S1285 Rwanda Endoscopy Week 2025: Expanding Endoscopic Capacity and Sustaining GI Care—Seven Years of Programmatic Impact

Introduction: The 7th Rwanda Endoscopy Week (REW 7.5) was held from March 10–14, 2025, marking the first event following Rwanda's Marburg Virus Disease (MVD) outbreak in late 2024. Originally scheduled for November 2024, REW was postponed due to the outbreak. This year's program underscored the resilience of Rwanda’s health system and its sustained commitment to expanding gastroenterology services. We present an overview of clinical activity, procedural outcomes, and system-level trends observed during REW 7.5. Methods: We prospectively collected data during REW 7.5 using a standardized survey tool. Data encompassed patient care, hands-on training, and academic workshops across 8 hospitals. A total of 899 endoscopic procedures were recorded and analyzed. Collected variables included patient demographics, anesthesia use, procedural indications, endoscopic findings (esophagus, stomach, duodenum, colon), interventions performed, and quality metrics (cecal intubation, bowel preparation quality). Results: A total of 899 procedures (mean age 45.6 years; 62.1% female) were performed across 8 locations: 822 EGDs, 70 colonoscopies, 6 endoscopic ultrasounds, and 1 ERCP. Clinical sites included district, private, military, and tertiary hospitals, reflecting an intentional expansion of endoscopy access beyond traditional referral centers. Procedures were both diagnostic and therapeutic, with interventions including 45 biopsies, 13 dilations, 6 snare polypectomies, 4 variceal ligations, and others such as clip placement. Anesthesia was used in 40.4% of cases (42.9% of EGDs, 92.9% of colonoscopies), signaling growth in procedural tolerance and safety. No procedural complications or nosocomial infections were reported. While REW 7.5 had fewer procedures than REW 6 (899 vs 1,069), this reflected temporary service disruption due to MVD. Still, the successful deployment of a binational team across 8 hospitals emphasized the durability of Rwanda’s endoscopy infrastructure. Since the inaugural REW in 2017, over 5,000 procedures have been performed. Conclusion: REW 7.5 demonstrated continued resilience, adaptability, and long-term vision of Rwanda Endoscopy Week. Despite logistical challenges, the program maintained its focus on high-quality care and training. This year’s findings underscore the need for improved triage protocols for dyspeptic patients and broader support for remote endoscopy access, anesthesia access, and GI fellowship sustainability to ensure long-term equity in procedural care delivery.