Background: Rituximab is currently approved for the treatment of relapsed and refractory indolent lymphomas, which was added to the protocol in Yemen although it was highly costly. The study aimed to determine the long-term response of rituximab on Non-Hodgkin Lymphomas (NHL) patients. Methods: A retrospective cohort study was conducted in the National Oncology Center (NOC) in Aden by review of medical registries for NHL patients from 2017-2020. Sociodemographic and clinical data were extracted from patients’ files by a well-trained team. SPSS version 23 was used for the analysis of data, and Kaplan Meier survival curve was used to measure overall survival (OS) and progression-free survival (PFS) between two groups CHOP (cyclophosphamide, doxorubicin, vincristine, and prednisolone) and rituximab-CHOP group in two follow up periods (12-months and 4-years). Cox regression was used to evaluate the association between the risk factors. A P-value of < 0.05 at a confidence interval of 95% is considered statistically significant. Results: Of 100 patients, 50 for each group of CHOP and R-CHOP. The under 60 years represented 70%. Advanced Stage represented 64% and diffuse large B cell lymphoma represented 47% of all subtypes of NHL. Significant association difference in OS in two periods of follow-up (12-month and 4-years) for CHOP vs. R-CHOP was 63% vs. 86%, and 10% vs. 33%, respectively (P=0.01 and P=0.04). In contrast, the difference was non-statically significant in the PFS in two periods 39% vs. 66%, and 12% vs. 27% for CHOP vs. R-CHOP, respectively (P=0.10 and P=0.31). The age group > 60 years, ≥ 6 cycles of chemotherapy received, abnormality of LDH, and married patients were the significantly hazard proportion that was associated with poor prognostic factors (P= 0.009, 0.001,0.010, and 0.011, respectively). Conclusion: The addition of rituximab to CHOP chemotherapy had a statistical difference in overall survival and there is no difference in PFS. Elderly, married patients, more than 6 cycles of chemotherapy received, and abnormality of LDH were the most important prognostic factors. Therefore, providing the oncology center with Rituximab for ongoing use of NHL patients especially those under 60 years, further assessment for hospital-related risk factors that lead to decreased survival are recommended.
Background Control of preventive chemotherapy-targeted neglected tropical diseases (PC-NTDs) depends on strengthened health systems. Efficient health information systems provide a stimulus to reaching the sustainable development goal aimed at ending PC-NTD epidemics. However, there is limited assessment of surveillance system functions linked to PC-NTDs that are hinged on the optimal performance of surveillance system attributes. Objective The aim of this study was to assess the usefulness and performance of the National Leishmania Control Program (NLCP), and to estimate the strength and weakness points of the system. Methods We followed the updated six steps of Centers for Diseases Control and Prevention (CDC) guidelines for evaluating public health surveillance systems. Data were collected using in-depth interviews with relevant stakeholders at the central level and semistructured questionnaires at the peripheral level. We used questions (yes, no) to assess the usefulness and a 5-point Likert scale to measure the attributes. The final score was interpreted as poor (<60), average (60-80), and good (>80). Results The NLCP seemed to be useful (86%) and some of its objectives were met. The system has average performance in flexibility (78%), simplicity (64%), acceptability (80%), and data quality (65%). Poor performance was indicated for stability (33%) and timeliness (8%). The overall performance of the NLCP was deemed to be poor (55%). Continuation of the system was the strongest point, whereas the lack of governmental and agency funds was the weakest point. Conclusions The NLCP was found to be useful regarding the attributes assessed; simplicity, flexibility, acceptability, and data quality were deemed to be average, whereas stability and timeliness were considered to be poor. Governmental financial support to the program is highly recommended. In addition, creating a database for staff at the peripheral level and expanding the number of health facilities that serve as Leishmania units are required.
BACKGROUND Control of preventive chemotherapy-targeted neglected tropical diseases (PC-NTDs) depends on strengthened health systems. Efficient health information systems provide a stimulus to reaching the sustainable development goal aimed at ending PC-NTD epidemics. However, there is limited assessment of surveillance system functions linked to PC-NTDs that are hinged on the optimal performance of surveillance system attributes. OBJECTIVE The aim of this study was to assess the usefulness and performance of the National <i>Leishmania</i> Control Program (NLCP), and to estimate the strength and weakness points of the system. METHODS We followed the updated six steps of Centers for Diseases Control and Prevention (CDC) guidelines for evaluating public health surveillance systems. Data were collected using in-depth interviews with relevant stakeholders at the central level and semistructured questionnaires at the peripheral level. We used questions (yes, no) to assess the usefulness and a 5-point Likert scale to measure the attributes. The final score was interpreted as poor (<60), average (60-80), and good (>80). RESULTS The NLCP seemed to be useful (86%) and some of its objectives were met. The system has average performance in flexibility (78%), simplicity (64%), acceptability (80%), and data quality (65%). Poor performance was indicated for stability (33%) and timeliness (8%). The overall performance of the NLCP was deemed to be poor (55%). Continuation of the system was the strongest point, whereas the lack of governmental and agency funds was the weakest point. CONCLUSIONS The NLCP was found to be useful regarding the attributes assessed; simplicity, flexibility, acceptability, and data quality were deemed to be average, whereas stability and timeliness were considered to be poor. Governmental financial support to the program is highly recommended. In addition, creating a database for staff at the peripheral level and expanding the number of health facilities that serve as <i>Leishmania</i> units are required.
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