty = 0.46) among the older children. The risk of developing radiation-induced biological effects was therefore higher for infant patients. The ESDs were generally higher than the internationally recommended reference doses. Careful adoption of internationally accepted exposure factors (high tube voltage and low tube load) is most recommended to optimise the dose.

Hearing impairment among chronic kidney disease patients on haemodialysis at a tertiary hospital in Ghana.

BACKGROUND: Chronic kidney disease is a major public health challenge, globally. Inadequate excretion of metabolic waste products by the kidneys results in circulation of these toxic materials in the body. This can cause damage to tissues and organ systems including the auditory system which can lead to hearing loss. AIM: The study was aimed at determining the prevalence, degrees and types of hearing impairment among Chronic kidney disease patients on haemodialysis in Ghana. METHODS: A case-control study involving 50 Chronic Kidney disease patients and 50 age and gender-matched control group was carried out at the Korle Bu Teaching Hospital (KBTH). A structured questionnaire was administered to obtain basic socio-demographic data and case history of the participants. Audiological assessment was performed using a test battery comprising otoscopy, tympanometry and pure tone audiometry in a soundproof booth. RESULTS: Higher hearing thresholds were recorded across all the frequencies tested among the case group than the control group (p < 0.05) in both ears. Only sensorineural hearing loss was identified among the cases. The prevalence of hearing loss was 32% among the case group and 12% among the control group. No significant association was observed between hearing loss and duration of Chronic kidney disease (p = 0.16), gender of Chronic kidney disease patient and hearing loss (p = 0.88), and duration of Chronic kidney disease and degree of hearing loss (p=0.31). CONCLUSION: Our study showed that Chronic Kidney disease patients on haemodialysis are at higher risk of experiencing hearing loss. FUNDING: None declared.

Interregional Newborn Hearing Screening via Telehealth in Ghana.

BACKGROUND: Newborn hearing screening is a vital aspect of the Early Hearing Detection and Intervention program, aimed at detecting hearing loss in children for prompt treatment. In Ghana, this kind of pediatric hearing service is available at only one health care facility located in the Greater Accra Region. The current practice in effect has virtually cut-off infants in the other regions from accessing hearing screening and other pediatric audiological services. This has prompted a study into alternative methodologies to expand the reach of such services in Ghana. The present study was designed to assess the feasibility of using telehealth to deliver newborn hearing screening across Ghana. PURPOSE: To assess the feasibility of using telehealth to extend newborn hearing screening services across the ten regions of Ghana. RESEARCH DESIGN: A correlational study was designed to determine the extent of association between test results of telehealth and the conventional on-site methods (COMs) for conducting newborn hearing screening. The design also allowed for testing duration between the two methods to be compared. STUDY SAMPLE: Fifty infants from the Brong-Ahafo Regional Hospital (BARH) were enrolled. The infants aged between 2 and 90 days were selected through convenience sampling. There were 30 males and 20 females. PROCEDURE: Newborn hearing screening using distortion product otoacoustic emissions were performed via telehealth. By adopting the synchronous telehealth model, an audiologist located at the Korle-Bu Teaching Hospital conducted real-time hearing screening tests over the internet on infants who were at the BARH. The former and latter hospitals are located in the Greater Accra and the Brong-Ahafo Regions, respectively. As a control, similar hearing screening tests were conducted on the same infants at BARH using the conventional face-to-face on-site hearing screening method. DATA COLLECTION AND ANALYSIS: The test results and testing duration of the telehealth method and the conventional on-site approach were compared and subjected to statistical analysis. Here, the Spearman's correlation coefficient (rs) was used to determine the level of correlation between the test results, whereas the paired t-test statistic was used to test the level of significance between the testing duration of the two methods. RESULTS: Analysis of the test results showed a significantly high positive correlation between the telehealth and the COMs (rs = 0.778, 0.878, 0.857, 0.823, p < 0.05 @ 2.0, 3.0, 4.0, and 5.0 kHz respectively). Also, the difference in testing duration of the two methods was not statistically significant [t(99) = 1.309, p > 0.05]. The mean testing duration (in seconds) of telehealth was 27.287 (standard deviation = 27.373) and that of the COM was 24.689 (standard deviation = 27.169). CONCLUSION: The study showed the feasibility of establishing an interregional network of newborn hearing screening services across Ghana using telehealth. It is more efficient to deploy telehealth for pediatric hearing services than to have patients travel many hours to the Greater Accra Region for similar services. Poor road network, high transportation costs, and bad weather conditions are a few of the reasons for avoiding long distance travel in Ghana.

Hearing impairment among chronic kidney disease patients on haemodialysis at a tertiary hospital in Ghana

Background: Chronic kidney disease is a major public health challenge, globally. Inadequate excretion of metabolic waste products by the kidneys results in circulation of these toxic materials in the body. This can cause damage to tissues and organ systems including the auditory system which can lead to hearing loss. Aim: The study was aimed at determining the prevalence, degrees and types of hearing impairment among Chronic kidney disease patients on haemodialysis in Ghana. Methods: A case-control study involving 50 Chronic Kidney disease patients and 50 age and gender-matched control group was carried out at the Korle Bu Teaching Hospital (KBTH). A structured questionnaire was administered to obtain basic socio-demographic data and case history of the participants. Audiological assessment was performed using a test battery comprising otoscopy, tympanometry and pure tone audiometry in a soundproof booth. Results: Higher hearing thresholds were recorded across all the frequencies tested among the case group than the control group (p < 0.05) in both ears. Only sensorineural hearing loss was identified among the cases. The prevalence of hearing loss was 32% among the case group and 12% among the control group. No significant association was observed between hearing loss and duration of Chronic kidney disease (p = 0.16), gender of Chronic kidney disease patient and hearing loss (p = 0.88), and duration of Chronic kidney disease and degree of hearing loss (p=0.31).Conclusion: Our study showed that Chronic Kidney disease patients on haemodialysis are at higher risk of experiencing hearing loss

Women in Radiography Practice in Ghana: Motivating and Demotivating Factors.

PURPOSE: To investigate and establish reasons for the smaller but increasing population of female radiographers in Ghana, and to evaluate the motivating and demotivating contributory factors associated with women's choice of the profession. METHODS: A descriptive quantitative survey design and a purposive sampling technique were used to recruit participants from hospitals, clinics, and private imaging centers in Ghana. Forty registered female radiographers were invited to participate in the survey, and 30 participants completed and returned the questionnaires. RESULTS: Fear of the possible effects of radiation exposure (57%) and other associated risks were identified by female radiographers as the primary reasons for the low number of women practicing radiography. Lack of training centers and lecturers (27%) and lack of books (23%) were other major demotivating factors. Job security (23%) and a desire to work in a hospital (30%) motivated their continued practice. DISCUSSION: Most of the motivating and demotivating factors found in this study were in agreement with the literature; however, approximately 27% of the respondents observed that lack of training centers and lecturers were the main challenges encountered during their professional studies, which is inconsistent with 1 study that found that the primary detractors for radiography students included poor remuneration, radiation hazards, poor societal recognition, lifestyle of radiographers, curriculum content, lack of a professional title, and male dominance. CONCLUSION: The number of women practicing radiography in Ghana is increasing. The male-to-female ratio is estimated to be 3 to 1. Although fear of the biologic effects of working with radiation was demotivating, job availability and a desire to work in health facilities were motivating. The need for effective career guidance and continued education at the high school level was identified as necessary to abate fears about the risks of working with radiation and to increase the number of women practicing radiography in Ghana.

Dichotomy between theory and practice in chest radiography and its impact on students.

INTRODUCTION: It is important that theory is synchronous with clinical practices that students engage in. Lack of congruence between theory and practice presents serious problems to students. This study was therefore conducted to determine if there was a theory-practice gap in chest radiography during clinical rotations, and any associated causes and effects on radiography students. METHOD: A descriptive survey design was used to conduct this study from 2 February to 27 July 2014. A semi-structured questionnaire consisting of open- and close-ended questions was used to purposively collect data from 26 radiography students in Ghana who had completed theory lessons in chest radiography and had either completed or were undertaking clinical rotations in chest radiography. RESULTS: Twenty-five (96%) respondents indicated the presence of theory-practice gap in chest radiography during clinical rotations, where differences between theory and clinical practice were observed. Lack of working materials 16 (62%), heavy workload 14 (54%), equipment breakdowns 14 (54%) and supervisory factors 11 (43%) were identified as the causes. Many students (81%) experienced diverse adverse effects such as confusion 10 (38%), poor performance during clinical examinations 6 (23%) and entire loss of interest in the professional training 1 (4%) of this dichotomy. CONCLUSION: Dichotomy between theory and practice found in chest radiography has diverse adverse effects on students. Regular feedback on the quality of clinical practice received by students should be encouraged to determine the existence of any gaps between theory and practice in order to promote effective clinical rotation programmes in radiography.

Caustic soda ingestion in children under-5 years presenting for fluoroscopic examinations in an Academic Hospital in Ghana.

BACKGROUND: Disastrous effects and lifelong complications, ranging from respiratory and gastrointestinal burns to death can result from caustic soda ingestion. Accidental and non-accidental ingestions occur in different age groups. However, it is very troubling to find ingestion of caustic soda a very common occurrence among children below 5 years since they do not have the developmental level required to independently weigh up risks and are also under parental and societal protections. This study was therefore planned to investigate the ingestions of caustic soda by these children for purposes of proposing measures to curb the problem. METHODS: Descriptive survey was employed for this study. A 14-item, semi-structure questionnaire was purposively issued to 57 parents/guardians whose wards had ingested caustic soda. Data was analysed with SPSS V.20. RESULTS: Twenty-seven (47.4 %) children got access to the soda at storage, 1 (1.86 %) was administered accidentally by a sibling while 29 (50.9 %) ingested during soap preparation. In respect of the former, the majority got access because it was stored in soft drink and water bottles in their parents/guardians rooms or kitchen. For the later, the children got access to the left-over soda because the soap-makers failed to adhere to good storage and disposal practices. CONCLUSION: Storage of caustic soda in soft drink and water bottles in accessible places, and training of children to drink directly from bottles influence caustic soda ingestion in children under five. Non-compliance to good practices of storage and disposal of caustic soda during soap preparation increases exposure and access of children to caustic soda ingestion.

Hysterosalpingographic findings among Ghanaian women undergoing infertility work-up: a study at the Korle-Bu Teaching Hospital.

BACKGROUND: Hysterosalpingography (HSG) is one of the commonly used radiological modalities for investigating infertility in women. In developing countries such as Ghana it remains the main tool for investigating some of the underlying causes of female infertility. The purpose of this study was to determine the predominance of various hysterosalpingographic results in patients that went through infertility work-up at the Korle-Bu Teaching Hospital between January 2011 and December, 2014. This is to help plan for preventive measures for the communities. RESULTS: This study collected retrospectively, 1140 consecutive radiologic reports from January 2011 to December, 2014 from the Department of Radiology, Korle-Bu Teaching Hospital. These reports were reviewed and diagnoses made were evaluated with Microsoft Excel. Secondary infertility was 52.4 % prevalent and primary infertility was 41 % prevalent. While 453 (39.7 %) patients presented with normal findings, 153 (13.4 %) had hydrosalpinx, 498 (43.6 %) had tubal blockage, and 290 (25.4 %) had fibroids. Also there were 10 (0.9 %) cases of patulous cervices, 8 (0.8 %) cases of uterine synechiae, 62 (5.4 %) of irregular uterine outline, 15 (1.3 %) of irregular cervical outline, 3 (0.3 %) of arcuate uteri, and 5 (0.4 %) cases of retroverted uteri. CONCLUSION: Tubal blockage which presented in 43.6 % of patients was the most common abnormal finding at HSG examinations carried out between January 2011 and December, 2014 at the KBTH. This was followed by fibroids with 25.4 % and hydrosalpinx with 13.4 %. Factors such as chronic pelvic inflammatory disease or pelvic infection following STIs, mismanaged pregnancies and septic abortions, may have accounted for this since the majority of the women presented with secondary infertility.