Anxiety and depression among cancer patients in Ethiopia: a systematic review and meta-analysis.

Introduction: Anxiety and depression are among the common comorbidities of people diagnosed with cancer. However, despite the progress in therapeutic options and outcomes, mental health care and support have lagged behind for cancer patients. Estimating the extent and determinants of mental health disorders among cancer patients is crucial to alert concerned bodies for action. In view of this, we aimed to determine the pooled prevalence and determinants of anxiety and depression among cancer patients in Ethiopia. Methods: Relevant literatures were searched on PubMed, African Journals Online, Hinari, Epistemonikos, Scopus, EMBASE, CINAHL, Cochrane Library, and Gray literature sources. Data were extracted into an Excel spreadsheet and analyzed using STATA 17 statistical software. The random effect model was used to summarize the pooled effect sizes with their respective 95% confidence intervals. The I2 statistics and Egger's regression test in conjunction with the funnel plot were utilized to evaluate heterogeneity and publication bias among included studies respectively. Results: A total of 17 studies with 5,592 participants were considered in this review. The pooled prevalence of anxiety and depression among cancer patients in Ethiopia were 45.10% (95% CI: 36.74, 53.45) and 42.96% (95% CI: 34.98, 50.93), respectively. Primary and above education (OR= 0.76, 95% CI: 0.60, 0.97), poor social support (OR= 2.27, 95% CI: 1.29, 3.98), occupational status (OR= 0.59; 95% CI: 0.43, 0.82), advanced cancer stage (OR= 2.19, 95% CI: 1.38, 3.47), comorbid illness (OR= 1.67; 95% CI: 1.09, 2.58) and poor sleep quality (OR= 11.34, 95% CI: 6.47, 19.89) were significantly associated with depression. Whereas, advanced cancer stage (OR= 1.59, 95% CI: 1.15, 2.20) and poor sleep quality (OR= 12.56, 95% CI: 6.4 1, 24.62) were the factors associated with anxiety. Conclusion: This meta-analysis indicated that a substantial proportion of cancer patients suffer from anxiety and depression in Ethiopia. Educational status, occupational status, social support, cancer stage, comorbid illness and sleep quality were significantly associated with depression. Whereas, anxiety was predicted by cancer stage and sleep quality. Thus, the provision of comprehensive mental health support as a constituent of chronic cancer care is crucial to mitigate the impact and occurrence of anxiety and depression among cancer patients. Besides, families and the community should strengthen social support for cancer patients. Systematic Review Registration: https://www.crd.york.ac.uk/prospero/, identifier CRD42023468621.

Modelling the longitudinal measurement of chronic obstructive pulmonary disease outpatient follow-up in the northwestern Ethiopia.

Chronic obstructive pulmonary disease is a condition which can be prevented and treated and is characterized by difficulty of breathing that is not entirely curable. The overall objective of this study was to model the variation of longitudinal measurement over time for outpatients with chronic obstructive pulmonary diseases at the University of Gondar referral hospital. From February 1, 2019, to February 1, 2022, a retrospective study of outpatients with chronic obstructive pulmonary disease was conducted in a hospital. The data was extracted from all patients' data records from the patient's chart. The information includes the fundamental demographic and clinical details of each outpatients with chronic obstructive pulmonary disease. Mixed linear model were used to investigate the determinant factor of chronic obstructive pulmonary disease. From a total of 266 outpatients, Averages of the ratio of forced expiratory volume to forced vital capacity among chronic obstructive pulmonary disease patients were 0.65, with a standard deviation of 0.043. Comorbidities (average = 2.18, 95% CI 0.43:3.9, P = 0.0133), HIV(average = 4.83, 95% CI 1.94:7.72, P = 0.0012), education (average = 2.98; 95% CI 0.75:4.8, P = 0.008), and weight (average = 0.178, 95% CI 0.045:0.311, P = 0.009) are risk factors for change in forced vital capacity. This study clearly shows that there is a high COPD prevalence in Ethiopia. The risk factors for chronic obstructive pulmonary diseases are the smoking status, comorbidities, HIV, education status of the patient, weight, and time of the visit.

The association between HIV infection and precancerous cervical lesion. A systematic review and meta-analysis of case-control studies.

Background: The effect of human immunodeficiency virus (HIV) on precancerous cervical lesion is not consistent across studies. Besides to the variability in the presence of a significant association between HIV and precancerous cervical lesion, the reported strengths are inconsistent among studies that report a significant association. Therefore, we sought to determine the impact of HIV on women's risk of precancerous cervical lesion by conducting a systematic review and meta-analysis of case-control studies in Ethiopia. Methods: Relevant articles were systematically searched on African Journals Online, Cochrane Library, Science Direct, Google Scholar, and PubMed from January 1, 2023, to February 20, 2023. After critical appraisal, pertinent data were extracted into an Excel spreadsheet and then exported to STATA 14 for further statistical analysis. The pooled effect size was estimated using the random-effect model. The Egger's regression test and I 2 statistics were employed to assess publication bias and heterogeneity among included studies, respectively. Results: Ten case-control studies with a total of 3035 participants (992 cases and 2043 controls) were involved in this meta-analysis. According to our analysis, HIV-infected women were 2.86 times more likely to develop precancerous cervical lesion as compared with their counterparts (odds ratio: 2.86, 95% confidence interval: 1.79, 4.58). Conclusion: We found that HIV-infected women have a higher risk of precancerous cervical lesion. Thus, targeted screening programs should be considered to reduce the burden of cervical cancer among HIV-infected women in Ethiopia.

Multilevel analysis of individual and community level factors associated with the application of cow dung and oil on the umbilical cord stump in Ethiopia.

Background: Hygienic umbilical cord care is one of the essential interventions advocated to reduce neonatal mortality. However, traditional cord care measures-applying cow dung and oil-that have harmful health consequences are commonly practiced in Ethiopia. Hence, in this study, it was planned to analyze individual and community-level factors associated with the application of cow dung and oil on the umbilical cord stump in Ethiopia. Methods: Data from the 2016 Ethiopian demographic and health survey were used to identify individual and community level factors associated with women's practice of applying cow dung and oil on the umbilical cord stump of their neonate. Taking into account for the hierarchical structure of the data; multilevel binary logistic regression analysis has been employed to a nationally representative weighted sample of 7,168 women. Results: In Ethiopia, 780 (10.88%) with 95% CI (10.18-11.62) women apply oil and/or cow dung on the neonate's umbilical cord stump. Age increase by one year [AOR = 0.97; 95% CI (0.94-0.99)] and giving birth in a health facility [AOR = 0.61; 95% CI (0.42-0.89)] were individual-level factors that reduced women's practice of applying cow dung and oil on the umbilical cord stump of their neonate. Whereas, rural residence [AOR = 2.54; 95% CI (1.28-5.06)] was the predictor at the community level that raised the practice of applying cow dung and oil on the neonate's umbilical cord stump. Conclusion: This nationwide study revealed that a significant number of mothers in Ethiopia still apply cow dung and/or oil on the umbilical cord stump of their neonates. Both the individual and community level characteristics: maternal age, place of delivery, and residence were found to have significant influence on the practice of applying cow dung and/or oil on the umbilical cord stump in Ethiopia. Thus, to reduce neonatal mortality due to avoidable umbilical cord infections, clean cord care practice strategies should be designed by considering these factors.