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Diagnostic and Therapeutic Endoscopy
Volume 2013, Article ID 798651, 6 pages
http://dx.doi.org/10.1155/2013/798651
Research Article

Colonoscopy Practice in Lagos, Nigeria: A Report of an Audit

1Gastroenterology Unit, Department of Medicine, Lagos State University College of Medicine/Teaching Hospital, P.O. Box 203 Satelitte Town, Lagos, Nigeria
2Gastroenterology Unit, Department of Medicine, Lagos State University Teaching Hospital, PMB 21266, Ikeja, Lagos, Nigeria
3Clinical Pharmacology Unit, Department of Medicine, Lagos State University College of Medicine/Teaching Hospital, PMB 21266, Ikeja, Lagos, Nigeria
4Cornell Health Centre, Surulere, Lagos, Nigeria
5Department of Medicine, University of Lagos College of Medicine/Teaching Hospital, Private Mail Bag 12003, Lagos, Nigeria

Received 26 October 2012; Accepted 25 January 2013

Academic Editor: P. J. O'Dwyer

Copyright © 2013 C. A. Onyekwere et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Background. Colonoscopy effectiveness depends on the quality of the examination. Community-based report of quality of colonoscopy practice in a developing country will help in determining standard and also serve as a stimulus for improvement in service. Aim. To review the quality of colonoscopy practice and document pattern of colonic disease including polyp detection rate in Lagos, Nigeria. Method. A protocol that captured the patients’ demographics, indication, and some quality indices of colonoscopy was developed and sent to all the identified colonoscopy units in Lagos to complete for all procedures performed between January 2011 and June 2012. All data were collated and analyzed. The quality indices studied were compared with guideline standard. Results. Twelve colonoscopy centers were identified but only nine centers responded. The gastroenterologist/endoscopists were physicians (3) and surgeons (5). Six hundred and seven colonoscopy procedures were performed during this period (M : F = 333 : 179) while the sex was not disclosed in 95 subjects. The examination indications were lower GI bleeding (24.2%), altered bowel habits (9.2%), lower abdominal pain (9.1%), screening for CRC (4.3%) and unspecified (46.8%). Conscious sedation was generally used while bowel preparation (good in 81.4%) was done with low residue diet and stimulant laxatives. Caecal intubation rate was 81.2%. Common endoscopic findings were haemorrhoids (43.2%), polyps/masses (13.4%), diverticulosis (11.1%), and no abnormality (23.4%). Polyp was detected in 6.8% of cases. Conclusion. Colonoscopy utilization is low, and the quality of practice is suboptimal; although limited resources could partly explain this, however it is not clear if the low rate of polyp detection is due to missed lesions or low population incidence.