Surgical applications of ultrasound use in low- and middle-income countries: A systematic review

Sergio M Navarro; Hashim Shaikh; Hodan Abdi; Evan J Keil; Simisola Odusanya; Kelsey A Stewart; Eugene Tuyishime; Dennis Mazingi; Todd M Tuttle

doi:10.1002/ajum.12302

Surgical applications of ultrasound use in low- and middle-income countries: A systematic review

Australas J Ultrasound Med. 2022 Jun 1;25(2):80-97. doi: 10.1002/ajum.12302. eCollection 2022 May.

Authors

Sergio M Navarro¹, Hashim Shaikh², Hodan Abdi¹, Evan J Keil¹, Simisola Odusanya¹, Kelsey A Stewart³, Eugene Tuyishime^{4

5}, Dennis Mazingi⁶, Todd M Tuttle¹

Affiliations

¹ Department of Surgery University of Minnesota 420 Delaware Street SE Minneapolis MN 55455 USA.
² Department of Orthopaedics University of Rochester 601 Elmwood Avenue Rochester NY 14642 USA.
³ Department of Anaesthesia, Critical Care, and Emergency Medicine University of Rwanda KN 4 Ave Kigali Rwanda.
⁴ Department of Anaesthesia University of Toronto 123 Edward Street Toronto ON M5G 1E2 Canada.
⁵ Department of Obstetrics and Gyenecology University of Minnesota 420 Delaware Street SE Minneapolis MN 55455 USA.
⁶ Department of Surgery University of Zimbabwe Mazowe Street A168 Harare Zimbabwe.

Abstract

Background: Ultrasound is a portable technology able to deploy health care effectively in low resource settings. This study presents a systematic review to determine trends in the utility and applicability of this technology in low- and middle-income countries (LMIC), specifically for surgical applications. The review includes characterising and evaluating trends in the geographic and specialty-specific use of ultrasound pertaining to surgical disease.

Methods: The databases such as Medline OVID, EMBASE and Cochrane were searched from 2010 through March 2019 for studies available in English, French and Spanish. Commentaries, opinion articles, reviews and book chapters were excluded. A categorical analysis of ultrasound use for surgical disease in LMICs was conducted.

Results: A total of 6276 articles were identified, with 4563 studies included for the final review. A total of 221 studies were selected researching ultrasound use in LMICs to treat surgical disease. Most studies identified ultrasound usage focused on general surgery, acute care surgery and surgical ICU topics (52%, 115) followed by computed tomography surgery studies (20%, 44). Most studies were retrospective in nature, with 81% (180) of research studies generated in four countries (India, Pakistan, Nigeria and Egypt). Ultrasound proved to be a feasible technique for utility in pre-operative diagnosis, cost-effectiveness and prediction of surgical outcomes. Findings are limited by the limited number of randomised clinical trials reported.

Conclusion and global health implications: Our systematic literature review of ultrasound use in LMICs demonstrates the growing utilisation of this relatively low-cost, portable imaging technology in low resource settings for surgical disease.

Keywords: LMICs; surgery; systematic review; ultrasound.