Gastrointestinal Surgical Outcomes Study (GISOS): a 30-day monocentric prospective cohort study in Ethiopia.

OBJECTIVE: The impact of perioperative mortality and morbidity extends globally, playing substantial roles in mortality rates, levels of disability and economic consequences. This study was primarily designed to provide insights into the surgical outcomes of gastrointestinal surgeries carried out in a high-volume centre in Ethiopia in the year 2023. DESIGN: A 30-day prospective cohort observational study employed. SETTING: High volume surgical specialised hospital in Ethiopia. PARTICIPANTS: All adult patients who had abdominal surgery. OUTCOME MEASURES: 30th-day postoperative mortality and complications. RESULTS: During this prospective observational study, data from 259 patients were collected. This prospective observational study found that 30-day complication rate was 30.5%. Surgical site infection is the leading complications (15.8%) followed by postop acute kidney injury (9.3%). Malignant pathology (adjusted OR (AOR)=1.43 (1.01 to 3.06); p=0.035, ASA III (AOR=4.00 (1.01 to 16.5); p=0.049), ECOG III (AOR=2.8 (1.55 to 7.30); p=0.025) and comorbidity (AOR=2.02 (1.02 to 3.18); p=0.008) had statistically significant association with 30-day complication rates. We also found that a 30-day mortality rate was 14.3%. Emergency surgery (AOR=5.53 (1.4 to 21.6); p=0.014), Eastern Cooperative Oncology Group III (AOR=8.6 (1.01 to 74.1); p=0.0499), American Society of Anesthesiology III (AOR=12.7 (1.9 to 85.5); p=0.009) and comorbidity (AOR=7.5 (1.4 to 39.1); p=0.017) had statistical significance association with a 30-day mortality rate after gastrointestinal surgery. CONCLUSION: The findings of this study indicated that postoperative mortality and complications were alarmingly high, which highlights the need for innovative solutions to lower postoperative mortality and complications.

National Burden and Trend of Cancer in Ethiopia, 2010-2019: a systemic analysis for Global burden of disease study.

Over the last two decades, we have tracked the national burden of cancer and its trends in Ethiopia, providing estimates of incidence, death, and disability adjusted life years. In Ethiopia, there were an estimated 53,560 (95% UI 52,480-55,540) new incident cases, 39,480 deaths (95% UI 32,640-46,440), and 1.42 million (95% UI 1.16-1.68) DALYs of cancer 2019. Cancer incidence, death, and DALYs counts increased by 32% (95% UI 11-55%), 29% (95% UI 12-44%), and 19% (95% UI - 2 to 44%) between 2010 to 2019, respectively, while age-standardised incidence, death, and DALYs rates increased by 5% (95% UI - 7 to 18%), 2% (95% UI - 9 to 14%), and - 2% (95% UI - 15 to 12%) respectively. In 2019, the leading incidence cases were leukemia, cervical cancer, breast cancer, colon and rectum cancer, and stomach cancer, while leukemia, breast cancer, cervical cancer, and stomach cancer were the most common killer cancers in Ethiopia. According to the findings of this study, tobacco-related cancers such as pancreatic, kidney, and lung cancer have increased in Ethiopian females over the last decade, while genitourinary cancer has increased in Ethiopian males. Another significant finding was that infection-related cancers, such as stomach cancer and Hodgkin lymphoma, have been rapidly declining over the last decade.

Burden and trend of colorectal cancer in 54 countries of Africa 2010-2019: a systematic examination for Global Burden of Disease.

BACKGROUND: Colorectal cancer plays significant role in morbidity, mortality and economic cost in Africa. OBJECTIVE: To investigate the burden and trends of incidence, mortality, and disability-adjusted life-years (DALYs) of colorectal cancer in Africa from 2010 to 2019. METHODS: This study was conducted according to Global Burden of Disease (GBD) 2019 analytic and modeling strategies. The recent GBD 2019 study provided the most updated and compressive epidemiological evidence of cancer incidence, mortality, years lived with disability (YLDs), years of life lost (YLLs), and DALYs. RESULTS: In 2019, there were 58,000 (95% UI: 52,000-65,000), 49,000 (95% UI: 43,000-54,000), and 1.3 million (95% UI: 1.14-1.46) incident cases, deaths and DALYs counts of colorectal cancer respectively in Africa. Between 2010 and 2019, incidence cases, death, and DALY counts of CRC were significantly increased by 48% (95% UI: 34-62%), 41% (95% UI: 28-55%), and 41% (95% UI: 27-56%) respectively. Change of age-standardised rates of incidence, death and DALYs were increased by 11% (95% UI: 1-21%), 6% (95% UI: - 3 to 16%), and 6% (95% UI: - 5 to 16%) respectively from 2010 to 2019. There were marked variations of burden of colorectal cancer at national level from 2010 to 2019 in Africa. CONCLUSION: Increased age-standardised death rate and DALYs of colorectal cancer indicates low progress in CRC standard care-diagnosis and treatment, primary prevention of modifiable risk factors and implementation of secondary prevention modality. This serious effect would be due to poor cancer infrastructure and policy, low workforce capacity, cancer center for diagnosis and treatment, low finical security and low of universal health coverage in Africa.

Perforated peptic ulcer disease in Zewditu Hospital.

BACKGROUND: Peptic ulcer perforation is a serious complication of peptic ulcer disease with a significant morbidity and mortality. OBJECTIVE: To evaluate 76 patients operated for peptic ulcer perforation and analyse the associated factors in Zewditu Memorial Hospital, Addis Ababa from September 2006 to August 2008. PATIENTS AND METHODS: A retrospective analysis of medical records of 76 patients who were operated up on for perforated peptic ulcer over a two year period (2006-2008). RESULTS: The male to female ratio was 6.6:1 with a mean age being 31.5 years. The most common presenting symptom was abdominal pain in 76 (100%) patients. History of smoking and khat chewing was documented in 53/64 (82.8%) and 48/64 (75%) of the patients respectively. Twenty five per cent of the patients gave no history of previous peptic ulcer disease. Seventy patients (92.1%) presented after 48 hours of their illness. The mean hospital stay was 14.5 days. Leucocytosis was found in 31.6% of the cases. Sixty five (85.5%) patients had duodenal ulcer perforation. Postoperative complications occurred in 24 (31.6%) patients. Twelve (15.8%) patients died in the hospital. CONCLUSION: Early presentation of patients and change in life style may reduce morbidity and mortality in patients with peptic ulcer perforation.