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Safeguards on CT scans ease fears of exposure to radiation

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Did
you know that sitting next to a room where a patient is undergoing an X-ray can
actually be harmful to you?

Did
you also know that even just walking past a room where the procedure is taking
place can be dangerous to your health?

Well,
this, according to health experts, is the case if you are exposed to
uncontrolled doses of radiation, which can lead to cancer.

To
complicate matters, in most cases, it is impossible to definitively attribute
cancer to radiation exposure that occurred years or even decades earlier.

As
the country’s population grows, coupled with the government’s ambitious
programme to offer quality and affordable health services to virtually every
citizen, the demand for ultrasounds of 2D, 3D, and 4D systems and CT scans has
been on the rise.

This
demand has seen the Government invest in modern technology to reduce patients’
exposure to dangerous radiation in hospitals.

But
are the patients seeking imaging services in facilities with unqualified
radiologists, or who are qualified but simply do not take safety measures when
performing the routine?

As
one way of dealing with the problem and ensuring better health care, the
government is installing Computed Tomography (CT)
scan machines that are free from exposure to dangerous levels of radiation.

 

TAMING THE RISK

Just
like other X-ray imaging exams, CT scans expose you briefly to a small,
targeted amount of ionising radiation, which helps create an image of
structures inside your body.

The CT scans provide more detailed images of more
types of tissue than traditional X-rays do, which allows your doctor to detect
and locate many medical conditions.

What
is produced is detailed, three-dimensional images that enable doctors to see
things previously visible only through a biopsy or surgery.

Health PS Peter Tum says the modern machines being installed at
various county hospitals have been fixed with a gadget that taps radiation to
minimise the exposure risk to the patient, specialists and anyone working
in an adjacent room or even walking near the scan machine.

Some radiographers and radiologists had sought an assurance on the safety of medics who will be operating the new
machines.

Health
CS Sicily Kariuki has also assured the specialists of the safety
of the new machines, saying the technology being used is far much better than
what the country has been relying on.

“The
safety and level of accuracy of this equipment, in terms of diagnostics and
subsequent treatment, is better than what we have had before,” Kariuki said
recently.

Commissioning a CT scan centre in Lamu on November 17, she said the
machines will complement universal health care (UHC) programmes
by the government.

“The
government is committed to improving health services to all Kenyans by installing
37 CT scan machines in 16 counties. The machines will help hospitals deal with
renal medical emergencies and reduce referrals,” the CS said.

 

BACKED BY RESEARCH

According
to a study by Beaumont Health System, a not-for-profit health organisation in
southeast Michigan, the use of advanced CT scanning equipment is helping to
address the important concern of patient exposure to radiation.

The
research, published in the Journal of Cardiovascular
Computed Tomography
, found that the use of advanced CT
scanning equipment is helping to address the concern by clinicians that the
growing use of CT scans could be placing patients at a higher lifetime risk of
cancer from radiation exposure.

The
study, of 2,085 patients at nine centers in the US and Middle East, found
that using newer generation, dual-source CT scanners significantly reduced
radiation exposure for patients when compared with first generation, 64-slice,
single-source scanners or first generation, dual-source CT scanners.

Patient
radiation exposure was reduced by 61 per cent with the newer scanners, with no
significant difference in image quality for patients having CT scans for
coronary artery disease, pulmonary embolism or aortic disease.

US
Food and Drug Administration says radiation dose from CT
procedures varies from patient to patient. The particular radiation dose will
depend on the size of the body part examined, the type of procedure, and the
type of CT equipment and its operation. This, according to health experts, is a
technology that was not available with the use of earlier equipment.

According
to the Health ministry, radiology department, on top of acquiring the
CT scanners to improve on CT scan services, the government is transforming how radiation safety monitoring is done in the public
sector.

A senior ministry official, who did not want to be named, said: “Traditionally,
film-based technology was used for radiation monitoring. But with the newer, more
powerful digital CT scan equipment being installed, there is a need to change to
Thermo-luminescent Dosimeters (TLDs). These dosimeters will monitor radiation
levels for the healthcare workers, and assess background and
environmental radiation leakage within the radiology departments.”

TLDs
are wearable devises that measure ionising radiation exposure levels from
radiation-emitting devices like general X-ray units and CT scanners.

To
boost professionalism in dealing with the new equipment, 30 radiographers and
radiologists jetted back to the country from China last month after receiving a
month-long training.

They
were trained in basic operations, post-processing images, archiving and
filming, and positioning patients. They also underwent a mentorship course
under the supervision of specialists from China and Europe, in partnership with Megascope Healthcare.

 

UNIVERSAL CARE 

During
the 58th World Health Assembly of 2005, WHO member states committed to provide
affordable universal coverage and access for all citizens on the basis of
equity and solidarity.

Early
this year, President Uhuru Kenyatta pledged UHC as part
of the Big Four agenda over the next four years.

“For
Kenya to achieve universal health coverage, we need high-quality services for
health promotion, prevention, treatment, rehabilitation, palliation and
financial risk protection,” he said.

Uhuru
said accurate diagnosis is the first step in developing an individualised
treatment plan, and it is guided by laboratory tests and imaging.

“From
the current developments in the world, CT-scan images are classified as basic
diagnostic equipment,” he said.

The
President is expected to officially launch the national UHC pilot phase on
December 13, in Kisumu county. Four counties — Nyeri, Isiolo, Machakos and
Kisumu — have been picked for the piloting. The pilot phase of the programme will
run for six months. Thereafter, the government will roll out the full programme, if it proves to be successful.

In
2014, the government carried out an assessment of all the hospitals and found out
that most of them did not have the capacity to make diagnosis using CT
scan machines.

Where
the CT scan machines were available, they were old, of low capacity and were not
being serviced and maintained as per the standard operating requirements.

“The
goal of UHC is to improve access and availability of quality health services.
The CT scanners being installed will ensure that this important diagnostic tool
is available and affordable to most Kenyans, without travelling to Nairobi, where CT scanners were previously found,” PS Tum said recently.

According
to the National Hospital Insurance Fund’s annual report, CT scan services were
ranked number 12 in terms of its health expenditure during the financial
years 2016-17 and 2017-18, at Sh285,069,617 and Sh311,512,561 respectively.

“This
is an indication of a need for this crucial service. With the increasing burden
of cancer and road accidents, these machines will greatly transform operations
in public health facilities and help the local population reduce expenses on
medical care as well as reduce distances covered to access imaging services,” the PS said.

Data
from the Health ministry shows that about 10,000 Kenyans travel abroad annually
for medical treatment and spend at least Sh10 billion over the same period.

Last
year, 116 patients suffering from non-communicable diseases travelled to India
between January and March. Cancer patients accounted for 57.8 per cent of the
patients, while 16.8 per cent were those suffering from renal disease, 7.8 per
cent had cardiovascular disease and 3.4 per cent had skeletal disorders.

The
ministry blamed this on inadequate specialists and specialised medical equipment,
high cost of treatment and the long waiting period for cancer treatment and
kidney transplants.

Figures
from 2016 to March 2018 indicate that over 31.5 per cent of Kenyans
sought cancer treatment 31.5, 16.8 per cent chronic kidney disease, while heart
disease accounted for 9.19 per cent. Ninety-eight percent of the patients sought medical
attention in India, while the rest visited South Africa, Turkey, Italy, USA, UK
and Russia.

Tum
added that besides the CT scanners project, the Health ministry is putting
up centralised X-ray and CT scan reporting centres.

“This
will allow reporting of CT scans from far-flung health facilities, where there
may be no capability of reading or interpreting the scans. This will also enable
doctors to discuss and guide diagnosis of patients by specialists who may be
found in Nairobi or outside the country,” he said.



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