Impact of Delay Prior to Treatment in Ethiopian Children with Acute Lymphoblastic Leukemia.

Introduction: More than 85% of childhood malignancies occur in developing countries with less than a 30% cure rate as opposed to more than 80% cure rate in developed countries. This disproportionately significant difference might be due to delays in diagnosis, treatment initiation, lack of adequate supportive care, and treatment abandonment. We aimed to determine the impact of overall treatment delay on induction mortality of children with acute lymphoblastic leukemia treated at Tikur Anbessa specialized hospital (TASH). Methods: A cross-sectional study was conducted among children who were treated from 2016 to 2019. Children with Down syndrome and relapsed leukemia were excluded from this study. Results: A total of 166 children were included; most patients were males (71.7%). The mean age at diagnosis was 5.9 years. The median time interval from the onset of symptoms to the first TASH visit was 30 days and the median period from TASH's first clinic visit to diagnosis was 11 days. The median time to initiate chemotherapy after diagnosis was 8 days. The total median time from the first onset of symptoms to chemotherapy initiation was 53.5 days. Induction mortality was 31.3%. High-risk ALL and patients with an overall delay between 30 and 90 days were more likely to experience induction mortality. Discussion: Patient and healthcare system delay is high compared to most studies done and a significant association has been noted with induction mortality. Efforts to expand the pediatric oncology service in the country and efficient diagnostic and treatment approach need to be established to reduce mortality associated with overall delay.

Turn-over rate of academic faculty at the College of Health Sciences, Addis Ababa University: a 20-year analysis (1991 to 2011).

BACKGROUND: Faculty turn-over affects both workers and organizations. Turnover of faculty and researchers is increasing alarmingly and costing the universities and the country at large. Fast turnover of health professionals from the health system and from academic institutions has recently received substantial attention from both academia and health sector managers. This paper calculates the faculty turnover rate at the College of Health Sciences of Addis Ababa University during the period of September 1991 to August 2011. METHODS: The study was conducted at the College of Health Sciences, Addis Ababa University. Retrospective analysis of employee records was done. All records of the faculty that were working in the College during the 20-year period, starting from September 1991 to August 2011 were retrospectively reviewed. Data were collected from the employee records accessed from the College's human resources database and supplemented by payroll sheets and different reports. A structured checklist was used to extract the required data from the database. The crude turnover rate for academic faculty was calculated. RESULTS: Within the 20-year period of September 1991 to August 2011, a total of 120 faculty members left. The overall turn-over rate was 92.8 %. The rate in the most recent five years (172 %) is 8.5 times higher than the rate for the first five years (20 %). The average retention period before the termination of an employment contract was 4.9 years. The top five departments where employment contracts were relatively higher include: Nursing 15 (15.6 %), Internal Medicine 12 (12.5%), Public Health 10 (10.4%), Pediatrics 9 (9.4%) and Surgery 9 (9.4%). About two thirds (66.6%) of the faculty who were leaving were at the ranks of assistant professorship and above. CONCLUSION: This study revealed that outflow of faculty has been continuously increasing in the period reviewed. This implies that the College had been losing highly skilled professionals with considerably higher costs in monetary terms. In this regard, an urgent response is required to retain or significantly decrease the outflow of faculty. Different motivation and retention mechanisms should be identified and implemented. Various modalities of faculty development programs should also be initiated.

Juvenile polyposis in an Ethiopian family.

An 8-year-old boy from Arsi, central Ethiopia, seen at Tikur Anbessa Hospital, a tertiary and teaching hospital, Addis Ababa, Ethiopia, with a history of protruding mass per anum during straining at defecation and micturition and rectal bleeding of 12 months, diagnosed to have juvenile polyposis is presented The condition was complicated by severe anemia and hypoproteinemia. Following abdominal surgery (subtotal colectomy, ileoproctostomy and proctoscopic diathermy of rectal polyps) and supportive measures, the bleeding stopped and his general condition improved His father and two of his three siblings were also proved to have colonic polyposis, earlier. Clinical presentation, investigations, intra-operative and histologic findings, and prognosis are discussed with background literature review.