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.

Clinical practice competencies and associated factors among graduating nursing students attending at universities in Northern Ethiopia: institution-based cross-sectional study.

OBJECTIVE: To assess clinical practice competencies and associated factors among graduating nursing students attending public universities found in the Amhara Region, Ethiopia DESIGN: Institution-based cross-sectional study design SETTING: The study was conducted in six universities found in the Amhara Region from February to April 2018. PARTICIPANTS: 307 graduating nursing students participated. Of these, 173 were male and 134 were females from different ethnic groups; Amhara 145, Oromo 84, Tigris 44 and Gurage 17. Graduating nursing students attending regular degree programmes were included. OUTCOME MEASUREMENTS: Clinical instructor (good vs not good), clinical environment (conducive vs not conducive), assessment method (measurable vs not measurable), clinical staff-student interaction (good vs not good), clinical practice competency (competent vs incompetent). RESULT: The study revealed that 33.6% (95% CI 26.3% to 39.41%) of students were clinically competent. Orientation about the objective of clinical practice (adjusted OR, AOR 2.387; 95% CI 1.011 to 5.635), enough time for mentoring during clinical practice (AOR 2.247; 95% CI 1.100 to 4.593). Students followed by instructors during conducting a procedure (AOR 2.655; 95% CI 1.294 to 5.449), assessment checklist during clinical practice (AOR 2.663; 95% CI 1.324 to 5.358), students who were allowed by clinical staffs to perform tasks (AOR 5.858; 95% CI 2.657 to 12.916), clinical instructor factors (AOR 3.051; 95% CI 1.717 to 5.421) and student-staff interaction factors (AOR 2.348; 95% CI (1.337 to 4.124) were statistically significant variables with the level of competency. CONCLUSION: Around one-third of the students were clinically competent. Clinical instructor and staff-student interaction were significantly associated with clinical practice competencies among graduating nursing students. Therefore, designing an appropriate clinical practice protocol that includes improving the supervision of a clinical instructor is important to enhance the clinical practice competency of students.

Prevalence of Anemia and Its Associated Factors Among Chronic Kidney Disease Patients Attending Selected Public Hospitals of Addis Ababa, Ethiopia: Institutional-Based Cross-Sectional Study.

BACKGROUND: Anemia is a global public health problem with high mortality and morbidity. It is becoming more prevalent in Ethiopia. Therefore, this study aimed to estimate the prevalence of anemia and its associated factors among chronic kidney disease patients at selected public hospitals of Addis Ababa, Ethiopia. METHODS: An institutional-based cross-sectional study was conducted on selected public hospitals in Addis Ababa for studies on anemia in CKD patients. Data was entered into EPI Info version 4.4.1 and exported to SPSS version 24 for analysis. Both bivariate and multivariate logistic regression analyses were used to identify independently associated factors of anemia in CKD patients. Multivariate analysis was used to control the possible effect of confounders. RESULTS: A total of 387 participants were included to estimate the prevalence of anemia among chronic kidney disease patients. The prevalence of anemia was 53.5% (95% CI). Being females were 2 times more likely to develop anemia as compared to their counterparts (AOR=2.04, 95%:1.18, 2.46) and hemodialysis history had two times higher odds for anemia (AOR=2.754, 95% CI: 1.218-6.229, P=0.015) compared to patients without hemodialysis history. CONCLUSION: The overall prevalence of anemia across all stages of CKD is 53.5%. From the stage of CKD, stage 5 CKD has a higher (90.9%) anemia prevalence compared to others, and females showed a higher frequency of anemia when compared with males. Therefore, situation-based interventions and country context-specific preventive strategies should be developed to reduce the prevalence of anemia in this patient group.

Survey on the Quality of Care Standards in a Nursing/Midwifery Training Hospital at Tikur Anbessa Specialized Hospital in Addis Ababa, Ethiopia, 2019.

OBJECTIVE: The aim of this article was to conduct a survey on the quality of care standards in nursing/midwifery training hospital of Tikur Anbessa Specialized Hospital in Addis Ababa, Ethiopia. METHODS: A multiple methods design was used for the study. For the quantitative phase, 35 nurses, 35 patients, and 52 patient charts were selected by simple random sampling from eight randomly selected wards of the hospital. For the qualitative phase, purposive sampling was employed to select participants for focus group discussion and in-depth interview. Twelve instructors and 11 head nurses were recruited. The Quality Audit tool developed by Ethiopian Federal Ministry of Health was applied. RESULTS: It was found that the nursing and midwifery service quality standards were low and did not meet Ministry of Health standards. The chart review showed that 83% of nursing and midwifery assessments were not completed within eight hours of patient arrival, and in over half the charts (58%), there was no written evidence of compilation of data based on Gordon's functional model. Only two wards met Standard 1 with adequate medical equipment for nursing diagnosis or intervention. Seventy-five percent of the wards had a scarcity of materials and supplies needed to provide a quality nursing service. Half the nursing stations had adequate patient visibility, and half had an organized chart filing system based on the patient's bed number. CONCLUSION: A high proportion of wards were not meeting Ministry of Health standards for nursing midwifery services. Improvement in care standards is vital to enable the hospital to function as a clinical setting for the education of health-care students. This might be achieved through ongoing attention to quality improvement and a program of in-service training regarding national care quality standards for managers, nurses, and midwives.

Willingness and acceptability of cervical cancer screening among women living with HIV/AIDS in Addis Ababa, Ethiopia: a cross sectional study.

BACKGROUND: In Ethiopia, cervical cancer (CC) ranks the 2nd most frequent cancer and the country had 27.19 million women at risk of developing the disease though only 0.6 % women age 18-69 years was screened every 3 years. Nearly a quarter (22.1 %) of southern Ethiopia HIV (Human Immunodeficiency Virus) infected Women were positive for precancerous cervical cancer. Doing regular screening can prevent the disease by around half (45 %) of the cases in age of 30s and three quarter (75 %) cases in 50s and 60s.In the presence of high risk for acquiring cervical cancer among HIV patients, willingness and acceptance of the screening is low in Addis Ababa, Ethiopia thus the current study was aimed to assess willingness and acceptability of cervical cancer screening and its determinants among women living with HIV/AIDS in Addis Ababa, Ethiopia. METHOD: A facility based cross sectional study was conducted among HIV positive women attending HIV treatment centers in Addis Ababa. The respondents were identified using systematic random sampling method. Data was collected using pretested questionnaire and were entered in to Epi-info version 3.5.1 software and exported in to SPSS version 20 statistical package for analysis. The criterias for entering independent variables into multivariate analysis were having p-value 0.05 or less at bivariate analysis and not co-linear. RESULT: One third (34.2 %) of participants knew cervical cancer and two third (62.7 %) were willing for the test though only a quarter (24.8 %) were accepted the test. The independent variables significantly associated with acceptance of screening were educational level, source of information, awareness for the test and preventability of the disease. CONCLUSION: In current study willingness and acceptance of CC (cervical cancer) were low thus organizations working on cancer and HIV/AIDS should establish cervical cancer screening program and further enhance awareness creation.