Background Depression is a common co-morbid, disabling disorder that affects 10–25% of cancer patients. It causes substantial functional impairment and lowers survival rate of breast cancer patients. Therefore, the aim of this study is to determine the magnitude of depression and its association with social support among breast cancer patients in Addis Ababa, Ethiopia. Methods A cross-sectional study which included 428 breast cancer patients was conducted in seven health facilities in Addis Ababa, Ethiopia. Depression and Social Support were assessed using standard tools Patient Health Questionnaire 9 (PHQ 9) and Multidimensional Scale of Perceived Social Support (MSPSS) respectively. Descriptive statistics were done based on the standard PHQ9 cut off points (0–4, 5–9, 10–14, 15–19 and ≥ 20). Mann-Whitney and Kruskal Wallis tests were employed to compare MSPSS score among depressed and non-depressed patients and across the different levels of depression. Bivariate and multivariate logistic regression was done to identify factors associated with depression. Result The prevalence of depression among breast cancer patients was 25% (107/428), andaccording to the PHQ9 score categorization, 70/428 (16.4%), 30/428 (7.01%) and 7/428 (1.64%) of these patients were having moderate, moderately severe and severe depression respectively. Age, occupation, type of health facility treated, severity of pain, hormonal therapy and having problem with employer/ family were significantly associated with depression. The participants’ MSPSS total score was overall found to be high (70.35 ± 16.81). Those women who had moderate and severe depression had lower mean MSPSS scores compared to women with none/ minimal depression ( P = 0.002). Conclusion This study found that one in four breast cancer patients had depression. Depression is associated with poor social support given by family, friends and significant others. Therefore, screening for depression and psychosocial service should be integrated in the routine breast cancer care in Ethiopia. Electronic supplementary material The online version of this article (10.1186/s12885-019-6007-4) contains supplementary material, which is available to authorized users.

BackgroundPolyneuropathy is one of the commonest complications of long-standing diabetes. Progressive sensory loss can predispose patients to foot ulcer and the neuropathy oftentimes causes pain. The pain can significantly affect the quality of life of patients.ObjectivesTo describes the health-related quality of life of patients with type II diabetes mellitus suffering from painful diabetic peripheral neuropathy at two referral hospitals in Addis Ababa, Ethiopia, 2017.MethodsAn institution based cross sectional study with internal comparison was conducted among a sample of 220 type II diabetes mellitus patients in a 1:1 matched ratio of those with and without diabetes associated peripheral neuropathic pain. All were having regular follow up at two hospitals in Addis Ababa, Ethiopia. The Short Form (SF-36) health-related quality of life instrument was used to collect data on quality of life while basic socio-demographic and other disease specific features were collected using a structured questionnaire. Descriptive statistics was used to examine the mean scores of health related quality of life. Cronbach’s alpha coefficient and Pearson’s correlation coefficient were applied to estimate the internal consistency, and the level of agreement between the different domains of SF-36, respectively. To measure association between health related quality of life domains and explanatory variables, independent T-test and ANOVA were performed followed by multiple linear regression analyses.ResultsThe health related quality of life of type II diabetes mellitus patients with peripheral neuropathic pain was poorer than those without pain in all the eight domains and the two summary scores by SF-36 (p < 0.001). Higher mean score difference was observed in Mental Component Summary Score (MCS) (14.6) compared to Physical Component Score (PCS) (9.3). Among the eight domains, the largest mean difference was found with the physical one (39.1) followed by mental health (38.2) and physical functioning (30). Pain intensity had a statistically significant negative correlation with all domains as well as the two summary scores. Younger age, a higher level of education, being single, a higher monthly income, normal body mass index, HbA1c less than seven mmo/L, absence of other diabetic complications and taking only oral hypoglycemic agents were found to predict better health related quality of life.ConclusionThe presence of diabetic peripheral neuropathic pain was found to negatively influence the health-related quality of life of type II diabetic patients; the greatest impact being on the ‘role physical’ and ‘mental health’ domains. Older age, presence of diabetes related complications, longer duration of illness negatively influenced the health-related quality of life.

BackgroundRapid Ethical Assessment (REA) is an approach used to design context tailored consent process for voluntary participation of participants in research including human subjects. There is, however, limited evidence on the design of ethical assessment in studies targeting cancer patients in Ethiopia. REA was conducted to explore factors that influence the informed consent process among female cancer patients recruited for longitudinal research from Addis Ababa Population-based Cancer Registry.MethodsQualitative study employing rapid ethnographic approach was conducted from May–July, 2017, at the Tikur Anbessa Specialized Referral Hospital. In-depth and key informants’ interviews were conducted among purposively selected 16 participants. Regular de-briefings among the study team helped to identify emerging themes and ensure saturation. Interviews and debriefings were tape recorded in Amharic, and transcribed and translated to English. Coding of the transcripts was facilitated by use of NVivo software. Thematic analysis was employed to respond to the initial questions and interpret findings.ResultsPerceived barriers to voluntary study participation included lack of reporting back study results of previous studies, the decision making status of women, hopelessness or fatigue in the patients, shyness of the women, data collectors approach to the patient, and patient’s time constraints. Most of the patients preferred oral over written consent and face-to-face interview over telephone interview. Provision of detail information about the study, using short and understandable tool, competent, compassionate and respectful enumerators of the same gender were suggested to assure participation. Due to the perceived severity, the use of the term “cancer” was associated with fear and anxiety. Alternatively, uses of phrases like “breast or cervical illness/disease” were suggested during patient interviews.ConclusionsVoluntary participation is not straight forward but affected by different factors. Using competent, compassionate and respectful enumerators, short and precise questioning tools to limit the time of the interview could improve voluntary participation. Moreover, careful consideration of the patients and families concept of the disease such as wording and information has to be taken into account. This assessment helped in improving the consent process of the ongoing project on breast and cervical cancer patients.

Background Although oesophageal cancer is a public health problem in Ethiopia, there are limited data on the magnitude and distribution of the disease in the country. The aim of this study is to assess the magnitude, socio-demographic and clinical characteristics of oesophageal cancer patients in selected referral hospitals of Ethiopia.Methods A retrospective document review was employed in ten referral hospitals in different regions of Ethiopia. Data were extracted from clinical care records of all clinically and pathologically confirmed oesophageal cancer patients who were diagnosed and treated in those hospitals from 2012 - 2017. A structured data extraction tool was used to collect important variables. Descriptive statistics such as median, interquartile range (IQR) and percentages were computed to describe the regional and national distribution of the disease.Results Over the past six years, a total of 777 oesophageal cancer cases were identified and the median age of these patients was 55 years with IQR of 19. More than half 428 (55.1%) of the cases were males and majority of them were reported from Oromia and Somali regional states with 388 (49.9%) and 202 (25.9%) respectively. The highest number of oesophageal cancer cases were recorded in 2016 with a total number of 185 (23.8%) while the lowest 98 (12.6%) was in 2012. Eighty percent of oesophageal cancer cases were diagnosed at late stage of the disease. More than one-fourth 210 (27.0%) of patients were operated with the majority 156 (74.3%) to insert a feeding tube followed by trans-hiatal oesophagostomy 23 (10.9%). Of the 118 results analysed, squamous cell carcinoma and adeno carcinoma were the predominant histologic type with 67(56.7%), and 43(36.4%) respectively. One fourth 194 (25.0%) of the patients were alive and more than two third 557 (71.7%) patients’ current status were unknown at the time of the review.Conclusions In referral hospitals of Ethiopia, many oesophageal cancer patients came at late stage of the disease and needed palliative care measures. The number of patients seen in Oromia and Somali region hospitals by far exceeds hospitals of the other regions thus postulating possibly unique risk factors in those geographic areas.

ObjectivesThis multimethods study aimed to: (1) compare the prevalence of intimate partner violence (IPV) during pregnancy pre-COVID-19 and during the COVID-19 pandemic using quantitative data and (2) contextualise pregnant women’s IPV experiences during the COVID-19 pandemic through supplemental interviews.DesignQuantitative analyses use data from Performance Monitoring for Action-Ethiopia, a cohort of 2868 pregnant women that collects data at pregnancy, 6 weeks, 6 months and 1-year postpartum. Following 6-week postpartum survey, in-depth semistructured interviews contextualised experiences of IPV during pregnancy with a subset of participants (n=24).ParticipantsAll pregnant women residing within six regions of Ethiopia, covering 91% of the population, were eligible for the cohort study (n=2868 completed baseline survey). Quantitative analyses were restricted to the 2388 women with complete 6-week survey data (retention=82.7%). A purposive sampling frame was used to select qualitative participants on baseline survey data, with inclusion criteria specifying completion of quantitative 6-week interview after the onset of the COVID-19 pandemic, and indication of IPV experience.InterventionsA State of Emergency in Ethiopia was declared in response to the COVID-19 pandemic approximately halfway through 6-week postpartum interview, enabling a natural experiment (n=1405 pre-COVID-19; n=983 during-COVID-19).Primary outcome measuresIPV during pregnancy was assessed via the 10-item Revised Conflict and Tactics Scale.Results1-in-10 women experienced any IPV during pregnancy prior to COVID-19 (10.5%), and prevalence of IPV during pregnancy increased to 15.1% during the COVID-19 pandemic (aOR=1.51; p=0.02). Stratified by residence, odds of IPV during the pandemic increased for urban women only (aOR=2.09; p=0.03), however, IPV prevalence was higher in rural regions at both time points. Qualitative data reveal COVID-19-related stressors, namely loss of household income and increased time spent within the household, exacerbated IPV.ConclusionsThese multimethods results highlight the prevalent, severe violence that pregnant Ethiopian women experience, with pandemic-related increases concentrated in urban areas. Integration of IPV response and safety planning across the continuum of care can mitigate impact.

Background Global cancer estimations for Ethiopia announced 77 352 new cases in 2020 based on the only population-based registry in Addis Ababa. This study characterizes cancer patients in rural Ethiopia at 8 primary and secondary hospitals between 2014 and 2019. Patients and Methods All clinically or pathologically confirmed cancer cases that were diagnosed between 1 May 2014 and 29 April 2019 were included. A structured data extraction tool was used to retrospectively review patients’ charts and descriptive analysis was done. Results A total of 1298 cancer cases were identified, of which three-fourths were females with a median age of 42 years. Breast (38%) and cervical (29%) cancers were the most common among females, while prostate (19%) and oesophageal cancers (16%) were the most common among males. Only 39% of tumors were pathologically confirmed. Nearly two-thirds of the cases were diagnosed at an advanced stage. Surgery was the only accessible treatment option for more than half of the cancer patients, and systemic treatment (except endocrine) was rarely available. One in 5 patients did not receive the recommended surgical procedure, half due to patient refusal or lack of the patient returning to the hospital. Conclusion The pattern of cancer diagnoses in rural hospitals shows an exceptionally high burden in women in their middle-ages due to breast and cervical cancers. Advanced stage presentation, lack of pathology services, and unavailability of most systemic treatment options were common. The surgery was offered to nearly 60% of the patients, showing the significant efforts of health workers to reduce sufferings.

Objectives Supportive care needs survey short form has a total of 34 items that have 5 domains that measure the unmet needs of cancer patients. It is important to validate this tool since there are differences in culture, geographic areas, and clinical care service which influence patients’ needs. Therefore, this study aimed to assess the construct validity and reliability of the tool. Methods The study was conducted among 170 cancer patients from April 1st to 30th 2019 in Hawassa hospital, South Ethiopia. Confirmatory factor analysis was done using fit indices. Convergent and discriminant validity was evaluated using average variance extracted and maximum shared variance respectively. Known group validity was checked using the Mann-Whitney U test. The reliability of the instrument was examined using Cronbach’s alpha. Results Domains except for health system and information, and patient care and support maintained convergent and divergent validity. The remaining validity was maintained after removing items that were redundant and double loading. The average variance extracted of domains varied from 0.52–0.81. The Square of correlation between constructs was lower than the average variance extracted for the constructs. The tool had reliability r = 0.932. The root mean square error of approximation was 0.057, comparative fit index 0.954, and the other fit indices were also indicating a good fit. Known groups difference was seen by age and type of treatment taken across the different domains. Conclusion After the health system and information, and patient care, and support domain validity issues were corrected by removing 8 items, the reduced tool was found to be a valid and reliable tool. The validated tool will be valuable if included in routine cancer care in our clinical settings.

BackgroundRubella is a vaccine-preventable contagious disease causing an estimated 100,000 children to be born with congenital rubella syndrome each year globally. Studies documented that 18 rubella outbreaks were occurred each year in Ethiopia. Yeka sub-city woreda 13 public health emergency management office reported two measles suspected cases on 8 February, 2018. We investigated this outbreak to identify its etiology, describe the outbreak and implement control measures.MethodsWe described the outbreak using descriptive epidemiology. The study population was defined as students learning in the school where the outbreak occurred. Suspected rubella case was defined as student with generalized rash whereas confirmed case was suspected case tested positive for rubella IgM. Questionnaires, checklists and students record review were used to collect data. We searched for new cases in classes daily and excluded them from classes. The school environment was assessed and the outbreak was described in person and time.ResultsWe identified 58 cases (median age: 4.6 years; IQR: 4–5 years) with six of them rubella IgM positive and 52 epidemiologically linked. The outbreak began on 8 February 2018 having multiple intermittent peaks during its course reaching its highest peak at 2 April, 2018 and ended on 20 April, 2018. Index cases were reported from two classes; however, cases were occurred in 13/15(86.67%) of the classes during the entire outbreak. Fifty five percent (32/58) and 45/58(77.59%) of the cases were females and 3–5 years children, respectively. Overall attack rate was 58/531(4.05%). Attack rate was higher in females 32/252 (12.7%) than in males 26/279 (9.32%), and higher 45/275(16.36%) in 3–5 years than those in 5–8 years 13/256(5.08%) children. Case fatality ratio was zero. All cases were vaccinated against measles but unvaccinated against rubella.ConclusionsAttack rate was higher in females than in males and higher in 3–5 years than 5–8 years children. We recommended establishing rubella surveillance system, conducting sero-prevalence of rubella among child bearing age females and establishing CRS surveillance among young infants to provide evidence-based information for RCV introduction. It was also recommended to develop a national rubella surveillance guideline which aid to exclude rubella cases from schools during outbreak.Electronic supplementary materialThe online version of this article (10.1186/s12879-019-3873-y) contains supplementary material, which is available to authorized users.