Research in global health: The Introduction of FAST in Uganda Jennifer Y. Wang

Challenges in global health research Identifying mutual areas of research interest Resource building –Training in research techniques (laboratory, epidemiology, and statistics) Determining feasibility and cost-effectiveness Using available technology for data transfer/sharing

Injury in Uganda Road traffic crashes top the list of injuries Result in 30% of casualty visits Injury prevention!! Improve patient management upon hospital arrival

Current Management Plain X-rays Peritoneal Aspiration Ultrasound by ultrasonographer (if available) “Observation” Exploratory laparotomy And now…FAST –Focused Assessment with Sonography for Trauma –Free fluid in pericardial, RUQ, LUQ, pelvis views

FAST study WHO Guidelines of Essential Trauma Care 2004: ultrasound is “desirable” Identified in a April 2005 meeting to be area of interest for Ugandan surgeons Innovations Grant from UCSF Global Health Sciences Portable US machine donated by Sonosite

Study Aims Aim 1: To evaluate the feasibility of FAST training for surgeons at a major Ugandan trauma center. Aim 2: To compare the management and outcomes of Ugandan trauma patients before and after the use of FAST, and to assess its cost-effectiveness.

FAST course November 13-16, 2006 ~20 hours of training 19 participants plus ultrasonographer Daily lectures, practical sessions, and final practical exam

Website created by the Mulago-UCSF Malaria collaboration

Ongoing work 1st 4 weeks of images –In 13/23, instructors agreed with all 4 images –In 10/23, instructors agreed with 3/4 images Surgeons continuing to acquire FAST images (need 25 each) Data collection on trauma outcomes underway- 83 subjects from Dec 1 to mid Jan.

Acknowledgements The UCSF team: Dr. Peggy Knudson, P.I.; Dr. Rochelle Dicker, Co-I; Dr. Jeremy Durack, Radiology Resident; Eric Chen, UC Davis Our colleagues at Mulago: Dr. Jackie Mabweijano, Victor Angajoubi, Mr. Isaac Ezati, Geoff Lavoy