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  • 1
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    Online Resource
    Health system cost of breast cancer treatment in Addis Ababa, Ethiopia
    Public Library of Science (PLoS) ; 2022
    In:  PLOS ONE Vol. 17, No. 10 ( 2022-10-6), p. e0275171-
    Details
    In: PLOS ONE, Public Library of Science (PLoS), Vol. 17, No. 10 ( 2022-10-6), p. e0275171-
    Abstract: Breast cancer is the leading cancer among women with an annual crude incidence of 27.4 per 100,000 in Ethiopia. The aims of this study were to (a) estimate the unit cost of breast cancer treatment for the standard Ethiopian patient, (b) identify the cost drivers, (c) project the total cost of breast cancer treatment for the next five years, and (d) estimate the economic burden of the disease in the main specialized tertiary hospital—Tikur Anbessa Specialized Hospital (TASH) Addis Ababa. Methods Primary data were collected from health and non-health professionals. Secondary data were collected from patient`s charts and official reports from various national and international organisations including data from TASH. To establish work-time estimates, we asked professionals on their time usage. Result A total of US$ 33,261 was incurred to treat 52 Addis Ababa resident female breast cancer patients in TASH between July 2017 and June 2019. The unit cost of treatment for a hypothetical breast cancer patient to complete her treatment was US$ 536 for stage I and US$ 705 for stage II and III using the existing infrastructure. This cost increased to US$ 955 for stage I and US$ 1157 for stage II and III when infrastructure amortization was considered. The projected total costs of breast cancer treatment in TASH is between US$ 540,000 and US$ 1.48million. However, this will increase to US$ 870,000 and US$ 2.29 million when the existing fixed assets are changed. Conclusion The economic burden of breast cancer treatment is high compared to the economic status of the country. Thus, it is recommended that TASH should revise its charges and breast cancer should be included in the Social and Community based health insurance scheme. JEL classification: H51, H75, I18, P46
    Type of Medium: Online Resource
    ISSN: 1932-6203
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    DOI: 10.1371/journal.pone.0275171
    DOI: 10.1371/journal.pone.0275171.t001
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    DOI: 10.1371/journal.pone.0275171.r001
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    DOI: 10.1371/journal.pone.0275171.r006
    Language: English
    Publisher: Public Library of Science (PLoS)
    Publication Date: 2022
    detail.hit.zdb_id: 2267670-3
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  • 2
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    Randomized Controlled Trials on Chronic Obstructive Pulmonary Disease in Africa: A Systematic Review
    COPD Foundation ; 2023
    In:  Chronic Obstructive Pulmonary Diseases: Journal of the COPD Foundation ( 2023)
    Details
    In: Chronic Obstructive Pulmonary Diseases: Journal of the COPD Foundation, COPD Foundation, ( 2023)
    Type of Medium: Online Resource
    ISSN: 2372-952X
    URL: Article
    DOI: 10.15326/jcopdf.2023.0387
    Language: Unknown
    Publisher: COPD Foundation
    Publication Date: 2023
    detail.hit.zdb_id: 2771715-X
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  • 3
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    An Emerging Problem of Shisha Smoking among High School Students in Ethiopia
    MDPI AG ; 2021
    In:  International Journal of Environmental Research and Public Health Vol. 18, No. 13 ( 2021-06-30), p. 7023-
    Details
    In: International Journal of Environmental Research and Public Health, MDPI AG, Vol. 18, No. 13 ( 2021-06-30), p. 7023-
    Abstract: Shisha smoking is also known as hookah, water pipe, goza, and nargile. Shisha use among the young is increasing globally. Shisha smoke results in a high concentration of carbon monoxide, tar, nicotine, and heavy metals which can be toxic to humans, especially with chronic exposure. This study aims to determine the prevalence and risk factors of shisha smoking among in-school adolescents in Ethiopia. Four regional states in Ethiopia (Oromia, Amhara, Southern Nations, Nationalities, and Peoples’ Region, Tigray) and the capital city (Addis Ababa) were the study areas. A two-stage cluster sampling approach was employed to produce a representative sample. From the sampling frames in the study areas, 36 high schools were selected randomly. A multi-level logistic regression analysis was used to account for cluster-specific random effects, the effect of individuals’, and school-level variables for ever-use of shisha. A total of 3355 secondary school grade 9 and 10 students aged between 13 and 22 years took part in this study. A total of 86 (2.6%) and 20 (0.6%) of the study participants, reported that they had ever smoked or were current smokers of shisha, respectively. Of all study participants, 38.6% perceived shisha as less harmful than cigarettes and 48.5% reported that they do not know which was more harmful to health. Students were more likely to ever use shisha if they had friend/s who smoke shisha (AOR = 16.8, 95% CI: 6.4–44.3), ever smoked cigarettes (AOR = 8.2, 95% CI: 3.4–19.8), ever used khat (AOR = 4.2, 95% CI: 1.9–10.4), ever used marijuana (AOR = 3.9, 95% CI: 1.4–11.1), ever used smokeless tobacco (AOR = 3.1 95% CI: 1.1–8.4), and students had received income from their parents (AOR = 3.1 CI: 1.1–8.8). Prevalence of ever and current use of shisha among high school students is low in Ethiopia compared to many countries in Africa. The majority of adolescents perceived shisha as less harmful to health than cigarette smoking. Health education about the harmful effects of shisha should be delivered to adolescents, along with information on other substances like khat, cigarettes, marijuana, and smokeless tobacco to prevent initiation of substance use.
    Type of Medium: Online Resource
    ISSN: 1660-4601
    URL: Article
    DOI: 10.3390/ijerph18137023
    Language: English
    Publisher: MDPI AG
    Publication Date: 2021
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  • 4
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    Adherence to Newly Implemented Tamoxifen Therapy for Breast Cancer Patients in Rural Western Ethiopia
    S. Karger AG ; 2021
    In:  Breast Care Vol. 16, No. 5 ( 2021), p. 484-490
    Details
    In: Breast Care, S. Karger AG, Vol. 16, No. 5 ( 2021), p. 484-490
    Abstract: 〈 b 〉 〈 i 〉 Introduction: 〈 /i 〉 〈 /b 〉 Endocrine therapy for breast cancer (BC) patients is highly underutilized in rural Ethiopia and other African countries. 〈 b 〉 〈 i 〉 Objective: 〈 /i 〉 〈 /b 〉 This study aims to assess the feasibility of and adherence to tamoxifen therapy in rural Ethiopia. 〈 b 〉 〈 i 〉 Methods: 〈 /i 〉 〈 /b 〉 We ascertained the hormone receptor (HR) status in 101 women diagnosed with BC from January 2010 to December 2015 and who had surgery in Aira Hospital, in rural Ethiopia. From 2013, tamoxifen was offered to patients with HR-positive (HR+) tumors. Prescription refill records and a structured questionnaire were used to assess receipt of and adherence to tamoxifen. 〈 b 〉 〈 i 〉 Results: 〈 /i 〉 〈 /b 〉 Of the 101 BC patients tested for HR status during the study period, 66 (65%) patients were HR+ and were eligible for tamoxifen treatment. However, 15 of the HR+ patients died before tamoxifen became available in 2013. Of the remaining 51 HR+ patients, 26 (51%) initiated tamoxifen but only 9 of them (35%) adhered to therapy (medication possession rate ≥80%, median observation 16.2 months). After 1 year, 52% of the patients were still adherent, and 9 patients had discontinued therapy. The reasons for non-initiation of tamoxifen included patient factors ( 〈 i 〉 n 〈 /i 〉 = 5), including financial hardship or lack of transportation, and health care provider factors ( 〈 i 〉 n 〈 /i 〉 = 12). 〈 b 〉 〈 i 〉 Conclusions: 〈 /i 〉 〈 /b 〉 Endocrine therapy for BC patients seems feasible in rural Western Ethiopia, although non-adherence due to financial hardship and a less developed health care infrastructure remains a major challenge. We postulate that the implementation of breast nurses could reduce patient and health system barriers and improve initiation of and adherence to endocrine treatment.
    Type of Medium: Online Resource
    ISSN: 1661-3791 , 1661-3805
    URL: Article
    DOI: 10.1159/000512840
    Language: English
    Publisher: S. Karger AG
    Publication Date: 2021
    detail.hit.zdb_id: 2205941-6
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  • 5
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    Non-pharmacological interventions to achieve blood pressure control in African patients: a systematic review
    BMJ ; 2022
    In:  BMJ Open Vol. 12, No. 2 ( 2022-02), p. e048079-
    Details
    In: BMJ Open, BMJ, Vol. 12, No. 2 ( 2022-02), p. e048079-
    Abstract: This systematic review aims to evaluate the evidence of non-pharmacological strategies to improve blood pressure (BP) control in patients with hypertension from African countries. Design We performed a systematic review and searched Medline, Central, CINAHL and study registers until June 2020 for randomised studies on interventions to decrease BP of patients with hypertension in African countries. We assessed the study quality using the Cochrane risk of bias tool and narratively synthesised studies on non-pharmacological hypertension interventions. Setting We included studies conducted in African countries. Participants Adult African patients with a hypertension diagnosis. Interventions Studies on non-pharmacological interventions aiming to improve BP control and treatment adherence. Outcomes Main outcomes were BP and treatment adherence. Results We identified 5564 references, included 23 with altogether 18 153 participants from six African countries. The studies investigated educational strategies to improve adherence (11 studies) and treatment by healthcare professionals (5 studies), individualised treatment strategies (2 studies), strategies on lifestyle including physical activity (4 studies) and modified nutrition (1 study). Nearly all studies on educational strategies stated improved adherence, but only three studies showed a clinically relevant improvement of BP control. All studies on individualised strategies and lifestyle changes resulted in clinically relevant effects on BP. Due to the type of interventions studied, risk of bias in domain blinding of staff/participants was frequent (83%). Though incomplete outcome data in 61% of the studies are critical, the general study quality was reasonable. Conclusions The identified studies offer diverse low-cost interventions including educative and task-shifting strategies, individualised treatment and lifestyle modifications to improve BP control. Especially trialled physical activity interventions show clinically relevant BP changes. All strategies were trialled in African countries and may be used for recommendations in evidence-based guidelines on hypertension in African settings. PROSPERO registration number CRD42018075062.
    Type of Medium: Online Resource
    ISSN: 2044-6055 , 2044-6055
    URL: Article
    DOI: 10.1136/bmjopen-2020-048079
    Language: English
    Publisher: BMJ
    Publication Date: 2022
    detail.hit.zdb_id: 2599832-8
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  • 6
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    Protocol for a systematic review on tertiary prevention interventions for patients with stroke in African countries
    BMJ ; 2020
    In:  BMJ Open Vol. 10, No. 9 ( 2020-09), p. e038459-
    Details
    In: BMJ Open, BMJ, Vol. 10, No. 9 ( 2020-09), p. e038459-
    Abstract: Stroke is one of the common causes of mortality, morbidity and years of life lost worldwide. Baseline research on stroke epidemiology, prevention, acute and rehabilitative interventions in Africa is necessary to approach specific contexts and regional circumstances. Most studies on stroke have been conducted in high-income countries. This protocol describes the methodology to summarise the best available evidence on tertiary preventive strategies like rehabilitation interventions for patients with stroke in African contexts. Methods and analysis We will include experimental studies and prospective cohort studies conducted in African countries. A protocol has been registered in PROSPERO. Systematic search will include eight electronic databases (MEDLINE, Embase, the Cochrane Library, CINAHL, Cab-Direct, Physiotherapy Evidence Database (PEDro), African Journals Online and African Index Medicus) and the International Clinical Trials Register Platform and base on predefined search terms. We will search from inception of each database and repeat this strategy 3 months prior to review submission. Details of all eligible studies will be extracted and risk of bias for outcomes on global disability or dependence in daily living will be assessed. Main aim of this systematic review is to provide a narrative description of evidence on tertiary prevention strategies (including rehabilitation) for stroke. This description will be visualised in structured tables to aid interpretation of study characteristics, intervention effects and certainty of the evidence. Ethics and dissemination No ethical approval is necessary. Results will be presented in national and international conferences and published in a peer-reviewed journal. PROSPERO registration number CRD42020159125.
    Type of Medium: Online Resource
    ISSN: 2044-6055 , 2044-6055
    URL: Article
    DOI: 10.1136/bmjopen-2020-038459
    Language: English
    Publisher: BMJ
    Publication Date: 2020
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  • 7
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    “If I don’t smoke shisha, I won’t be able to sleep”: lived experiences of high school students in Ethiopia
    Inishmore Laser Scientific Publishing Ltd ; 2022
    In:  Journal of Global Health Reports Vol. 6 ( 2022-4-25)
    Details
    In: Journal of Global Health Reports, Inishmore Laser Scientific Publishing Ltd, Vol. 6 ( 2022-4-25)
    Abstract: Shisha smoking predisposes the users to cardiovascular diseases, cancer, and infections, such as tuberculosis, hepatitis, and herpes. In Ethiopia, there is little data on the adolescents’ shisha smoking experience. This study aimed to explore the lived experience of high school students and inform ongoing and future prevention and control interventions. Methods This study was conducted in Addis Ababa and Adama cities in Ethiopia. Twenty-five secondary school students aged 15-22 years who had shisha smoking experience participated in this study. A topic guide was used to facilitate the in-depth interviews (IDIs) and a digital audio recorder recorded the interviews. Interviews varied between 40-90 minutes and were conducted in private open-air spaces where only the interviewee and researcher were present. Each transcript was coded using Atlas.ti version 8 software. The analytical approach was iterative, with interview transcripts analyzed at the time of coding and re-analyzed after a preliminary result was drafted to search for additional themes. Results Students described two key factors that influenced their decision to initiate shisha smoking: peer influence and perceiving it as a means to release stress. After initiating shisha use students maintained the behaviour because of: peer influence, khat chewing, enjoyment of shisha smoking, having prolonged leisure time, and accessibility to shisha. Students regretted the impact shisha use had on their lives, such as conflict with their families, poor academic performance, and spending money on shisha smoking. Female students were also concerned about reproductive health risks related to shisha use. Conclusions Peer influence played a major role both in initiating and maintaining shisha use. However, students admitted concern over the impact of shisha smoking on academic performance and their relationship with their families. Since shisha use is associated with khat chewing; shisha smoking control programs cannot be successful without controlling khat. Especially young girls had worries about their reproductive health risks associated with shisha use. This suggests that targeted awareness raising programs highlighting the dangers of shisha use for both health and safety; especially for young women is required.
    Type of Medium: Online Resource
    ISSN: 2399-1623
    URL: Article
    DOI: 10.29392/001c.33806
    Language: English
    Publisher: Inishmore Laser Scientific Publishing Ltd
    Publication Date: 2022
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  • 8
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    Vulvar cancer in Ethiopia : A cohort study on the characteristics and survival of 86 patients
    Ovid Technologies (Wolters Kluwer Health) ; 2018
    In:  Medicine Vol. 97, No. 9 ( 2018-03), p. e0041-
    Details
    In: Medicine, Ovid Technologies (Wolters Kluwer Health), Vol. 97, No. 9 ( 2018-03), p. e0041-
    Type of Medium: Online Resource
    ISSN: 0025-7974
    URL: Article
    DOI: 10.1097/MD.0000000000010041
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2018
    detail.hit.zdb_id: 2049818-4
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  • 9
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    Randomised controlled trials on prevention, diagnosis and treatment of diabetes in African countries: a systematic review
    BMJ ; 2022
    In:  BMJ Open Vol. 12, No. 5 ( 2022-05), p. e050021-
    Details
    In: BMJ Open, BMJ, Vol. 12, No. 5 ( 2022-05), p. e050021-
    Abstract: The epidemiological transition from infectious to chronic diseases leads to novel challenges in African health systems. The prevalence of diabetes mellitus (DM) is increasing dramatically. Undiagnosed and undertreated DM leads to numerous complications including end-organ damage and death. Our objectives were to collect the best locally generated evidence on DM interventions, identify knowledge gaps and determine underexplored research areas. Design A systematic review and meta-analysis of randomised controlled trials. Participants and setting African patients in primary, secondary and tertiary prevention, diagnosis and treatment DM type 1 (DM1), type 2 (DM2) and gestational DM (GDM). Outcome All-cause mortality, glycaemic control, complications, quality of life, hospital admission, treatment adherence and costs. Data sources Articles published in MEDLINE Ovid, CENTRAL, CINAHL, African Journals Online and African Index Medicus and the International Clinical Trials Registry Platform in English language without time restrictions. The systematic search was last updated in October 2020. Results Out of 3736 identified publications, we included 60 eligible studies conducted in 15 countries, 75% were conducted in urban healthcare settings, including 10 112 participants. We included 8 studies on DM1, 6 on GDM, 2 on pre-DM, 37 on mainly DM2 including 7 on DM-related complications. The design of the studied intervention was heterogeneous with a focus on educational strategies. The other studies investigated the efficacy of nutritional strategies including food supplementations, pharmacological strategies and strategies to enhance physical activity. Seven studies included interventions on DM-related complications. Conclusions Research activities increased in recent years, but available evidence is still not representative for all African countries. There is a big lack of evidence in primary healthcare and rural settings, implementation research, pharmacological interventions, especially in poorer countries. Nevertheless, the identified studies offer a variety of effective interventions that can inform medical care and future research. PROSPERO registration number CRD42019122785.
    Type of Medium: Online Resource
    ISSN: 2044-6055 , 2044-6055
    URL: Article
    DOI: 10.1136/bmjopen-2021-050021
    Language: English
    Publisher: BMJ
    Publication Date: 2022
    detail.hit.zdb_id: 2599832-8
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