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Considering individual differences caused by personality differences is crucial for end users' technology acceptance. However, previous studies overlooked the influence of users' technology readiness on technology acceptance. This study, therefore, aimed to evaluate the influence of technology readiness on teleradiology acceptance in the Amhara Regional State Public Hospitals using a technology readiness acceptance model. An institutional-based cross-sectional mixed study design was conducted in September 2021 among 547 health professionals working at sixteen public hospitals in the Amhara region of northwest Ethiopia. Eight key informants were interviewed to explore organizational-related factors. Face-to-face and Google Meet approaches were used to collect the data. We applied structural equation modeling to investigate the influence of technology readiness on health professionals' teleradiology acceptance using Analysis of Moment Structures Version 23 software. Of the total participants, 70.2% and 85.7% were ready and intended to use teleradiology, respectively. According to technology readiness measuring constructs, optimism and innovativeness positively influenced health professionals' technology acceptance. Perceived ease of use and perceived usefulness showed a statistically positive significant effect on health professionals' intention to use teleradiology. In addition, a statistically significant mediation effect was observed between technology readiness measuring constructs and behavioral intention to use. Furthermore, a shortage of budget, inadequate infrastructure, and users' lack of adequate skills were reported as critical organizational challenges. We found a higher proportion of readiness and intention to use teleradiology among health professionals. Personality difference measuring constructs and organizational factors played considerable influence on teleradiology acceptance. Therefore, before the actual implementation of teleradiology, ensuring the system's user-friendliness, improving infrastructure, allocating an adequate budget, and availing of capacity-building opportunities are recommended.

Background Limited access to onsite radiologists in Low- and Middle-Income Countries (LMICs) poses challenges for health facilities in delivering timely radiology services resulting in prolonged patient waiting times and dissatisfaction with the insufficient radiology services. In recent years, teleradiology has emerged as a potential solution to improve the timely diagnosis and treatment process. Therefore, this paper analysed the effect of a web-based teleradiology system that was developed and deployed to evaluate its effect on patient waiting time and service satisfaction in public hospitals of the Amhara Regional State. Methods A pre-post study design was employed to evaluate the effect of a web-based teleradiology system on patient waiting time and service satisfaction. The study included a total of 836 participants, out of which 417 participated during the pre-intervention and 419 in the post-intervention periods. Data were collected from October 2021 to February 2022 and from May 2022 to January 2023 for the pre-and post-implementation periods, respectively. Supportive measures, including user guides, onsite training, and onsite/virtual assistance, were given during the teleradiology implementation period. The effects of the teleradiology on waiting time and service satisfaction were evaluated with the Mann-Whitney U-test and the Generalized Linear Model. Waiting time was measured as the duration between image consultation and report completion. Furthermore, satisfaction was assessed using a 31-item, 5-point Likert scale. The statistical analysis was done using Stata version 17 software. Results After the implementation of the web-based teleradiology system, a significant decrease in the median waiting time was observed from 43.5 h (IQR: 22.88–71.63) to 4.62 h (IQR: 2.52–10.53) ( p -value < 0.01). The effect size for this improvement was found to be 0.84. Furthermore, the median patient satisfaction score was significantly improved from 96 (IQR: 89–103) to 113 (IQR: 105–124) ( p -value < 0.01) and an effect size of 0.65. Similarly, the percentage of the scale mean score (%SM) showed an increase in patient satisfaction levels from 52.6% (pre-implementation) [95% CI: 51.8–53.5] to 65.7% (post-implementation) [95% CI: 64.5 -66.9%]. The GLM analysis demonstrated a 71% decrease in patient waiting time and an 11% increase in radiography service satisfaction ( p -value < 0.01). Conclusion Implementing the web-based teleradiology system improved the patient’s waiting time and service satisfaction remarkably. The notable reduction in waiting time and the significant improvement in patient satisfaction scores highlighted the benefits of teleradiology in enhancing timely diagnosis and treatment. Deploying a web-based teleradiology system in public hospitals is recommended to enhance efficiency and improve patient satisfaction in radiology consultations. Trial registration number PACTR202401789144564. Trial registration date 09 January 2024.

Background Medical imaging plays a vital role in the accurate diagnosis, treatment and outcome prediction of many diseases and injuries. However, in many African countries, deserving populations do not have access to the proper medical imaging specialists’ services. As a result, clinicians continue to struggle to provide medical imaging via consultation. However, little is known about conventional referral consultation practices and their challenges. This study, therefore, aimed to explore the practice and challenges of medical imaging service consultation among health professionals and patients in the context of the Ethiopian public healthcare delivery system. Methods Descriptive phenomenological study was employed to explore the practice of medical imaging service consultation among health professionals and patients in public hospitals of Amhara region from October 12, 2021 to December 29, 2021. Semi-structured interview guides were prepared separately for key-informant and in-depth interviews. A total of 21 participants (6 hospital managers, 4 medical directors, 4 department heads, 3 medical imaging coordinators and 4 patients) were selected using the maximum variation sampling technique. All interviews were audio-recorded, transcribed verbatim and subjected to inductive thematic analysis using Open Code 4.02 software. Results Six major themes emerged following the thematic analysis: (1) medical image service delivery practices; (2) medical imaging consultation modalities; (3) benefits and drawbacks of the consultation modalities; (4) challenges; (5) challenge mitigation strategies; and (6) future recommendations. Image films, compact disks, and telegram apps were the consultation modalities used by the referring clinicians to send the medical images to radiologists. Frequent failure of imaging machines, delayed equipment maintenance, inadequate infrastructure, shortage of budget, lack of radiologists, and low-quality of printed image films were among the challenges influencing the medical imaging consultation service. Conclusions This research explored onsite and referral imaging consultation practices. However, there are many challenges encountered by the referring clinicians and the radiologists during the consultation process. These challenges could potentially affect clinicians’ ability to provide timely diagnosis and treatment services which would ultimately affects patient health status and service delivery. Virtual consultation via teleradiology and enhancing clinicians’ competence through long-term and short-term trainings are recommended to improve the referral consultation practice.

Background Low back pain (LBP) is one of the most serious public health problem globally with substantial socioeconomic implications. Degenerative disc disease is an important cause of LBP in the elderly. Magnetic resonance imaging (MRI) is routinely ordered by physicians in evaluation of patients with suspected degenerative disc disease in the lumbar spine. However there is no unanimous agreement in the literatures when it comes to the association of degree of disability to that of severity of lumbar MRI findings. Objective The aim of this study is to assess the association between degree of disability measured using Oswestry Disability Index (ODI) and findings on lumbar spine MRI in patients with degenerative disc disease at University of Gondar comprehensive Specialized Hospital, North West Ethiopia, 2020. Methods and materials A prospective cross-sectional study was conducted on 72 consecutively enrolled patients with degenerative disc disease who underwent lumbar MRI scan. Degree of disability was measured using ODI questionnaire translated to local language. Association between lumbar spine MRI parameters and ODI score and category was tested using Spearman’s rank correlation coefficient and Chi square tests. Results The mean age of the study subjects was 43.81 ± 1.88 years (range 22–83 years). Forty-three (59.7%) of the study population were female. In terms of ODI category, most fell under minimal 33 (45.8%) or moderate 25 (34.7%) disability. Disc bulge (81.9%) and foraminal stenosis were the most frequent MRI abnormalities detected. ODI score showed weak correlation with grade of spinal canal stenosis. Grade of foraminal stenosis showed no correlation with ODI score. Conclusion The clinical relevance of MRI findings in predicting degree of disability in patients with degenerative disc disease is limited and MRI study should be sparingly ordered in evaluation of these patients particularly in resource constrained settings.

Background Kartagener’s syndrome is a subset of primary ciliary dyskinesia, an autosomal recessive inherited disorder characterized by the clinical triad of chronic sinusitis, bronchiectasis, and situs inversus. Abnormal ciliary structure or function leading to impaired ciliary motility is the main pathophysiologic problem in Kartagener’s syndrome. Case presentation A 24-year-old man from Gondar town, North-West Ethiopia, presented to University of Gondar Hospital with recurrent episodes of nasal congestion with itching and paranasal discomfort, and productive cough for more than a decade. Clinical and imaging findings revealed chronic sinusitis, bronchiectasis, dextrocardia, and situs inversus. He was treated with orally administered antibiotics, mucolytic, and chest physiotherapy. He was symptomatically better with the above therapy, and started on a long-term low-dose prophylactic antibiotic. Conclusions Patients with Kartagener’s syndrome exist in Ethiopia as cases of chronic recurrent sinopulmonary infections. As there is no easy, reliable non-invasive diagnostic test for Kartagener’s syndrome and the correct diagnosis is often delayed by years, it may cause chronic respiratory problems with reduced quality of life. Genetic counseling and fertility issues should be addressed once Kartagener’s syndrome is diagnosed.

Introduction: Teleradiology allows distant facilities to electronically transmit images for interpretation, thereby bridging the radiology service gap between urban and rural areas. The technology improves healthcare quality, treatment options, and diagnostic accuracy. However, in low resource settings like Ethiopia, teleradiology services are limited, posing challenges for implementation. Therefore, this study is aimed at exploring the factors that facilitated or hindered the implementation of web‐based teleradiology in the public hospitals of the South Gondar Zone, Northwest Ethiopia. Methods: In this study, a purposive sampling method was employed to select seventeen participants, including hospital managers, physicians, emergency surgeons, and radiologists, for an in‐depth interview (IDI). The interviews were conducted from March to May 2023. A reflexive thematic analysis was conducted using an abductive coding technique at the semantic/explicit level. Data were collected through semistructured interviews conducted face‐to‐face and virtually, with audio recordings transcribed, translated, and analyzed using Open Code version 4.02 software. Trustworthiness was ensured through prolonged engagement, reflective journaling, and review by coauthors. Results: The study examined eight main themes, with barriers to sustainable teleradiology implementation falling into five categories: technological, organizational, environmental, individual, and workflow and communication. Conversely, identified facilitators included improved radiology service efficiency, system accessibility, collaboration opportunities, and user trust in the radiology ecosystem. Within each theme, factors with potential impacts on teleradiology system sustainability were identified, such as the lack of system handover mechanisms, absence of a central image consultation center, and inadequate staffing of full‐time radiologists and technical personnel. Conclusions: The study highlights the positive user perception of a web‐based teleradiology system’s user‐friendliness and efficiency. Overcoming challenges and leveraging facilitators are crucial for optimizing teleradiology and improving service delivery and patient outcomes. A centralized consultation center with dedicated radiologists and technical personnel is recommended for maximizing efficiency.

Abdominal ultrasound (US) is increasingly used in the diagnostic work-up of infectious diseases, but studies on its diagnostic value in visceral leishmaniasis (VL) are lacking. US could help to identify complications of spleen aspiration (SA). We aimed to assess the diagnostic value of US and the evolution of findings after VL treatment; the incidence and degree of splenic injury; and the pain perceived during SA. We conducted a cross-sectional prospective study at the Leishmaniasis Research and Treatment Center, Gondar, Ethiopia between Oct 2017 and Dec 2018. We enrolled VL suspects undergoing tissue aspiration; US were conducted before and after SA, and at the end of VL treatment. Splenic injury was graded using the American association of surgery trauma injury scale (grade 1-4). The pain perceived during SA was graded using a visual analogue scale. Out of 392 VL suspects, 192 (49%) were confirmed VL cases. The median age was 25 years (IQR 21-30). Massive splenomegaly and hepatomegaly were the most common US findings. Splenic nodules were seen in 3.7% of the 190 VL cases and 1.5% of the 197 non-VL cases. Ascites was more common in VL (16.4%) than in non-VL cases (9.1%). The frequency of US abnormalities decreased with treatment. None of the US findings had sufficient sensitivity and specificity to justify its use as a diagnostic test. US detected splenic injury in four of the 318 patients who had post-SA US. All four patients remained clinically stable. Pain was perceived as moderate or severe in 51% of patients. The diagnostic value of abdominal US for VL was low but found useful to detect subclinical splenic injury. SA caries a risk of splenic injury and was perceived painful by most. Further research on less invasive diagnostic tools is needed.

Neuromyelitis optica spectrum disorder is an autoimmune, astrocytopathic CNS disease, mainly involving the optic nerves, spinal cord, and brain stem regions. The \"International Panel for NMOSD Diagnosis (IPND) Diagnostic Criteria\" was implemented to define the disorder. A 38-year-old patient presented with visual loss of eight months' duration and weakness of the lower extremities of one week's duration. The patient had bilateral optic atrophy on fundoscopic examination, and flaccid paraplegia with sensory loss below T4 level. Serological tests for syphilis, HIV infection, and SLE were negative. Aquaporin-4 antibody test was not done due to limited clinical setup. T2-spine MRI revealed long central thoracic segment (T3 to T6) hyperintense lesion with mild cord expansion. Long segment central canal dilation (syrinx) was noted in the cord proximal to the lesion. Diagnosis of opticospinal variant, NMOSD was made using IPND diagnostic criteria. The patient was started on dexamethasone 50 mg, IV, four times daily (QID) for one week, and changed to prednisolone 1 mg/kg (40 mg) PO daily for one month, to be tapered over three-to-six months. The patient was scheduled to initiate azathioprine 50 mg PO twice daily. The case emphasizes the existence of neuromyelitis optica spectrum disorder in clinical settings of the developing world. High index of suspicion of this rare disease is required to avoid delayed diagnosis and treatment.

Background Head injuries pose a major global health issue, especially among young adults in developing countries. Data on head trauma patterns in conflict situations is scarce, and computed tomography (CT) is the main imaging method for evaluating acute head injuries. Objectives This study aimed to assess the CT scan patterns of traumatic head injury among northern Ethiopian victims of war who were treated at the University of Gondar Comprehensive Specialized Hospital during the armed conflict in 2020 and 2021. Methods A cross-sectional study was conducted on 76 cases of traumatic head injury who underwent CT scans from November 1, 2020, to January 30, 2021, at the Department of Radiology. Data regarding age, sex, mechanism of injury, and CT scan findings were collected and analyzed. Results A total of 76 patients were assessed, with 73 (96.1%) being males and a male-to-female ratio of 24:1. Ages ranged from 19 to 48 years, with the most affected group being ≤ 29 years (44 or 57.9%). Common head injury mechanisms included bullets (50%), blunt trauma (26%), and blasts (21%). Abnormal CT findings were noted in 60 cases (78.95%), with the most common findings being skull fractures (64.5%), cerebral contusions (33%), and metallic foreign bodies (36%). Scalp and brain hematoma, presence of soft tissue foreign body, pneumocephalus, and subfalcine herniation exhibited a statistically significant correlation with bullet injuries (p-value < 0.05). Conclusion This study found a high rate of abnormal CT scans mainly involving young males as the primary victims of traumatic head injuries in war-affected areas of Northern Ethiopia. The leading causes were bullet injuries, with common CT scan findings including skull fractures and cerebral contusions, many requiring immediate intervention. The high rate of abnormal CT scans in these patients underscores the need to improve access to CT scans in conflict-affected areas. Graphical abstract