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Assessing the utility of ultrasound in Liberia

Sub-Saharan Africa has sparse imaging capacity, and data on ultrasound (US) use is limited. We collected prospective data on consecutive patients undergoing US to assess disease spectrum and US utility in Liberia. A total of 102 patients were prospectively enrolled. Average age was 33 years (0-84), 80% were female. US indications were: 53% Obstetrics/Gynecology (OB/GYN) (24% gynecologic, 17% second/third trimester, 12% first trimester), 14% hepatobiliary, 10% intraperitoneal/intrathoracic fluid, 8% cardiac, 5% focused assessment of sonography in trauma, and 4% renal. US changed management in 62% of cases. Greatest impact was in first trimester OB (86%), FAST (83%), ECHO (80%), and second/third trimester OB (77%). US changed management in 47% of right upper quadrant and 33% of gynecologic studies. Curvilinear probe addressed over 80% of need. The primary role for US in developing countries is in management of obstetrics, with a secondary role for traumatic and a-traumatic abdominal processes. Most needs can be met with the curvilinear probe. Training should begin with obstetrics and should be a primary focus for curriculum.