{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,11]],"date-time":"2026-03-11T14:20:28Z","timestamp":1773238828470,"version":"3.50.1"},"reference-count":33,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2012,2,29]],"date-time":"2012-02-29T00:00:00Z","timestamp":1330473600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100000862","name":"Doris Duke Charitable Foundation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000862","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100011485","name":"North Carolina Translational and Clinical Sciences Institute, University of North Carolina at Chapel Hill","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100011485","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["World j. surg."],"published-print":{"date-parts":[[2012,5]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Esophagogastroduodenoscopy (EGD) is a valuable tool for diagnosing and treating upper gastrointestinal disease. Prioritizing the use of EGD in resource\u2010limited settings must be customized to local populations to maximize population benefit from the examination.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Cross\u2010sectional, retrospective review of EGD reports was conducted at Kamuzu Central Hospital (KCH), Lilongwe, Malawi. Esophageal tumors were defined as obstructive or nonobstructive and esophageal varices were graded on a scale of I to IV. Descriptive statistics were calculated and logistic regression performed for each disease state compared with all other reports.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 1,034 cases were reviewed (56% male; mean age (standard deviation), 44 (17) years). The most common indications were dysphagia (37%), hematemesis (21%), and epigastric pain (16%). The most common diagnoses were normal (36%), esophageal cancer (27%), and esophageal varices (17%). Eighty\u2010six percent of esophageal tumors were obstructive and 45% of esophageal varices were grade III or IV. Normal examinations were more likely to be female, younger, and present with dyspepsia. Esophageal cancers were more likely to be male, older, present with dysphagia, and present from districts outside Lilongwe. Esophageal varices were more likely to present with hematemesis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>EGD is a limited resource at KCH; patient selection should be guided by patient age and indication. The high burden of esophageal cancer and varices in Malawi suggests that therapeutic endoscopy would be beneficial.<\/jats:p><\/jats:sec>","DOI":"10.1007\/s00268-012-1490-7","type":"journal-article","created":{"date-parts":[[2012,2,28]],"date-time":"2012-02-28T19:12:17Z","timestamp":1330456337000},"page":"1074-1082","source":"Crossref","is-referenced-by-count":17,"title":["Esophagogastroduodenoscopy in a Public Referral Hospital in Lilongwe, Malawi: Spectrum of Disease and Associated Risk Factors"],"prefix":"10.1002","volume":"36","author":[{"given":"Lindsey L.","family":"Wolf","sequence":"first","affiliation":[{"name":"University of North Carolina Project Lilongwe Malawi"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rahim","family":"Ibrahim","sequence":"additional","affiliation":[{"name":"Department of General Surgery Kamuzu Central Hospital Lilongwe Malawi"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Changchun","family":"Miao","sequence":"additional","affiliation":[{"name":"Department of General Surgery Kamuzu Central Hospital Lilongwe Malawi"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Arturo","family":"Muyco","sequence":"additional","affiliation":[{"name":"Department of General Surgery Kamuzu Central Hospital Lilongwe Malawi"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mina C.","family":"Hosseinipour","sequence":"additional","affiliation":[{"name":"University of North Carolina Project Lilongwe Malawi"},{"name":"Division of Infectious Diseases University of North Carolina\u2014Chapel Hill Chapel Hill NC USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Carol","family":"Shores","sequence":"additional","affiliation":[{"name":"University of North Carolina Project Lilongwe Malawi"},{"name":"Department of Otolaryngology\/Head and Neck Surgery, Lineberger Comprehensive Cancer Center University of North Carolina\u2014Chapel Hill Chapel Hill NC USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2012,2,29]]},"reference":[{"key":"e_1_2_6_2_2","first-page":"80","article-title":"Factors associated with carcinoma of the oesophagus at Mulago Hospital, Uganda","volume":"8","author":"Ocama P","year":"2008","journal-title":"Afr Health Sci"},{"key":"e_1_2_6_3_2","first-page":"249","article-title":"Epidemiology of gastrointestinal and liver tumors","volume":"14","author":"Herszenyi L","year":"2010","journal-title":"Eur Rev Med Pharmacol Sci"},{"key":"e_1_2_6_4_2","doi-asserted-by":"publisher","DOI":"10.1186\/1471\u20102156\u201011\u201047"},{"key":"e_1_2_6_5_2","doi-asserted-by":"publisher","DOI":"10.4314\/mmj.v22i3.62190"},{"key":"e_1_2_6_6_2","doi-asserted-by":"publisher","DOI":"10.1186\/1471\u20102407\u20106\u2010287"},{"key":"e_1_2_6_7_2","first-page":"193","article-title":"Clustering and geographic variation of upper gastrointestinal cancers in a high\u2010risk region of esophageal cancer in northern China","volume":"12","author":"Zhang N","year":"2011","journal-title":"Asian Pac J Cancer Prev"},{"key":"e_1_2_6_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejca.2009.09.018"},{"key":"e_1_2_6_9_2","first-page":"97","article-title":"Upper gastrointestinal bleeding in Malawian adults and value of splenomegaly in predicting source of haemorrhage","volume":"66","author":"Harries AD","year":"1989","journal-title":"East Afr Med J"},{"key":"e_1_2_6_10_2","doi-asserted-by":"publisher","DOI":"10.4269\/ajtmh.1978.27.197"},{"key":"e_1_2_6_11_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1442\u20102050.2009.01022.x"},{"key":"e_1_2_6_12_2","doi-asserted-by":"publisher","DOI":"10.1258\/td.2008.080142"},{"key":"e_1_2_6_13_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.trstmh.2007.10.006"},{"key":"e_1_2_6_14_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140\u20106736(83)90882\u20106"},{"key":"e_1_2_6_15_2","first-page":"98","article-title":"Pattern and validity of clinical diagnosis of upper gastrointestinal diseases in south\u2010west Nigeria","volume":"6","author":"Agbakwuru EA","year":"2006","journal-title":"Afr Health Sci"},{"key":"e_1_2_6_16_2","unstructured":"National Cancer Institute.Surveillance Epidemiology and End Results Stat Fact Sheets: Esophagus.http:\/\/seer.cancer.gov\/statfacts\/html\/esoph.html. Accessed 18 Jan 2011"},{"key":"e_1_2_6_17_2","first-page":"53","article-title":"A clinicopathologic review of oesophageal carcinoma in Lagos","volume":"18","author":"Abdulkareem FB","year":"2008","journal-title":"Nig Q J Hosp Med"},{"key":"e_1_2_6_18_2","first-page":"12","article-title":"Upper gastrointestinal endoscopy at the Korle Bu teaching hospital, Accra, Ghana","volume":"41","author":"Aduful H","year":"2007","journal-title":"Ghana Med J"},{"key":"e_1_2_6_19_2","first-page":"38","article-title":"Gastro\u2010esophageal decongestion and splenectomy GEDS (Hassab), in the management of bleeding varices","volume":"83","author":"Hassab MA","year":"1998","journal-title":"Review of literature. Int Surg"},{"key":"e_1_2_6_20_2","first-page":"49","article-title":"Patterns of upper gastrointestinal diseases based on endoscopy in the period 1998\u20132001","volume":"12","author":"Lodenyo H","year":"2005","journal-title":"Afr J Health Sci"},{"key":"e_1_2_6_21_2","first-page":"97","article-title":"Upper gastrointestinal endoscopy: a review of 10,000 cases","volume":"42","author":"Taye M","year":"2004","journal-title":"Ethiop Med J"},{"key":"e_1_2_6_22_2","doi-asserted-by":"publisher","DOI":"10.1177\/004947559102100410"},{"key":"e_1_2_6_23_2","first-page":"95","article-title":"Oesophagogastroduodenoscopies: a review of 720 cases","volume":"21","author":"Kefenie H","year":"1983","journal-title":"Ethiop Med J"},{"key":"e_1_2_6_24_2","first-page":"149","article-title":"Analysis of fibreoptic gastroduodenoscopy in 1084 Ethiopians","volume":"33","author":"Tsega E","year":"1981","journal-title":"Trop Geogr Med"},{"key":"e_1_2_6_25_2","first-page":"675","article-title":"Upper gastrointestinal endoscopic experience at Kenyatta National Hospital","volume":"56","author":"Wankya BM","year":"1979","journal-title":"East Afr Med J"},{"key":"e_1_2_6_26_2","first-page":"49","article-title":"Fibre\u2010optic upper\u2010gastrointestinal endoscopy on 300 patients","volume":"15","author":"Tsega E","year":"1977","journal-title":"Ethiop Med J"},{"key":"e_1_2_6_27_2","first-page":"327","article-title":"Upper gastrointestinal tract endoscopy indications in northern Nigeria","volume":"19","author":"Olokoba AB","year":"2009","journal-title":"J Coll Physicians Surg Pak"},{"key":"e_1_2_6_28_2","doi-asserted-by":"publisher","DOI":"10.4103\/1117-1936.181028"},{"key":"e_1_2_6_29_2","first-page":"87","article-title":"Fifteen years of upper gastrointestinal endoscopy in Zaria (1978\u20131993)","volume":"28","author":"Danbauchi SS","year":"1999","journal-title":"Afr J Med Med Sci"},{"key":"e_1_2_6_30_2","doi-asserted-by":"publisher","DOI":"10.1177\/004947559502500103"},{"key":"e_1_2_6_31_2","first-page":"261","article-title":"The contribution of endoscopy in the diagnosis of esophago\u2010gastro\u2010duodenal disorders in a tropical milieu. Experience in Benin with 930 examinations","volume":"27","author":"Kodjoh N","year":"1991","journal-title":"Ann Gastroenterol Hepatol (Paris)"},{"key":"e_1_2_6_32_2","first-page":"279","article-title":"Upper gastrointestinal endoscopy in Zaria, northern Nigeria","volume":"9","author":"Malu AO","year":"1990","journal-title":"West Afr J Med"},{"key":"e_1_2_6_33_2","first-page":"69","article-title":"Endoscopy in upper gastro\u2010intestinal disease in Nigerians","volume":"8","author":"Adesola AO","year":"1978","journal-title":"Niger Med J"},{"key":"e_1_2_6_34_2","first-page":"420","article-title":"Experience with upper gastrointestinal endoscopy in Ibadan","volume":"8","author":"Lewis EA","year":"1978","journal-title":"Niger Med J"}],"container-title":["World Journal of Surgery"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/link.springer.com\/content\/pdf\/10.1007\/s00268-012-1490-7.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/link.springer.com\/article\/10.1007\/s00268-012-1490-7\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1007\/s00268-012-1490-7","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,1,11]],"date-time":"2024-01-11T03:18:54Z","timestamp":1704943134000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1007\/s00268-012-1490-7"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2012,2,29]]},"references-count":33,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2012,5]]}},"alternative-id":["10.1007\/s00268-012-1490-7"],"URL":"https:\/\/doi.org\/10.1007\/s00268-012-1490-7","archive":["Portico"],"relation":{},"ISSN":["0364-2313","1432-2323"],"issn-type":[{"value":"0364-2313","type":"print"},{"value":"1432-2323","type":"electronic"}],"subject":[],"published":{"date-parts":[[2012,2,29]]}}}