Abstract:

Background: OGD is a safe, widely available technique for which demand continues to grow, resulting in an increase in costs and waiting lists for endoscopic procedures so, the appropriateness of indications for OGD is critical in assessing quality in endoscopy units, improving cost-effectiveness and providing better patient care. The rationale of the study was to obtain information that will assist in formulating guidelines for upper GI endoscopy examination in BMC and probably Tanzania; so that a better quality of care is provided within such a financially constrained environment. The therapeutic services provided at the Bugando hospital endoscopy unit are also worth documenting and hence be in a position to suggest some solutions in order to improve or assist patient care.

Aim of the study: because endoscopic facilities and specialists are scarce in public hospitals as the result open access endoscopy referral system is widely practiced in Tanzania, hence the aim of the study is to profile by documenting the demographic characteristics, the clinical presentations and the most common endoscopic diagnosis of the patients undergoing esophageal gastroduodenoscopy at BUGANDO MEDICAL CENTRE endoscopic unit for the year 2021

Material and methods: This is the retrospective cross-sectional study carried out from January 2021 to December 2021 involved patients who were scheduled for esophageal gastroduodenoscopy as the part of work up, where as the reason for the procedure and the endoscopic finding will be recorded from the hospital files at the medical records and the endoscopy unit log book and will be finally analyzed using STATA version 11

Results: A total of 280 subjects aged between 12 and 87years were enrolled in the study whereby 128 were males and 152 were females. Most of the study population was from Mwanza that comprised of 52.2%. The indications for endoscopy procedure were mainly for diagnosis and few was for therapeutic reasons. These included abdominal pain(50.7%) followed by isolated dyspepsia(24.8%) and UGI bleeding (18%) and others, all diagnosed endoscopically, Significant endoscopic findings were detected; gastritis 96 patients (34.5%) followed by varices 25 patients ( 9%) and ulcer 15 patients (5.4%) There were 6.5% therapeutic endoscopic interventions performed during the study period doing the band ligations due to the bleeding varices

Conclusion: OGD plays a pivotal role in diagnosis and management of a number of upper GI diseases. At BMC, it is being utilized mostly by subjects aged 45.1yrs on average who came mainly from Mwanza and other lake zones areas. Abdominal pain remained the leading indication for the procedure and the commonest upper GI endoscopic finding was gastritis. Few therapeutic interventions were done during the study period 6,5%

Recommendations: Guidelines to do Upper GI endoscopy at BMC should be established pending a further evaluation by a larger prospective study, involving a number of endoscopy units in different regions where duration of symptoms and Histopathological results may be included. The demand for therapeutic/interventional endoscopy at BMC is high. The Hospital should acquire accessories required for these services, in order to improve quality of health care at the BMC endoscopy unit. Surveillance protocols and programme need to be strengthened so that significant people with potential risk for Upper GI malignancy may be picked earlier.