Creating a Sustainable Foundation for Interventional Radiology Services and Training in Sub-Saharan Africa: Five-Year Update on the Road2IR Initiative.

PURPOSE: To evaluate the growth and quality of an IR training model designed for resource-constrained settings and implemented in Tanzania, as well as its overall potential to increase access to minimally invasive procedures across the region. MATERIALS AND METHODS: IR training in Tanzania began in 10/2018 through monthly deployment of visiting teaching teams for hands-on training combined with in-person and remote lectures. A competency-based two-year Master of Science (MSc) in IR curriculum was inaugurated at the nation's main teaching hospital in 10/2019, graduating its first two classes in 2021 and 2022. Procedural data, demographics, and clinical outcomes were collected and analyzed throughout the duration of this program. RESULTS: From 10/2018 to 7/2022, 1,595 procedures were performed in Tanzania: 1,236 non-vascular and 359 vascular, all with local fellows as primary operators. 97.2% were technically successful, 95.2% were without complication, and 28.9% were performed independently by Tanzanian fellows and faculty with no difference in complication and technical success rates (p=0.63 and 0.90, respectively), irrespective of procedural class. Ten IR physicians graduated from this program during the study period, followed by another three per year going forward. Partner training programs in Uganda and Rwanda mirroring this model commenced in 2023 and 2024, respectively. CONCLUSION: The reported training model offers a practical and effective solution to meet many of the challenges associated with the lack of access to IR in sub-Saharan Africa.

Assessment of Required Patient Travel to Receive Interventional Radiology Services in the Resource-Limited Setting of Tanzania.

This study aimed to evaluate the geographic patient profile of a country's first interventional radiology (IR) service in sub-Saharan Africa. From October 2018 to August 2022, travel time (1,339 patients) and home region (1,184 patients) were recorded from 1,434 patients who underwent IR procedures at Tanzania's largest referral center. Distances traveled by road were calculated from the administrative capital of each region using a web mapping platform (google.com/maps). The effect of various factors on distance and time traveled were assessed. Patients from all 31 regions in Tanzania underwent IR procedures. The mean and maximum calculated distance traveled by patients were 241.6 km and 1,387 km, respectively (Sk2 = 1.66); 25.0% of patients traveled for over 6 hours for their procedure. Patients traveled furthest for genitourinary procedures (mean = 293.4 km) and least for angioplasty and stent placement (mean = 123.9 km) (P < .001). To increase population access and reduce travel times, geographic data should be used to decentralize services.

Tanzania IR Initiative: Training the First Generation of Interventional Radiologists.

Despite a population of nearly 60 million, there is currently not a single interventional radiologist in Tanzania. Based on an Interventional Radiology (IR) Readiness Assessment, the key obstacles to establishing IR in Tanzania are the lack of training opportunities and limited availability of disposable equipment. An IR training program was designed and initiated, which relies on US-based volunteer teams of IR physicians, nurses, and technologists to locally train radiology residents, nurses, and technologists. Preliminary results support this strategy for addressing the lack of training opportunities and provide a model for introducing IR to other resource-limited settings.