Introduction: Lung cancer is the most common cause of cancer deaths worldwide, accounting for 1.8 million deaths each year. Only 20% of lung cancer cases are reported to occur in low-and middle-income countries. An estimated 1.5% of all Ethiopian cancers involved the lung; however, no nationwide cancer registry exists in Ethiopia. Thus, accurate data on clinical history, histopathology, molecular characteristics, and risk factors for lung cancer are not available. The aim of this study was to describe the clinical, radiologic, and pathologic characteristics, including available molecular profiles, for lung cancer at Tikur Anbessa Specialized Hospital (TASH), the main tertiary referral center in Addis Ababa, Ethiopia. Methods: A cross-sectional study was conducted at TASH among 146 patients with pathologically confirmed primary lung cancer, diagnosed from 2015 to 2019 and recorded in the Addis Ababa Cancer Registry at TASH. Clinical data were extracted from patient medical records, entered into a Research Electronic Data Capture database, and analyzed using Statistical Package for the Social Sciences statistical software. Variables collected included sociodemographics, personal exposures, comorbidities, clinical manifestations at presentation, chest imaging results, diagnostic procedures performed, histopathological classification, cancer staging, and type of treatment (if any). A subset of lung biopsies fixed in formalin for 2 to 7 days, which could be retrieved from the files of the Pathology Department of TASH, were reviewed, and molecular analysis was performed using next-generation sequencing to identify the tumor-oncogenic drivers.Results: Among the 146 patients studied, the mean (SD) age was 54 plus or minus 13 years; 61.6% (n ¼ 90) were male and 25.3% (n ¼ 37) had a history of tobacco use. The most common clinical manifestations included cough (88.4%, n ¼ 129), chest pain (60.3%, n ¼ 88), and dyspnea (53.4%, n ¼ 78). The median duration of any symptoms was 6 months (interquartile range: 3-12 mo). The most common radiologic features were lung mass (84.9%, n ¼ 129) and

Data from much of Africa are still scarce on the clinical characteristics, outcomes of treatment, and factors associated with disease severity and mortality of COVID-19. A cross-sectional study was conducted at Eka Kotebe General Hospital, Ethiopia’s first COVID-19 treatment center. All consecutive symptomatic SARS CoV-2 RT-PCR positive individuals, aged 18 and older, admitted to the hospital between March 13 and September 16, 2020, were included. Of the total 463 cases, 319 (68.9%) were male. The median age was 45 years (interquartile range 32–62). The most common three symptoms were cough (69%), shortness of breath (SOB; 44%), and fatigue (37%). Hypertension was the most prevalent comorbidity, followed by diabetes mellitus. The age groups 40 to 59 and ≥ 60 were more likely to have severe disease compared with those < 40 years of age (adjusted odds ratio [aOR] = 3.45, 95% confidence interval [CI]: 1.88–6.31 and aOR = 3.46, 95% CI: 1.91–6.90, respectively). Other factors associated with disease severity included the presence of any malignancy (aOR = 4.64, 95% CI: 1.32–16.33) and SOB (aOR = 3.83, 95% CI: 2.35–6.25). The age group ≥ 60 was significantly associated with greater in-hospital mortality compared with those < 40 years. In addition, the presence of any malignancy, SOB, and vomiting were associated with higher odds of mortality. In Ethiopia, most COVID-19 patients were male and presented with cough, SOB, and fatigue. Older age, any malignancy, and SOB were associated with disease severity; these factors, in addition to vomiting, also predicted mortality.

COVID-19, the novel coronavirus, has posed a major threat to low- and middle-income countries (LMICs) due to inadequate health infrastructure and human resources. Ethiopia, a low-income country with the second largest population in Africa, has coordinated a strategic response, leveraging existing infrastructure and health systems and mobilizing public health professionals and specialist expert physicians for a multifaceted, unified government approach and adaptive response. Resource limitations, particularly in critical care, have still posed challenges, but the public health and clinical interventions thus far have prevented the catastrophic toll that many predicted. As the pandemic continues, Ethiopia expects to use a triple care model integrated at all levels, consisting of COVID-19 care, isolation care for suspected cases, and essential health services, and urges intensified non-pharmaceutical interventions alongside equitable global vaccine distribution as the ultimate answers to pandemic control. This paper draws on existing data, national planning and guidelines, and expertise from health leadership to describe this response in hopes of providing an example of how future large-scale health challenges might be faced in LMICs, using Ethiopia’s successes and challenges in facing the pandemic.

Rationale Lung cancer is the most common cancer worldwide, accounting for 1.8 million deaths each year. Twenty percent of cases occur in lower-income countries. A previous study found roughly 1.5% of all Ethiopian cancers involved the lung. But no nationwide cancer registry exists in Ethiopia, and data on risk factors, histopathology, and clinical history is not collected, making these aspects of cancer progression and classification unclear. This is an update on our previous abstract on 125 patients, presented at the ATS 2019 conference. Methods A cross-sectional study was conducted at TASH, the main tertiary referral center in Ethiopia, among patients with histopathologically-confirmed primary lung cancer diagnosed from 2015 to 2018 who had medical records available (n=146) from the Addis Ababa Cancer registry. Clinical data was collected from patient medical records into a survey managed by REDCap and analyzed using SPSS statistical software. Variables collected from patient records included socio-demographics (age, gender, region of residence, education level, occupation), risk factors and exposures (smoking history, alcohol/chat/shisha use, family history of lung cancer, history of radiation therapy to the chest), comorbidities, clinical manifestations at presentation, chest x-ray/CT findings, cancer staging, histopathological classification, diagnostic procedures performed, and type of treatment (if any). Results Among 146 patients, mean (SD) age was 54(13) year, 90 patients (61.6%) were male, 37 patients (25.3%) had a prior history of smoking. Fifty nine patients (58%) presented with stage IV cancer and no staging reported in 44 patients (30%). The most common histopathological classifications were adenocarcinoma in 49 patients (33.6%), and squamous cell carcinoma(SCC) in 28 patients (19.2%) and in 62 patients (42.5%), the histology was not specified. Conclusion Lung cancer may be more common in Ethiopia than previously recognized. Notably, only 25% of patients smoked cigarettes, indicating the possibility of novel risk factors such as household air pollution and occupational exposures. Patients present at later stages and younger ages compared to high-income populations. Lung cancer screening guidelines and treatment protocols should be adapted to account for these differences. It is critical for Ethiopia to invest in creating a national cancer registry, and ensure that every cancer patient has the resources to receive a timely diagnosis: trained specialists, subsidies for travel to regional cancer centers, and access to diagnostic procedures like bronchoscopy.

Objectives: The objectives of the study were to evaluate the benefit of awake prone positioning in COVID-19 patients hospitalized at Eka Kotebe General Hospital, Addis Ababa, Ethiopia. Materials and Methods: Consecutive patients with COVID-19 who require supplemental oxygen to maintain oxygen saturation of ≥90% during the month of October 2020 were enrolled. Structured questionnaires were employed to collect data. Admission oxygen saturation was recorded for each patient before and after their first proning session. Analysis of descriptive and comparison statistics was done using SPSS version 25. Results: A total of 61 patients were included in the study. The mean age (+SD) for the cohort was 55.4 (+16.9) years. The average duration of proning was 5+2.5 h/session and 8+6 h/day. The average oxygen saturation before proning was 89% (SD 5.2) and 93% (SD 2.8) 1 h after proning (P < 0.001); supplemental oxygen requirements significantly decreased with prone ventilation, before proning: FiO2 0.33 (+0.14) versus 1 h after prone ventilation: FiO2 0.31 (+0.13) (P < 0.001). Oxygen improvement with prone ventilation was not associated with duration of illness or total prone position hours. When assessed at 28 days after admission, 55.7% (n = 34) had been discharged home, 1.6% (n = 1) had died, and 42.6 (n = 26) were still hospitalized. Conclusion: Awake prone positioning demonstrated improved oxygen saturation in our oxygen requiring COVID-19 patients. Even though further studies are needed to support causality and determine the effect of proning on disease severity and mortality, early institution of prone ventilation in appropriate oxygen requiring COVID-19 patients should be encouraged.