Late Diagnosis of Breast Cancer and Associated Factors Among Women Attending Hawassa University Comprehensive and Specialized Hospital Southern Ethiopia

Background; Breast cancer is a significant public health issue in sub-Saharan Africa and the second commonest cancer overall. In Ethiopia, most women present at the late-stage presentation. This is because Ethiopian government gives less attention, and is not well-studied as well. Therefore, it is important to assess delays in diagnosis and treating breast cancer that has been associated with a more advanced stage of the disease and a decrease in patient survival rates.Objective: To assess the magnitude and associated factors for late diagnosis of breast cancer among women attending Hawassa University Comprehensive Specialized Hospital in Southern Ethiopia. Methodology: A facility-based cross-sectional study was conducted from December to January 2019. Data were collected from 261 consecutively selected clients based on the arrival of their hospital visit by using a pretested structured questionnaire and checklist. Physicians performed physical examinations and diagnoses. Data was checked for completeness and consistency, and entered into epi data, then exported to SPSS for analysis. Descriptive, Bivariate, and multivariable logistic regression analyses were performed using SPSS Version 25 Statistical Software.Results: The magnitude of late diagnosis of breast cancer was 86.3%. The woman who had no initial advice for breast biopsy [AOR=5.1, 95% (CI=1.4-18.9)], not sharing the problem to others [AOR=4.7, 95% (CI=1.8-12.2)] and using traditional and faith healers as a first treatment choice [AOR=3.3, 95% (CI=1.2 - 8.8)] were associated with late diagnosis of breast cancer.Conclusions: The majority of women having breast cancer were diagnosed at a late stage. It needs attention to provide better options of the modern health service, and providing accessible initial advice for breast biopsy, and creating awareness about the benefit of sharing problems with family to improve the health of mothers by early diagnosing and managing the breast cancer.

Incidence and predictors of mortality among patients with head injury admitted to Hawassa University Comprehensive Specialized Hospital, Southern Ethiopia: A retrospective follow-up study

Introduction Head injury is the leading cause of morbidity and mortality throughout the world, especially in resource-limited countries including Ethiopia. However, little is known about the mortality rate and its predictors among these patients in Ethiopia. Thus, the study aims to assess the incidence rate of mortality and its predictors among patients with head injury admitted at Hawassa University Comprehensive Specialized Hospital. Methods Institutional based retrospective follow-up study was conducted among 1220 randomly selected head injury patients admitted from July 2017 to July 2019. Bivariable and multivariable Cox regression models were fitted to identify the predictors of mortality. Proportionality assumption was tested by a global test based on the Schoenfeld residuals test. Results The incidence of the mortality rate was 2.26 (95%CI: 1.9–2.6) per 100-person day observation. The independent predictors of time to death were age above 65 years (AHR:3.49, 95%CI:1.63, 7.48), severe TBI (AHR: 8.8, 95%CI:5.13, 15.0), moderate TBI (AHR:3, 95%CI:1.73,5.31), hypotension (AHR:1.72, 95%CI: 1.11,2.66), hypoxia (AHR:1.92, 95%CI: 1.33,2.76), hyperthermia (AHR:1.8, 95%CI: 1.23,2.63) and hypoglycemic (AHR:1.94, 95%CI: 1.34, 2.81) positively associated with mortality, while underwent neurosurgery was negatively associated with mortality (AHR: 0.25, 95% CI: 0.11,0.53). Conclusion The incidence of mortality rate among head injury patients was high. Older age, moderate and severe TBI, hypotension and hypoxia at admission, neurosurgical procedure, and the episode of hyperthermia and hypoglycemia during hospitalization were the independent predictors of mortality among head injury patients. Therefore, intervention to reduce earlier deaths should focus on the prevention of secondary brain insults.

Time-to-recovery After Cesarean Section Delivery Among Women who Gave birth through Cesarean Section at Hawassa University Comprehensive Specialized Hospital, south Ethiopia: A Prospective Cohort Study

Background: Despite the progressive increment of caesarean section rates worldwide over the last decades; still the trend has not been accompanied by significant maternal or perinatal benefits. Moreover, information on the quality of the service, as measured by timely recovery, is scarce. This study assessed predictors of time-to-recovery after cesarean section delivery among women who gave birth through cesarean section at Hawassa University Comprehensive Specialized Hospital (HU-CSH), southern Ethiopia.Methods: Institution based prospective cohort study was conducted on 381 randomly selected women who gave birth by cesarean section in HU-CSH during the follow up period. Pre-tested structured questionnaire was used to collect the data. Data were analyzed using Kaplan Meir (KM) curve, Log rank test and Cox-Proportional hazard model. The outputs of the bivariable and multivariable Cox model are presented using Adjusted Hazard Ratio (AHR) with the respective 95% confidence intervals (CIs).Results: After a maximum of 19 days of stay, 96.2% [95%CI: 94.04-98.4%] of the women were early recovered. The overall median IQR) time of recovery was 2.00 (2, 3) days. The overall incidence density rate (IDR) of recovery in the cohort was 0.34 per Person-days or 2.38 per person-week. On the other hand the overall mean survival time was 3.07(95%CI: 2.75-3.40) days. Women who had ANC follow-up (AHR=1.49, 95%, CI: 1.05-2.10) and discharge from the wound site (AHR=0.13, 95%, CI: 0.03-0.56) were identified as significant positive and negative predictors of time-to- recovery after CS delivery respectively. Conclusion: This study showed that the rate of early recovery was high and is comparable to the global level figures. However, further improving preoperative maternal status, intraoperative follow up and post-operative care is needed to improve early recovery.

Pattern of skin diseases among patients attending Hawassa university comprehensive specialized hospital, Hawassa, Ethiopia

<p><strong>Background</strong>: Spectrum of skin diseases varies from region to region due to several factors such as genetics, socioeconomic and environmental. This study aimed to determine the pattern of various skin disorders appearing in the dermatology department of a tertiary care hospital.</p><p><strong>Methods</strong>: All patients attending the dermatology clinic of the Hawassa university comprehensive specialized hospital, from January 2017 to December 2018 were included in this retrospective analysis. The medical records of the patients were obtained from registry books. </p><p><strong>Results: </strong>A total of 7727 patients attended the dermatology clinic of HUCSH. Out of these samples, 18.1% of patients repeatedly came to the hospital for a follow up visit related to their diseases, while 81.9% were enrolled as new cases.</p><p>There were more males (51.9%) than females. More than three quarter of the cases were aged above 16 years while less than a quarter were children below 16 years. Eczema was diagnose in 2734 (35.4%), being the most common cause for attendance, followed by infectious disease (23.3%) and disease of the skin appendages (12.1%).</p><p class="abstract"><strong>Conclusions</strong>: Eczema was the most common skin disease seen in our study, followed by infectious disease and disease of the skin appendages. Concerted effort need to be made to control these conditions and training of the primary health care providers and education of General Practitioners in Dermatology must emphasize these common conditions, with the aim of improving primary health care and alleviating the burden of hospital care.</p>

Long-Term Immunological and Virological Outcomes in Children Receiving Highly Active Antiretroviral Therapy at Hawassa University College of Medicine and Health Sciences, Southern Ethiopia

Purpose. To determine immunological and virological failure and associated factors among children infected with human immunodeficiency virus receiving antiretroviral treatments at Hawassa University Hospital, Southern Ethiopia. Methods. A hospital-based cross-sectional study was conducted among 273 HIV-infected children from July 1 to December 1, 2019. Data were collected using a structured questionnaire and review of patient records. Blood samples for viral load and CD4 count were collected. Data were analyzed using SPSS version 20. Significance group comparison was done by the Kaplan-Meier log-rank test. The Cox proportional hazard model was used to select significant factors of the variability between groups. Results. A total of 273 children, between the age ranges of 1 to 14 years, were included. Of these, 139 (50.9%) and 134 (49.1%) were males and females, respectively. Children from the rural area were almost five times more vulnerable for virological and immunological failure than those children from the urban area ( AOR = 4.912 , (1.276-8.815), P = 0.032 ). The overall viral load suppression was 196 (71.8%) with a good adherence of 226 (82.9%). Nonsuppressed HIV viral load was found to be 77 (28.2%) which had two times more viral load copies ( AOR = 2.01 , (1.21–2.66), P = 0.001 ) when compared to those who had suppressed viral load copies. The proportions of children who had immunological nonresponse were 45.6% (21 out of 46), 30.4% (14 out of 46), and 23.9% (11 out of 46) among children with baseline CD4 of <200, 201-500, and >500 cells/μl, respectively. Unimproved outcomes among females were noted for immunological and virological failure in this study ( AOR = 1.901 , (1.038-3.481), P = 0.038 ). Conclusion. In conclusion, the highly active antiretroviral treatment appeared highly effective in terms of immunological and virological long-term outcomes. However, viral suppression (71.8%) in our study was far apart from the UNAIDS target of 90% in 2020. For that reason, strengthening adherence counseling and early initiation of HAART is important.