Vol 62, No 4 (2024): OCTOBER 2024 VOLUME 62 NUMBER 4

Introduction: Gastric cancer is the fifth most often diagnosed cancer and the third most frequent reason of cancer death worldwide. It is also associated with a lack of standard treatment strategies, particularly following first-line therapy. In Ethiopia, the survival status of gastric cancer patients was not well understood.

Objective: This study aimed to determine the clinical outcomes and prognostic factors for survival among gastric cancer (GC) patients in the adult oncology unit of Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia.

Methods: Hospital-based retrospective cohort study was conducted on 164 study participants recruited from patient registry between 1 January 2016 to 31 December 2020. Data was collected using a structured tool from medical records and telephone interviews Data analysis was performed using Descriptive and inferential statistics.

Results: The median (±SD) age of the study participants at diagnosis was 48.50 ±14.48 years. Adenocarcinoma accounted for 73.8% of the cases. Regarding clinical stage, 92 (56.1%) of the patients were diagnosed with stage IV and 84 (51.2%) of the cases had metastasized cancer, of which 47 (28.7%) participants presented with liver metastasis. About 40% (65) of the cases were treated with partial gastrostomy followed by bypass surgery. At the end of treatment follow-up, 110 (67.1%) of the patients were dead. A 5-year overall survival rate was 11% with a median survival time of 18.6 months. In multivariate logistic regression, ECOG ≥ 2 (AHR= 2.5, P=0.001), adenocarcinoma histologic type (AHR=0.4, P=0.004),ovary metastasis (AHR=2.9, P=0.035), liver + lung metastasis (AHR=2.4, P= 0.048), paclitaxel + carboplatin chemotherapy (AHR=0.3, P= 0.044) were found to significantly affect survival of the GC patients.

Conclusion: The survival outcome of gastric cancer is low and requires early detection in this study setting. The findings underscore the importance of early detection and tailored treatment approaches based on prognostic factors.

Key words: Gastric cancer, treatment outcome, prognostic factor, Tikur Anbessa Specialized Hospital.

Background: Bronchial asthma is a chronic inflammatory airway disease that substantially burdens individuals and healthcare systems. Regular investigation of its prevalence and identifying the factors that lead patients to seek medical care is crucial for effective health planning, management, and prevention to reduce healthcare costs and morbidity/mortality rates while fostering productive citizenship. This study aimed to assess asthma’s prevalence and to determine the factors that prompt adult patients to visit healthcare services in the Awi administrative zone of Northwestern Ethiopia.

Method: Data from 662 asthma patients were collected using structured questionnaires using a multistage sampling method. The collected data were analyzed using the ordinal logistic regression model to determine how asthma status (the dependent variable) is affected by sociodemographic (independent) variables and the chi-square test of independence to determine the significance of the association between asthma status and the sociodemographic variables.

Results: The results revealed significant effects of various variables: bad smells in the environment (OR=1.921, p=0.043), marital status (OR=0.056, p=0.016), smoking (OR=3.167, p<0.001), educational level (OR=172.4, p<0.001), physical exercise (OR=0.357, p=0.017), family history of asthma (OR=1.336, p=0.02), presence of animals at home (OR=14.78, p=0.025), drug discontinuity (OR=1.289, p=0.001), high asthma distribution season (OR=21.79, p<0.001), limited daily activity (OR=2.640, p=0.032), and energy source for cooking (OR=28,453, p<0.001), all significantly associated with asthma status among patients.

Conclusion: The findings highlight the need for tailored interventions to promote asthma disease prevention strategies and the need for the implementation of several interventions by the Awi Zone health office and/or non-governmental organizations to reduce the prevalence of asthma disease.

Background: Limb amputation become one of the commonest procedures for various causes where the indications can be reduced by combination of public health interventions, improved public health access and early appropriate medical care. This study was aimed to highlight indications and patterns of amputation, compare to published data and provide possible ways in which the number can be reduced in Hawassa, Sidama region, Ethiopia.

Method: This was a retrospective study on 304 patients who underwent all types of amputations performed at Hawassa University Comprehensive Specialized Hospital from January 2019 to December 2021. Data was extracted from the operation registration log- book and patients’ chart.

Result: There were 231 (75%) male patients with mean age 32.8 years. Main indications for amputation were trauma in 87 (28.6%) patients, peripheral arterial disease (PAD) in 69 (22.7%) and severe infection in 54 (17.8%). Complications due to treatment by traditional bone setters (TBS) was the most common cause of amputation in those under 18 years. 13.8% of amputations were deemed preventable, 14.1% potentially preventable, and 72% not preventable.

Conclusion: sixty six percent of observed amputations occurred in children and working-age adults under 40 years, giving rise to a massive societal cost. Through enhanced health education regarding severe trauma prevention as well as early severe infection treatment, fostering collaboration with TBS, data collection via trauma registries, and affordable, timely trauma services, the number of amputations could be significantly reduced.

Abstract

Introduction: Cholera is an important public health problem worldwide. However, there was limited documentation of lessons learned that could be applied to future improvements in Ethiopia.

Objective: To assess the overall cholera outbreak response, validate existing mechanisms, and best practices and identify areas in Ethiopia, October 2019.

Methods and materials: This After-Action Review (AAR) was conducted in Ethiopia from October 23^rd to 25^th, 2019 focused on the cholera outbreak from April 2019 to September 2019. A qualitative method with a participatory approach was used, using the standardized World Health Organization (WHO) guide for AAR. A total of 40 participants were from three regions (Afar, Amhara, and Oromia), and the Ethiopian Public Health Institute. The facilitators were from the Ministry of Health and WHO. Five working groups examined eight functional areas in total examined eight functional areas in total.

Results: The emergency operation center coordinated the national and regional cholera response. Social mobilization and reactive Oral Cholera Vaccine campaigns reduced financial burden and fostered trust in healthcare. Damaged water sources and pipeline maintenance helped control the outbreak. Redeployment of mobile health teams alleviated human resource shortages. Challenges during the response included late detection, weak multi-sectoral taskforce functionality, budget constraints, poor infrastructure, inadequate human resources, laboratory supplies, and delayed initial effective response.

Conclusions: Enhancing the surveillance system, operationalizing multisectoral coordination, and promoting community engagement and early risk communication can enhance the country's preparedness for future public emergency response, thereby enhancing public health system responsiveness.

Keywords: After action review, Cholera, Outbreak response, Lessons learned, Core capacities, Ethiopia