Survival Status and Predictors of Mortality Among Children Admitted With Acute Lymphocytic Leukemia at Cancer Treatment Hospitals in Addis Ababa, Ethiopia.

BACKGROUND: Acute lymphocytic leukemia is a cancer affecting the blood and bone marrow and is the most frequently diagnosed cancer among children. In Ethiopia, it represents the predominant form of childhood leukemia, comprising approximately 80% of cases and serving as a leading cause of childhood cancer-related deaths. Therefore, the objective of this study is to examine the survival status and factors that may predict mortality in children admitted with acute lymphocytic leukemia at cancer treatment hospitals in Addis Ababa, Ethiopia. METHODS: A retrospective follow-up study was conducted at cancer treatment hospitals in Addis Ababa, focusing on children diagnosed with acute lymphocytic leukemia. The investigation covered records from January 1, 2017, to December 30, 2023, encompassing a sample of 230 study records. Variables with a P-value below 0.25 in the bivariate analysis were selected for entry into the multivariable analysis. Subsequently, variables demonstrating a P-value less than 0.05 in the multivariable Cox proportional hazards model were deemed statistically significant. RESULTS: The cumulative proportion of survival was 98.3% (95%CI: 94.8, 99.5), 89.2% (95%CI: 82.0, 93.6), and 24.1% (95%CI: 8.43, 44.1) at the end of the 20th, 40th, and 60th month, respectively. The incidence rate of mortality among cohort of children admitted with acute lymphocytic leukemia was 0.45 per 100 child months. History of relapse (AHR: 2.48; 95%CI: 1.01, 6.08) and infection (AHR: 2.34; 95%CI: 1.03, 5.31) were independent predictors of mortality among children admitted with acute lymphocytic leukemia. CONCLUSION: The likelihood of mortality increased in the later stages of follow-up for children admitted with acute lymphocytic leukemia, and the incidence density rate of mortality in this group was lower compared to previous reports from other regions. Furthermore, independent predictors of mortality among children with acute lymphocytic leukemia included a history of relapse and infection.

Cultural malpractice during pregnancy, childbirth, and the postnatal period and its associated factors among women who gave birth once in Dire Dawa city administration, Eastern Ethiopia, in 2021.

Background: Cultural practices are any experiences or beliefs that are socially shared views and behaviors practiced in a certain society at a certain time. Cultural malpractices are defined as socially shared views and traditionally accepted behaviors experienced in a certain society that harm maternal health. Worldwide, the period of pregnancy, labor, and delivery is embedded with different beliefs, customs, and rituals in different societies that contribute a lot to maternal death. They are responsible for the annual deaths of 303,000 mothers and 2.7 million newborns globally. In developing countries, it accounts for approximately 5%-15% of maternal deaths. In Ethiopia, approximately 18% of infant deaths occur due to cultural malpractice, and 52% of pregnant mothers give birth at home following cultural customs in Dire Dawa city. The objective of this study was to assess cultural malpractices during pregnancy, childbirth, and the postnatal period and its associated factors among women who gave birth once in Dire Dawa City in 2021. Methods: Community-based mixed study was conducted. A total of 624 study participants were selected through a systematic random sampling technique, and a purposive sampling method was used for qualitative data. The study was conducted in the randomly selected Kebeles of Dire Dawa City, Eastern Ethiopia, from November 1 to December 30, 2021. Data were entered into Epi Data version 4.1 and exported to SPSS version 24 for analysis. Bivariate and multivariate analyses were done, and the degree of association was measured by using the odds ratio with 95% CI and significance was declared at a p-value of <0.05. The qualitative data were analyzed thematically using ATLAS-ti version 7. Results: The overall prevalence of cultural malpractice during pregnancy, childbirth, and the postnatal period was 74.6% [95% CI: 70.59%, 77.49%]. Women over the age of 35 were two times more likely [AOR 2.61, 95% CI, 1.45-4.72] to commit cultural malpractice than women aged 15-24 and 25-34. Those with no antenatal care (ANC) follow-up were three times more likely to commit cultural malpractice [AOR 3.57, 95% CI, 1.72-7.40], those who were absent from health education were nearly two times more likely to commit cultural malpractice [AOR 1.83, 95%CI, 1.25-2.67], and women whose culture allows harmful traditional practices were nearly two times more likely to commit cultural malpractices than their counterparts [AOR 1.69, 95%CI, 1.29-2.54]. Conclusion: In this study, nearly three-fourths of participants were involved in cultural malpractices. Therefore, strengthening community education and behavioral change messages on the importance of ANC and avoiding unhealthy care during pregnancy, childbirth, postnatal and neonatal periods, especially with pregnancy at old age (age > 35), may help to reduce cultural malpractices.

Women experiencing homelessness in Dire Dawa city: Coping mechanisms and suggestions to stakeholder, 2021.

BACKGROUND: In Ethiopia, the number of homeless girls and women is increasing, and the government has yet to devise a strategy to address the issue of teenage homelessness. They are influenced by numerous dimensions of health, including physical health, mental health, and social isolation. At all stages of homelessness, the stakeholders and homeless people must work together to address the issue. As a result, this study will be helpful to generate relevant data that may guide policymakers in designing solutions for this underserved group of people. OBJECTIVES: To explore coping mechanisms and suggestions to stakeholders among women experiencing homelessness in Dire Dawa city, eastern Ethiopia, 2021. DESIGN: A community-based phenomenological qualitative study was conducted at Dire Dawa city. METHODS: Data were collected from women experiencing homelessness and key informants through focus group discussion and in-depth interviews using a semi-structured tool. A total of 31 women experiencing homelessness (13 in-depth interviews and 3 focus group discussion with 6 participants in each) and 2 key informants participated in this study. Data were analyzed thematically using computer-assisted qualitative data analysis software Atlas.ti 7. The thematic analysis follows six steps: familiarization, coding, generating themes, reviewing themes, naming themes, and writing up. RESULTS: Two major themes were driven: coping mechanisms and suggestions to stakeholders. There are three subthemes under the coping mechanism (begging, survival sex, and child prostitution) while there are a total of seven subthemes under suggestions to stakeholders (integration and collaboration, special attention to children, family education, shelter and job, schooling, sexual education, and addiction rehabilitation). CONCLUSION: Child prostitution and survival sex are a very common coping mechanism which is practiced by women experiencing homelessness. Changing society's mindset and paying special attention to children is critical. Furthermore, the government and various stakeholders should work together to develop a rehabilitation program for street children who have been exposed to substance use.