BackgroundCervical cancer is the leading cause of cancer related death among women in developing countries. Cervical cancer is preceded by cervical surface epithelial cell abnormalities (ECA) which can be detected by Pap smear test. Simultaneous human papillomavirus and human immunodeficiency virus (HIV) infection increases cervical cancer. Data on the prevalence and predictors of ECA among women in Ethiopia is limited. Hence, we aimed to determine the prevalence and associated factors of ECA among women.MethodsA comparative cross-sectional study was conducted among HIV+ and HIV- women attending gynecological examination in cervical cancer screening center at the Debre Markos referral hospital. The study subjects were stratified by HIV status and systematic random sampling method was used to recruit study participants. Cervical smears were collected for Pap smear examination. Logistic regression analysis was employed to examine the possible risk factors of cervical ECA.ResultsA total of 197 HIV+ and 194 HIV- women were enrolled in the study. The overall prevalence of cervical ECA was 14.1 % of which the prevalence of atypical squamous cells undetermined significance (ASCUS), low grade squamous intraepithelial lesion (SIL), high grade SIL, squamous cell carcinoma and ASC, cannot exclude high grade SIL (ASCH) were 5.1, 3.8, 4.1 and 1.0 %, 0.0 % respectively. Significantly higher prevalence of ECA (17.8 %) was observed among HIV+ women (COR 1.9, 95 % CI: 1.1 − 3.4, p = 0.036) as compared to HIV-women (10.3 %). Multiple sexual partnership (AOR 3.2, 95 % CI: 1.1 − 10.0, p = 0.04), early ages of first sexual contact (<15 years) (AOR 5.2, 95 % CI: 1.5 − 17.9, p = 0.009), parity greater than three (AOR 10.9, 95 % CI: 4.2 − 16.8, p < 0.001) and long term oral contraceptive pills (OCP) use (AOR 11.9, 95 % CI: 2.1 − 16.7, p = 0.02) were significant predictors of prevalence of ECA.ConclusionsCervical ECA is a major problem among HIV-infected women. Lower CD4+ T-cell counts of below 350 cells/μl, HIV infection, multiple sexual partnership, early age at first sexual contact, parity greater than three and long term OCP use were significant predictors of prevalence of ECA. Strengthening screening program in HIV+ women should be considered.

Summary Background Risk of mortality following surgery in patients across Africa is twice as high as the global average. Most of these deaths occur on hospital wards after the surgery itself. We aimed to assess whether enhanced postoperative surveillance of adult surgical patients at high risk of postoperative morbidity or mortality in Africa could reduce 30-day in-hospital mortality. Methods We did a two-arm, open-label, cluster-randomised trial of hospitals (clusters) across Africa. Hospitals were eligible if they provided surgery with an overnight postoperative admission. Hospitals were randomly assigned through minimisation in recruitment blocks (1:1) to provide patients with either a package of enhanced postoperative surveillance interventions (admitting the patient to higher care ward, increasing the frequency of postoperative nursing observations, assigning the patient to a bed in view of the nursing station, allowing family members to stay in the ward, and placing a postoperative surveillance guide at the bedside) for those at high risk (ie, with African Surgical Outcomes Study Surgical Risk Calculator scores ≥10) and usual care for those at low risk (intervention group), or for all patients to receive usual postoperative care (control group). Health-care providers and participants were not masked, but data assessors were. The primary outcome was 30-day in-hospital mortality of patients at low and high risk, measured at the participant level. All analyses were done as allocated (by cluster) in all patients with available data. This trial is registered with ClinicalTrials.gov , NCT03853824 . Findings Between May 3, 2019, and July 27, 2020, 594 eligible hospitals indicated a desire to participate across 33 African countries; 332 (56%) were able to recruit participants and were included in analyses. We allocated 160 hospitals (13 275 patients) to provide enhanced postoperative surveillance and 172 hospitals (15 617 patients) to provide standard care. The mean age of participants was 37·1 years (SD 15·5) and 20 039 (69·4%) of 28 892 patients were women. 30-day in-hospital mortality occurred in 169 (1·3%) of 12 970 patients with mortality data in the intervention group and in 193 (1·3%) of 15 242 patients with mortality data in the control group (relative risk 0·96, 95% CI 0·69–1·33; p=0·79). 45 (0·2%) of 22 031 patients at low risk and 309 (5·6%) of 5500 patients at high risk died. No harms associated with either intervention were reported. Interpretation This intervention package did not decrease 30-day in-hospital mortality among surgical patients in Africa at high risk of postoperative morbidity or mortality. Further research is needed to develop interventions that prevent death from surgical complications in resource-limited hospitals across Africa. Funding Bill & Melinda Gates Foundation and the World Federati...

Since Buschke and Löwenstein first described the giant condyloma in 1925 (which subsequently was named Buschke-Löwenstein tumor), there have been scattered reports over the past 90 years describing presentation and different avenues of treatment for patients with this condition. It is well known that immunocompromised individuals are at an increased risk of anogenital disease caused by human papillomavirus (HPV). In this report, we present the management of two HIV positive patients with giant condylomas. Both patients presented with urinary outflow obstruction and sepsis. Though giant condylomas are a rare phenomenon, these two cases underscore the importance of early treatment intervention, especially in the immunocompromised patient.

Background: Cervical cancer is the most common cancer among women living in sub-Saharan Africa. Ethiopia has a high incidence of cervical cancer (35.9 per 100,000 women), with 7,095 women diagnosed annually and 4,732 dying every year from the disease. Low provider awareness and poor understanding of appropriate prevention, treatment, and screening interventions pose challenges to addressing this problem. To gauge the extent of this information gap, the study explores variation in healthcare providers' knowledge about HPV and cervical cancer at Debre Markos Referral Hospital, a tertiary public facility located in Ethiopia's Amhara region.

Objective Given high unmet need for contraception in Ethiopia, this study aimed to determine prevalence and factors associated with early discontinuation of long-acting reversible contraceptives (LARC). Methods This institution-based cross-sectional study was conducted with 389 participants using exit interviews with clients presenting for removal of LARC at the family planning clinic of four government hospitals in Addis Ababa. SPSS version 26 was used for analysis. Descriptive statistics, bivariate, and multivariate logistic regression were computed. Result Among the 389 clients, 236 (60.7%) discontinued early. In multivariate regression, lack of pre-insertion counseling on side effects (AOR = 3.5, p = 0. 000; 95% C.I = 1.8—6.8), presence of side effects (AOR = 1.9, p = 0. 017; 95% C.I = 1. 1- 3.4), history of abortion (AOR = 3.5, p = 0. 001; 95% C.I = 1. 6- 7.4); and no prior contraception use (AOR = 2.9, p = 0. 000; 95% C.I = 1. 6- 5.3) were positively associated with early discontinuation. Whereas insertion outside of Saint Paul’s Hospital Millennium Medical College (AOR = 0.4, p = 0. 000; 95% C.I = 0. 2- 0.6), and influence on choice of contraceptives by others (AOR = 0.2, p = 0. 000; 95% C.I = 0. 2- 0.4) were negatively associated with early discontinuation. Conclusion Early discontinuation of LARC was high among study participants. Counseling about possible side effects and giving women the opportunity to decide their own choice of contraception might help in reducing early discontinuation.