Prevalence of late-stage presentation and associated factors of cervical cancer patients in Tikur Anbesa Specialized Hospital, Ethiopia: institutional based cross-sectional study

Background Cancer of the uterine cervix remains a main public health problem in Sub-Saharan Africa. About two-thirds of patients with cervical cancer were diagnosed at late stage with contributing factors of out-of-pocket medical bill, looking for care out of conventional health settings and multiple visits to healthcare facilities before diagnostic confirmations in Addis Ababa. Therefore, the aim of this study was to identify prevalence of late-stage presentation and associated factors among cervical cancer patients in Tikur Anbesa Specialized Hospital (TASH). Methods Institutional based cross-sectional study was conducted from March to April 2019 in TASH oncology center. Data were extracted from patient’s chart using structured checklist prepared in English and analyzed using STATA14.2. Binary logistic regression model was used to identify variables that affect the outcome variable. Results A total of 1057 cervical cancer patients were included in this five-years retrospective study. The prevalence of late-stage presentation among cervical cancer patients was 56.8%. It was affected by being anemic [AOR = 1.55,95%CI (1.17–2.10)], came from Oromia region (AOR = 0.65,95%CI (0.46–0.91) and Addis Ababa city [AOR:0.5;95%CI (0.34–0.73)], rural residency [AOR:1.88;95% (1.38–2.56)] and age ≥ 60 years [AOR:1.89;95%CI (1.12–3.20)]. Conclusion The study revealed that the prevalence of late-stage presentation among cervical cancer patients is high. Being anemic, regions where patients came from, rural residency and age group ≥ 60 years were statically significant. It is better to expand cervical cancer education for rural dwellers, expand cancer treatment centers and prioritize to patients with anemia and advanced age.

Prevalence and associated factors of baseline anemia among cervical cancer patients in Tikur Anbesa Specialized Hospital, Ethiopia

Background Almost one patient with cancer in two is anemic. About 40 to 64% of cervical cancer patients are anemic at time of presentation. The rate of anemia increases with the use of chemotherapy, radiotherapy, hormonal therapy and associated with poorer treatment outcome and quality of life. Therefore, the aim of this study was to assess prevalence and associated factors of baseline anemia among cervical cancer patients in Tikur Anbesa Specialized Hospital (TASH), Ethiopia. Methods Institutional based cross-sectional study was done from March to April 2019 at TASH cancer center. Data were collected from patient’s chart using structured checklist and analyzed using Stata14.2. Binary logistic regression model was used to identify covariates which affected the outcome variable. Result This is a 3-years retrospective study from 2014 to 2016. The prevalence of baseline anemia among cervical cancer patients was 50.95%. Being stage IV [AOR = 2.38, 95% CI (1.21–4.67)], having comorbidity [AOR = 3.32, 95% CI (2.25–4.90)] and using substances (patients who used one, two or all of the three substances (cigarate, chat and alcohol)) [AOR = 2.03, 95% CI (1.21–3.41)] significantly increased the occurrence of anemia while being divorced [AOR = 0.6, 95% CI (0.36–0.98)] decreased the occurrence of anemia in the current study. Conclusion The prevalence of baseline anemia was high in the current study compared to other literatures. Significant factors of baseline anemia of cervical cancer in the current study were advanced stage (stage IV), presence of comorbidity, substance usage and being divorced (protective). The authors recommend that it is better to give special attention to those patients with the stated factors that could interfere treatment outcome.

Preterm Neonatal Mortality and its predictors in Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia: a retrospective cohort study

BACKGROUND፡ Preterm neonatal death is a global problem. In Ethiopia, it is still high, and the trend in reduction is slower as compared to child mortality. Preterm neonatal birth is the leading cause. The magnitude and associated factors are also not well documented. Therefore, this study aimed to estimate the incidence of mortality and its predictors among preterm neonates in Tikur Anbesa Specialized Hospital (TASH).METHODS: An institution-based retrospective cohort study was conducted among 604 preterm neonates admitted to Tikur Anbesa Specialized Hospital. Data were collected by reviewing patient charts using systematic sampling with a checklist. The data entry was done using EpiData version 4.2, and analysis was done using Stata Version 14.1. Kaplan-Meier and log-rank tests were used to estimate the survival time and to compare it. Cox proportional hazard was also fitted to identify major predictors. Hazard Ratios (HRs) with 95% Confidence Intervals (CI) were used to assess the relationship between factors associated with the occurrence of death. Finally, statistical significance was declared at p-value < 0.05.RESULTS: In this study, a total of 604 patient charts were reviewed; of these, 571 met the inclusion criteria and were recruited to the study. A total of 170(29.7%) preterm neonates died during the follow-up period. The median follow-up time of preterm neonate under the cohort was 21 days (IQR: 4, 27). The incidence rate was 39.1 per 1000-person day. Rural residency (AHR: 1.45 (95% CI: 1.1,4.8)), Maternal diabetic Mellitus (AHR:2.29 (95%CI: 1.43,3.65), neonatal sepsis (AHR:1.62 (95% CI: 1.11,2.37), respiratory distress (AHR:1.54 (95% CI:1.03,2.31), extreme prematurity (AHR:2.87 (95% CI:1.61, 5.11), and low APGAR score (AHR:3.11 (95% CI:1.79, 5.05) was found to be predictors .CONCLUSION: The rate of preterm neonatal mortality is still an important problem. Having maternal gestational Diabetic Mellitus, neonatal sepsis, respiratory distress, and low Apgar score were major predictors for preterm neonatal mortality. Therefore, efforts have to be made to reduce the incidence of death and for timely management of mothers with Diabetic Mellitus. Healthcare professionals should also work on early diagnosis and treatment of preterm neonate with sepsis, respiratory distress, and low Apgar score.

Factors Associated With Delayed Diagnosis of Cervical Cancer in Tikur Anbesa Specialized Hospital, Ethiopia, 2019: Cross-Sectional Study

BackgroundCervical cancer is a preventable and curable disease if detected early enough. But, several numbers of women in Ethiopia strive for treatment when the disease has extended to last stage. Cervical cancer is the second most common cancer morbidity and the leading cause of women mortality related to cancer in Ethiopia. Delayed in diagnosis is the main reason for cervical cancer mortality in Ethiopia. The main objective of this study was to assess factors associated with delayed diagnoses of cervical cancer in Tikur Anbesa Specialized Hospital, Ethiopia. MethodsInstitution based cross-sectional study was conducted. Randomly selected 422 cervical cancer patients were interviewed and their medical records were reviewed. Data was entered using Epi data version 3.1 and analyzed using SPSS version 22. Bivariate and multivariate analysis was conducted to examine the association between independent and the outcome variables. ResultA total of 422 women were enrolled in our study yielding a response rate of 97.1%. The mean age of the women was 50 years (SD ±11.5). Half of the participants (50%) were can’t read and write, and 66.3% of participants income were <500 Ethiopian Birr (approximately 14 USD). Most (86.3%) of the women had delayed diagnosis of cervical cancer. Women who have <500 Ethiopian Birr (14 USD) income (adjusted OR=3.79, CI: 1.48, 9.67), haven’t awareness of cervical cancer disease (adjusted OR=1.33, CI: 1.05, 2.71) and haven’t awareness about cervical cancer screening (adjusted OR=1.64, CI: 1.16, 4.07) were more likely for delayed diagnosis of cervical cancer. ConclusionOur study reports a high prevalence of delayed diagnosis of women with cervical cancer. High level of illiteracy, low socioeconomic status, lack of awareness, traditional healers and absence of routine screening program, were accountable for delayed diagnosis of cervical cancer. Raising awareness, increasing access and improving health services for cancer should be promoted and advocated to decrease the usual delay of cervical cancer diagnosis.

Survival status and associated factors of death among cervical cancer patients attending at Tikur Anbesa Specialized Hospital, Addis Ababa, Ethiopia: a retrospective cohort study

Background Cervical cancer is a cancer of uterine cervix caused mostly by sexually-acquired infection called Human papillomavirus (HPV. In developing region of the globe, fewer than 50% of women with cervical malignancy survive more than 5 years. Therefore, the objective of this study was to assess survival status and associated factors of death among cervical cancer patients attending at Tikur Anbesa Specialized Hospital (TASH), Ethiopia. Methods Facility based retrospective cohort study was conducted from March to April 2019 at Tikur Anbesa Specialized Hospital oncology center. Data was collected from patient’s chart using pre-tested and structured checklist prepared in English and analyzed using STATA14.2. Cox regression model was used to identify Variables that affected survival. Result The overall survival rate was 38.62% at 5 years. There were a significance differences in survival experience between categories of stage of cervical cancer, age of patients, comorbidity, substance use, base line anemia and treatment modalities. Being stage IV [AHR = 11.76; 95% CI (4.02–34.4)],being advanced age [AHR = 5.99; 95% CI (2.1–17.08)], being comorbid [AHR = 1.58; 95%CI(1.14–2.19)], using substance [AHR = 1.56;95% CI(1.09–2.22)] and being anemic [AHR = 1.6;95% CI(1.11–2.36)] increased the risk of death. Conclusion The overall survival rate was lower than high- and middle-income countries and Significant factors of death after diagnosis of cervical cancer were; advanced FIGO stage, base line anemia, comorbidity, substance use, advanced age and treatment modality. Authors recommend that it is better to expand cervical cancer early screening programs and treatment facilities, strengthen awareness in collaboration with public medias about cervical cancer prevention, screening and treatment options.

Multi-drug resistant, extended spectrum beta-lactamase and carbapenemase-producing bacterial isolates among children under five years old suspected bloodstream infection in a specialized Hospital in Ethiopia: Cross-sectional study

Background : Bloodstream infections due to bacterial pathogens are a major cause of morbidity and mortality among pediatric patients. Emergence of drug resistance in high classes of antibiotics among the bacterial pathogens is another issue of the public health concern. Therefore, this study aimed to determine Multi-drug resistant, extended spectrum β-lactamase and carbapenemase producing bacterial isolates among septicemia suspected under five Children in Tikur Anbesa Specialized Hospital, Addis Ababa Ethiopia. Methods : Across-sectional study was conducted from September 2017 to June 2018 among pediatric patients with febrile illness aged under five in Tikur Anbesa Specialized Hospital. Three hundred forty blood samples were collected and processed following standard microbiological techniques and culture was performed using BacT/Alert machine in combination with conventional method. Antimicrobial susceptibility testing of the isolates was performed by Kirby-Bauer disc diffusion method and MIC technique. Result: A total of 137(40.2%) bacterial pathogens were isolated from 340 pediatric patients suspected of BSI with febrile illness. Of these isolates 54% were Gram negative bacteria. Among gram negative isolates 43 (31.4%) Klebsiella pneumonia e and Acinitiobacter species were the most frequently isolated pathogens. Klebsiella pneumoniae isolates were 95.6% MDR, 23.7% ESBL, and 27.1% CRE in children. Conclusion : In this study, Klebsiella pneumoniae is a common pathogens associated with BSI in pediatrics with high antimicrobial resistance. Extended spectrum beta-lactamase producing organisms were common in Klebsiella species and Escherichia coli isolates. Since most of isolates exhibit multidrug resistant, invitro- susceptibility of antimicrobials is mandatory. Strengthen antimicrobial surveillance system and antimicrobial stewardship is necessary for better management of antibiotics in addition to infection prevention practice in Hospital settings.