RESUMO
Background Laparoscopic cholecystectomy is not readily available in secondary care hospitals in Nigeria, even though it is now the gold standard for the treatment of cholelithiasis and other gallbladder diseases worldwide. Thus, many hospitals in Nigeria still offer open cholecystectomies. This retrospective study investigated the trend of cholecystectomies performed in the general surgery unit of a district hospital in Abuja before and after the commencement of laparoscopic surgery services in 2016. Methodology This retrospective study was conducted in Asokoro District Hospital, Abuja, Nigeria The records of all patients who underwent a cholecystectomy from January 2000 to December 2019 were retrieved and analyzed for the number, types, and rate of cholecystectomies performed per year. All open cholecystectomies were performed via a right subcostal incision, whereas all laparoscopic cholecystectomies were performed via the standard four-port incisions approach. Results A total of 96 patients underwent cholecystectomies from January 2000 to December 2019. In total, 50 (52.08%) open cholecystectomies were performed in 20 years with a yearly average of 2.5, and 46 (47.92%) laparoscopic cholecystectomies were performed in four years with a yearly average of 11.5. The trend of open cholecystectomies in four years dropped from three (30%) in 2016 to one (5.26%) in 2019, whereas laparoscopic cholecystectomies increased from seven (70%) to 18 (94.74%) within the same period. Conclusions There is a drop in the trend of open cholecystectomies and an increase in both laparoscopic and total cholecystectomies in our hospital. We recommend adequate capacity and subsidized laparoscopic cholecystectomy for secondary healthcare facilities in Nigeria.
RESUMO
Introduction: Mammography is a major tool for the screening and diagnosis of breast cancer globally. Poor funding and lack of good public health education for mammography in resource-limited countries limit access to mammographic services. In these settings, patients bear the cost of breast cancer screening from out-of-pocket expenses. The aim of this study was to interrogate the pattern of utilization of mammography by women of childbearing age, who attended Asokoro District Hospital (ADH) for Healthcare, with the view to increase uptake. Materials and Methods: This was a 4-year retrospective, cross-sectional study of 534 women who attended ADH from July 2015 to June 2019 for screening or diagnostic mammography. Data were extracted from completed questionnaire by women who had mammography during the period under review. The data were entered into Statistical Package for the Social Sciences version 27 by IBM for analysis. Results: The mean age of the women was 47.8 years ± 7.7 with a range of 30-82 years. Most of the women, 525 (94.9%), were referred for mammography by health workers; only nine (5.1%) had mammography on self-referral. In all, 71% of the women paid for their mammography from their pockets, whereas 28.1% made payments through the National Health Insurance Scheme (NHIS). A total of 100% of women who reported for mammography on self-referral paid for the services from their pockets. The association between the funding options and mode of referral was statistically significant, P = 0.049. Conclusion: This study showed that referral for mammography by health workers was responsible for not only most of the mammograms conducted but also all the women who utilized NHIS to pay for this service. Resources should therefore be directed towards creating awareness among health workers, especially with the present level of NHIS coverage in the population, in order to increase the uptake of screening mammography in the population.
