General objective

To assess the overall quality of bowel preparation in patients undergoing colonoscopy at Tertiary level  Hospitals in Rwanda.

Specific objectives

- To determine the proportion of inadequate bowel preparation in patients undergoing colonoscopy.

- To identify factors associated with inadequate bowel preparation in the Rwandan population.

Study design

This was a multi-center cross-sectional study

Study Site

The study was conducted at four tertiary level hospitals in Rwanda namely Kigali University Teaching Hospital, Butare University Teaching Hospital, Rwanda Military Hospital and King Faisal Hospital.

 Study Population and duration

The study was conducted in adult population (age ≥18 years)

The study was conducted from August, 2023 to August, 2024

Inclusion criteria

Referred patient in endoscopy unit for colonoscopy

Able to provide informed consent

 Exclusion criteria

Age less than 18 years old

Patients requiring urgent colonoscopy

Data collection process and analysis

Demographics, clinical characteristics and information related to the procedure were collected

Collected data were entered in Epidata version 3.1 and exported to Stata version 13 for statistical analysis

We enrolled 429 participants. The mean age was 50±15.7 years and 54.1% were male. Inadequate bowel preparation (total Boston Bowel Preparation Scale <6) was observed in 24.9% of cases. The most common indications for colonoscopy was constipation (48.3%), abdominal pain (27.5%) and lower gastrointestinal bleeding (23.5%) .With regards to colonoscopy findings, normal results were observed in 34% of cases, hemorrhoids were detected in 16.5% of patients, while polyps were found in 16.3%. On multivariate analysis, advanced age (>65 years), lower levels of education, inpatient status, constipation and incomplete dosage of purgative solution were predictors of inadequate bowel preparation.

The inadequate bowel preparation rate was 24.9%. Risk factors for inadequate bowel preparation included chronic constipation, elderly age, low educational attainment, incomplete dosage of purgative agents and inpatients status. Our findings suggest that an individualized approach is required for patients with risk factors of inadequate bowel preparation, including patient comprehensive educational program about bowel preparation before colonoscopy.