{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,18]],"date-time":"2026-10-18T02:30:12Z","timestamp":1792290612874,"version":"4.4.0"},"reference-count":51,"publisher":"Public Library of Science (PLoS)","issue":"6","license":[{"start":{"date-parts":[[2022,6,2]],"date-time":"2022-06-02T00:00:00Z","timestamp":1654128000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\">\n<jats:title>Background<\/jats:title>\n<jats:p>Frequencies of ultrasonographic findings and diagnoses in emergency departments in sub-Saharan Africa are unknown. This study aimed to describe the frequencies of different sonographic findings and diagnoses found in patients with abdominal symptoms or trauma presenting to a rural referral hospital in Tanzania.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec002\">\n<jats:title>Methods<\/jats:title>\n<jats:p>In this prospective observational study, we consecutively enrolled patients with abdominal symptoms or trauma triaged to the emergency room of the Saint Francis Referral Hospital, Ifakara. Patients with abdominal symptoms received an abdominal ultrasound. Patients with an abdominal or thoracic trauma received an Extended Focused Assessment with Ultrasound in Trauma (eFAST).<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec003\">\n<jats:title>Results<\/jats:title>\n<jats:p>From July 1<jats:sup>st<\/jats:sup> 2020 to June 30<jats:sup>th<\/jats:sup> 2021, a total of 88838 patients attended the emergency department, of which 7590 patients were triaged as \u2018very urgent\u2019 and were seen at the emergency room. A total of 1130 patients with abdominal symptoms received an ultrasound. The most frequent findings were abnormalities of the uterus or adnexa in 409\/754 females (54.2%) and abdominal free fluid in 368 (32.6%) patients; no abnormality was found in 150 (13.5%) patients. A tumour in the abdomen or pelvis was found in 183 (16.2%) patients, an intrauterine pregnancy in 129\/754 (17.1%) females, complete or incomplete abortion in 96 (12.7%), and a ruptured ectopic pregnancy in 32 (4.2%) females. In males, most common diagnosis was intestinal obstruction in 54\/376 (14.4%), and splenomegaly in 42 (11.2%). Of 1556 trauma patients, 283 (18.1%) received an eFAST, and 53 (18.7%) had positive findings. A total of 27 (9.4%) trauma patients and 51 (4.5%) non-trauma patients were sent directly to the operating theatre.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec004\">\n<jats:title>Conclusion<\/jats:title>\n<jats:p>In this study, ultrasound examination revealed abnormal findings for the majority of patients with non-traumatic abdominal symptoms. Building up capacity to provide diagnostic ultrasound is a promising strategy to improve emergency services, especially in a setting where diagnostic modalities are limited.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pone.0269344","type":"journal-article","created":{"date-parts":[[2022,6,2]],"date-time":"2022-06-02T17:39:39Z","timestamp":1654191579000},"page":"e0269344","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":6,"title":["Ultrasonographic findings in patients with abdominal symptoms or trauma presenting to an emergency room in rural Tanzania"],"prefix":"10.1371","volume":"17","author":[{"given":"Max","family":"Bauer","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Faraja","family":"Kitila","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ipyana","family":"Mwasongwe","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Issa S.","family":"Abdallah","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Evelyne","family":"Siongo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sylvester","family":"Kasunga","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Winfrid","family":"Gingo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1253-8970","authenticated-orcid":true,"given":"Robert","family":"Ndege","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karin","family":"Hasler","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4743-5987","authenticated-orcid":true,"given":"Daniel H.","family":"Paris","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maja","family":"Weisser","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0547-1923","authenticated-orcid":true,"given":"Martin","family":"Rohacek","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2022,6,2]]},"reference":[{"issue":"10100","key":"pone.0269344.ref001","doi-asserted-by":"crossref","first-page":"1211","DOI":"10.1016\/S0140-6736(17)32154-2","article-title":"Global, regional, and national incidence, prevalence, and years lived with disability for 328 diseases and injuries for 195 countries, 1990\u20132016: a systematic analysis for the Global Burden of Disease Study 2016","volume":"390","author":"T Vos","year":"2017","journal-title":"The Lancet"},{"key":"pone.0269344.ref002","volume-title":"Global Status Report on Road Safety 2009: time for action","author":"World Health Organization","year":"2009"},{"issue":"9","key":"pone.0269344.ref003","doi-asserted-by":"crossref","first-page":"e41458","DOI":"10.1371\/journal.pone.0041458","article-title":"Reductions in inpatient mortality following interventions to improve emergency hospital care in Freetown, Sierra Leone.","volume":"7","author":"M Clark","year":"2012","journal-title":"PLoS One"},{"key":"pone.0269344.ref004","doi-asserted-by":"crossref","first-page":"314","DOI":"10.2471\/BLT.04.019505","article-title":"Improved triage and emergency care for children reduces inpatient mortality in a resource-constrained setting","volume":"84","author":"E Molyneux","year":"2006","journal-title":"Bulletin of the World Health Organization"},{"issue":"3","key":"pone.0269344.ref005","doi-asserted-by":"crossref","first-page":"e676","DOI":"10.1542\/peds.2012-0026","article-title":"Decreased pediatric hospital mortality after an intervention to improve emergency care in Lilongwe, Malawi.","volume":"130","author":"JA Robison","year":"2012","journal-title":"Pediatrics"},{"issue":"1","key":"pone.0269344.ref006","first-page":"1","article-title":"Trends in mortality associated with opening of a full-capacity public emergency department at the main tertiary-level hospital in Tanzania","volume":"8","author":"HR Sawe","year":"2015","journal-title":"International journal of emergency medicine"},{"issue":"3","key":"pone.0269344.ref007","doi-asserted-by":"crossref","first-page":"e342","DOI":"10.1016\/S2214-109X(17)30488-6","article-title":"Access to emergency hospital care provided by the public sector in sub-Saharan Africa in 2015: a geocoded inventory and spatial analysis","volume":"6","author":"PO Ouma","year":"2018","journal-title":"The Lancet Global Health"},{"key":"pone.0269344.ref008","first-page":"626","article-title":"Emergency medical systems in low-and middle-income countries: recommendations for action","volume":"83","author":"OC Kobusingye","year":"2005","journal-title":"Bulletin of the World Health Organization"},{"key":"pone.0269344.ref009","first-page":"w20018","article-title":"Diagnoses made in an emergency department in rural sub-Saharan Africa.","volume":"149","author":"E Mchomvu","year":"2019","journal-title":"Swiss medical weekly."},{"issue":"1","key":"pone.0269344.ref010","doi-asserted-by":"crossref","first-page":"e000164","DOI":"10.1136\/tsaco-2018-000164","article-title":"Point-of-care biliary ultrasound in the emergency department (BUSED): implications for surgical referral and emergency department wait times.","volume":"3","author":"R Hilsden","year":"2018","journal-title":"Trauma surgery & acute care open"},{"key":"pone.0269344.ref011","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/s13049-020-00740-x","article-title":"Point-of-care ultrasound induced changes in management of unselected patients in the emergency department-a prospective single-blinded observational trial.","volume":"28","author":"J Weile","year":"2020","journal-title":"Scandinavian journal of trauma, resuscitation and emergency medicine."},{"issue":"3","key":"pone.0269344.ref012","doi-asserted-by":"crossref","first-page":"178","DOI":"10.5847\/wjem.j.1920-8642.2016.03.003","article-title":"Point-of-care ultrasound versus radiology department pelvic ultrasound on emergency department length of stay","volume":"7","author":"SP Wilson","year":"2016","journal-title":"World journal of emergency medicine"},{"issue":"1","key":"pone.0269344.ref013","doi-asserted-by":"crossref","first-page":"67","DOI":"10.1097\/PEC.0b013e31827b53f9","article-title":"Does the use of bedside pelvic ultrasound decrease length of stay in the emergency department?","volume":"29","author":"R Thamburaj","year":"2013","journal-title":"Pediatric emergency care."},{"issue":"3","key":"pone.0269344.ref014","doi-asserted-by":"crossref","first-page":"227","DOI":"10.1016\/j.annemergmed.2006.01.008","article-title":"Randomized controlled clinical trial of point-of-care, limited ultrasonography for trauma in the emergency department: the first sonography outcomes assessment program trial","volume":"48","author":"LA Melniker","year":"2006","journal-title":"Annals of emergency medicine"},{"issue":"5","key":"pone.0269344.ref015","doi-asserted-by":"crossref","first-page":"578","DOI":"10.1111\/acem.13169","article-title":"Diagnostic value and effect of bedside ultrasound in acute appendicitis in the emergency department.","volume":"24","author":"F Gungor","year":"2017","journal-title":"Academic Emergency Medicine"},{"issue":"17","key":"pone.0269344.ref016","doi-asserted-by":"crossref","first-page":"1593","DOI":"10.1056\/NEJMra1916062","article-title":"Point-of-care ultrasonography.","volume":"385","author":"JL D\u00edaz-G\u00f3mez","year":"2021","journal-title":"New England Journal of Medicine"},{"issue":"1","key":"pone.0269344.ref017","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/1865-1380-4-72","article-title":"Use of ultrasound in the developing world","volume":"4","author":"S Sippel","year":"2011","journal-title":"International journal of emergency medicine"},{"issue":"1","key":"pone.0269344.ref018","doi-asserted-by":"crossref","first-page":"10","DOI":"10.4103\/0974-2700.41785","article-title":"Assessing the utility of ultrasound in Liberia","volume":"1","author":"S Kotlyar","year":"2008","journal-title":"Journal of emergencies, Trauma and Shock."},{"issue":"3","key":"pone.0269344.ref019","doi-asserted-by":"crossref","first-page":"125","DOI":"10.1016\/j.afjem.2016.03.001","article-title":"Bedside ultrasound training at Muhimbili national hospital in Dar es Salaam, Tanzania and hospital San Carlos in Chiapas, Mexico.","volume":"6","author":"TA Reynolds","year":"2016","journal-title":"African Journal of Emergency Medicine"},{"issue":"12","key":"pone.0269344.ref020","doi-asserted-by":"crossref","first-page":"1525","DOI":"10.1111\/j.1365-3156.2011.02868.x","article-title":"Indications for ultrasound use in low\u2010and middle\u2010income countries.","volume":"16","author":"RS Groen","year":"2011","journal-title":"Tropical Medicine & International Health."},{"issue":"4","key":"pone.0269344.ref021","doi-asserted-by":"crossref","first-page":"261","DOI":"10.1007\/s12245-008-0074-7","article-title":"Introduction of a portable ultrasound unit into the health services of the Lugufu refugee camp, Kigoma District, Tanzania.","volume":"1","author":"D Adler","year":"2008","journal-title":"International journal of emergency medicine"},{"issue":"3","key":"pone.0269344.ref022","doi-asserted-by":"crossref","first-page":"118","DOI":"10.1016\/j.afjem.2017.04.011","article-title":"Evaluation of a point-of-care ultrasound scan list in a resource-limited emergency centre in Addis Ababa Ethiopia.","volume":"7","author":"M Stachura","year":"2017","journal-title":"African Journal of Emergency Medicine"},{"issue":"1","key":"pone.0269344.ref023","first-page":"1","article-title":"Impact of the introduction of ultrasound services in a limited resource setting: rural Rwanda 2008.","volume":"9","author":"SP Shah","year":"2009","journal-title":"BMC international health and human rights."},{"issue":"4","key":"pone.0269344.ref024","doi-asserted-by":"crossref","first-page":"e0194774","DOI":"10.1371\/journal.pone.0194774","article-title":"Impact of point-of-care ultrasound on clinical decision-making at an urban emergency department in Tanzania.","volume":"13","author":"TA Reynolds","year":"2018","journal-title":"PloS one"},{"issue":"8","key":"pone.0269344.ref025","doi-asserted-by":"crossref","first-page":"608","DOI":"10.1024\/1661-8157\/a003495","article-title":"Point-of-Care Ultrasound: A Useful Diagnostic Tool in Africa.","volume":"109","author":"O Ngome","year":"2020","journal-title":"Praxis"},{"issue":"3","key":"pone.0269344.ref026","doi-asserted-by":"crossref","first-page":"142","DOI":"10.1016\/j.ienj.2011.08.002","article-title":"The South African Triage Scale (adult version) provides reliable acuity ratings.","volume":"20","author":"M Twomey","year":"2012","journal-title":"International emergency nursing."},{"key":"pone.0269344.ref027","first-page":"651","volume-title":"Emergency Department in the St. Francis Referral Hospital, Ifakara, Tanzania.","author":"M Rohacek","year":"2017"},{"issue":"1","key":"pone.0269344.ref028","doi-asserted-by":"crossref","first-page":"119","DOI":"10.1016\/j.ccc.2013.08.005","article-title":"The FAST and E-FAST in 2013: trauma ultrasonography: overview, practical techniques, controversies, and new frontiers.","volume":"30","author":"SR Williams","year":"2014","journal-title":"Critical care clinics."},{"issue":"2","key":"pone.0269344.ref029","doi-asserted-by":"crossref","first-page":"224","DOI":"10.1007\/s00134-010-2079-y","article-title":"Sonographic diagnosis of pneumothorax.","volume":"37","author":"G. Volpicelli","year":"2011","journal-title":"Intensive Care Med"},{"issue":"12","key":"pone.0269344.ref030","doi-asserted-by":"crossref","first-page":"1735","DOI":"10.7863\/jum.2008.27.12.1735","article-title":"Utility of portable ultrasound in a community in Ghana.","volume":"27","author":"JK Spencer","year":"2008","journal-title":"Journal of Ultrasound in Medicine"},{"issue":"1","key":"pone.0269344.ref031","doi-asserted-by":"crossref","first-page":"119","DOI":"10.4269\/ajtmh.1999.60.119","article-title":"Ultrasonography as an aid to diagnosis and treatment in a rural African hospital: a prospective study of 1,119 cases","volume":"60","author":"J Steinmetz","year":"1999","journal-title":"The American journal of tropical medicine and hygiene"},{"key":"pone.0269344.ref032","unstructured":"WHO, UNICEF, UNFPA, World Bank Group, UN Population Division. Trends in maternal mortality: 1990 to 2015. Available from: http:\/\/apps.who.int\/iris\/bitstream\/10665\/194254\/1\/9789241565141_eng.pdf?ua=1."},{"issue":"18","key":"pone.0269344.ref033","doi-asserted-by":"crossref","first-page":"4372","DOI":"10.1002\/cncr.27410","article-title":"Cancer burden in Africa and opportunities for prevention","volume":"118","author":"A Jemal","year":"2012","journal-title":"Cancer"},{"issue":"2","key":"pone.0269344.ref034","doi-asserted-by":"crossref","first-page":"103","DOI":"10.1016\/S2468-1253(16)30161-3","article-title":"Characteristics, management, and outcomes of patients with hepatocellular carcinoma in Africa: a multicountry observational study from the Africa Liver Cancer Consortium","volume":"2","author":"JD Yang","year":"2017","journal-title":"The lancet Gastroenterology & hepatology"},{"issue":"2","key":"pone.0269344.ref035","doi-asserted-by":"crossref","first-page":"250","DOI":"10.1016\/j.jhep.2019.08.025","article-title":"Epidemiology and surveillance for hepatocellular carcinoma: New trends","volume":"72","author":"AG Singal","year":"2020","journal-title":"Journal of hepatology"},{"issue":"1","key":"pone.0269344.ref036","doi-asserted-by":"crossref","first-page":"37","DOI":"10.1111\/j.1365-2036.2009.04014.x","article-title":"Meta\u2010analysis: surveillance with ultrasound for early\u2010stage hepatocellular carcinoma in patients with cirrhosis.","volume":"30","author":"A Singal","year":"2009","journal-title":"Alimentary pharmacology & therapeutics"},{"issue":"3","key":"pone.0269344.ref037","doi-asserted-by":"crossref","first-page":"246","DOI":"10.1002\/uog.10054","article-title":"Ultrasound scanning of the pelvis and abdomen for staging of gynecological tumors: a review.","volume":"38","author":"D. Fischerova","year":"2011","journal-title":"Ultrasound in obstetrics & gynecology."},{"issue":"3","key":"pone.0269344.ref038","doi-asserted-by":"crossref","first-page":"352","DOI":"10.1002\/pbc.23050","article-title":"The use of ultrasound in endemic Burkitt lymphoma in Cameroon","volume":"58","author":"S Marjerrison","year":"2012","journal-title":"Pediatric blood & cancer"},{"key":"pone.0269344.ref039","doi-asserted-by":"crossref","DOI":"10.1155\/2018\/3684081","article-title":"The accuracy of point-of-care ultrasound in detecting small bowel obstruction in emergency department.","volume":"2018","author":"A Pourmand","year":"2018","journal-title":"Emergency medicine international."},{"issue":"10199","key":"pone.0269344.ref040","doi-asserted-by":"crossref","first-page":"652","DOI":"10.1016\/S0140-6736(19)30955-9","article-title":"The state of hypertension care in 44 low-income and middle-income countries: a cross-sectional study of nationally representative individual-level data from 1\u00b7 1 million adults","volume":"394","author":"P Geldsetzer","year":"2019","journal-title":"The Lancet"},{"issue":"12","key":"pone.0269344.ref041","doi-asserted-by":"crossref","first-page":"e0208931","DOI":"10.1371\/journal.pone.0208931","article-title":"Heart diseases and echocardiography in rural Tanzania: Occurrence, characteristics, and etiologies of underappreciated cardiac pathologies.","volume":"13","author":"DM Raphael","year":"2018","journal-title":"PloS one."},{"issue":"1","key":"pone.0269344.ref042","doi-asserted-by":"crossref","first-page":"46","DOI":"10.5811\/westjem.2015.11.28525","article-title":"Point-of-care multi-organ ultrasound improves diagnostic accuracy in adults presenting to the emergency department with acute dyspnea","volume":"17","author":"D Mantuani","year":"2016","journal-title":"Western Journal of Emergency Medicine"},{"issue":"1","key":"pone.0269344.ref043","doi-asserted-by":"crossref","first-page":"71","DOI":"10.1016\/j.ajem.2008.01.002","article-title":"Identification of congestive heart failure via respiratory variation of inferior vena cava diameter","volume":"27","author":"DJ Blehar","year":"2009","journal-title":"The American journal of emergency medicine"},{"issue":"5","key":"pone.0269344.ref044","doi-asserted-by":"crossref","first-page":"703","DOI":"10.1002\/ejhf.2032","article-title":"Ultrasound imaging of congestion in heart failure: examinations beyond the heart","volume":"23","author":"P Pellicori","year":"2021","journal-title":"European Journal of Heart Failure"},{"issue":"6","key":"pone.0269344.ref045","doi-asserted-by":"crossref","first-page":"1129","DOI":"10.1016\/j.ajem.2016.03.043","article-title":"Resolution of sonographic B-lines as a measure of pulmonary decongestion in acute heart failure","volume":"34","author":"JL Martindale","year":"2016","journal-title":"The American journal of emergency medicine"},{"issue":"4","key":"pone.0269344.ref046","first-page":"771","article-title":"Point-of-care lung ultrasound is more sensitive than chest radiograph for evaluation of COVID-19.","volume":"21","author":"JR Pare","year":"2020","journal-title":"Western Journal of Emergency Medicine."},{"issue":"1","key":"pone.0269344.ref047","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1136\/injuryprev-2015-041616","article-title":"The global burden of injury: incidence, mortality, disability-adjusted life years and time trends from the Global Burden of Disease study 2013.","volume":"22","author":"JA Haagsma","year":"2016","journal-title":"Injury prevention."},{"key":"pone.0269344.ref048","volume-title":"10th Edition of the Advanced Trauma Life Support\u00ae (ATLS\u00ae) Student Course Manual","author":"American College of Surgeons","year":"2018"},{"issue":"6","key":"pone.0269344.ref049","doi-asserted-by":"crossref","first-page":"727","DOI":"10.1017\/cem.2019.381","article-title":"Diagnostic accuracy of eFAST in the trauma patient: a systematic review and meta-analysis","volume":"21","author":"S Netherton","year":"2019","journal-title":"Canadian Journal of Emergency Medicine"},{"issue":"2","key":"pone.0269344.ref050","doi-asserted-by":"crossref","DOI":"10.7196\/SAMJ.3821","article-title":"FAST scanning in the developing world emergency department","volume":"100","author":"ZA Smith","year":"2010","journal-title":"South African Medical Journal"},{"issue":"1","key":"pone.0269344.ref051","doi-asserted-by":"crossref","first-page":"e000438","DOI":"10.1136\/tsaco-2020-000438","article-title":"Diagnostic performance of the extended focused assessment with sonography for trauma (EFAST) patients in a tertiary care hospital of Nepal.","volume":"5","author":"S Basnet","year":"2020","journal-title":"Trauma Surgery & Acute Care Open."}],"container-title":["PLOS ONE"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0269344","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,6,2]],"date-time":"2022-06-02T17:40:40Z","timestamp":1654191640000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0269344"}},"subtitle":[],"editor":[{"given":"Muhammad","family":"Abdel-Gawad","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2022,6,2]]},"references-count":51,"journal-issue":{"issue":"6","published-online":{"date-parts":[[2022,6,2]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pone.0269344","relation":{},"ISSN":["1932-6203"],"issn-type":[{"value":"1932-6203","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,6,2]]}}}