Ultrasound and infections on the Tibetan Plateau

• Published in: Journal of ultrasound 2012-06, Vol.15 (2), p.83-92
• Main Authors: Giordani, M.T., Giaretta, R., Scolarin, C., Stefani, M.P., Pellizzari, C., Tamarozzi, F., Brunetti, E.
• Format: Article
• Language: English
• Subjects: Cystic echinococcosis; International cooperation; Ultrasonography
• ISSN: 1971-3495; 1876-7931
• DOI: 10.1016/j.jus.2012.02.009

The authors report on an ultrasound (US) outreach program for the nomadic people living in Yushu, a remote area of Qinghai, Tibet, People's Republic of China (PRC) about 4800 m above sea level. The program was carried out in cooperation with ROKPA INTERNATIONAL, a non-profit organization (NGO) that aims at helping the poorest peoples living in remote regions of the world. A hand-held US scanner (Sonosite 180 Plus, Sonosite Inc., Bothell, WA, USA) equipped with a 3.5–5 MHz convex probe was used at a local clinic for 21 days in 2007 and for 32 days in 2009. A total of 1128 US examinations were performed (578 in 2007 and 550 in 2009). The main diagnoses were: Echinococcal cysts (66 cases; 6.23%) – Biliary tract and intrahepatic gallstones (10% of patients examined) – Ascariasis – Acute and chronic hepatitis, liver cirrhosis, abdominal masses – Abdominal tuberculosis – Miscellaneous (trophoblastic tumor, megacalicosis, splenomegaly in acute leukemia). After the first experience in 2007, collaboration with the local hospital was established for the treatment of patients affected by active echinococcal cysts using albendazole and puncture, aspiration and injection of scolicidal agent and re-aspiration (PAIR) and subsequent follow-up. US scanning was well accepted by the local population and allowed diagnosis, classification and choice of treatment of the echinococcal cysts according to recent criteria based on a stage-specific approach. Percutaneous treatment was also introduced, but more training of local healthcare providers is needed to secure continuation of this practice. Further experience may help improve the standard of health care services offered to the nomadic populations in this remote area. Scopo dello studio è valutare i risultati dell’integrazione dell’ecografia nel programma di assistenza alla popolazione nomade della ONG Rokpa International a Yushu, Qinghai, Tibet, PRC. Il programma fornisce dal 2003 assistenza sanitaria alla popolazione povera dell’altipiano (4.800 mt s l m) Un ecografo portatile Sonosite 180 Plus (Sonosite Inc, Bothell, WA, USA) con sonda convex da 3,5-5 MHz è stato usato per 21 gg nel 2007 e per 32 gg nel 2009 per esami addominali offerti alla popolazione che si presentava all’Ambulatorio e in un villaggio di tende nomadi. Sono stati eseguiti 1128 esami ecografici (578 nel 2007 e 550 nel 2009). Le principali patologie riscontrate: – Cisti da echinococco (66 casi, 6.23%). – Calcolosi della colecisti, delle vie biliari, intraep