Appropriateness of paediatric computed tomograph scan utilization in Muhimbili national hospital, Dar es salaam, Tanzania

Abstract

Short Background Computed Tomography scan is an imaging modality that uses high ionizing radiations. It is very useful and widely used to diagnose different diseases. Unlike adults, Children‟s cells are immature making them more sensitive and susceptible to radiation effects than adults. However, little is known about the frequency and appropriateness of CT scan usage in pediatric patients in Tanzania. Objective This study aimed at determining the appropriateness of pediatric CT scan usage at Muhimbili National Hospital-Dar es salaam, Tanzania. Methodology The study was a hospital-based cross-sectional study carried out by retrospective review of medical records of all pediatric patients aged 0-15years referred for CT scan imaging from January to march 2021. Data collection was done at MNH. A structured questionnaire was used to collect sociodemographic information, body parts imaged, clinical indications, radiation dosage used, professional position of the clinician who referred the patient for CT scan, admission status, protocol used to refer the patient and appropriateness of each pediatric CT imaging was evaluated according to ACR-AC . Data analysis used the statistical package SPSS version 23. Descriptive analysis was done where frequency tables were sketched and cross-tabulations were run for all variables that are included in the final analysis, median and range were used to describe the continuous variable such as the pediatric patient‟s age. The appropriateness of pediatric CT scans done at MNH compared to the standard ACR appropriateness criteria was done using Chi-square test. Logistic regression analysis was used to determine the influence of health facility factors, Clinician‟s professional position and patient related factors to pediatric CT scan imaging utilization at MNH.Results Appropriately imaged CT scans were only 42.07%. Appropriateness level was found to be mainly associated with study indication where by patients referred due to trauma were more likely to be appropriately imaged compared to those referred due to non-traumatic indications. Conclusion Majority of CT scan studies were ordered inappropriately. Physicians training, use of guidelines and preauthorization for pediatric CT scan should be implemented