Breast and cervical cancer patients’ experience in Addis Ababa city, Ethiopia: a follow-up study protocol

Gebremariam, Abebe; Addissie, Adamu; Worku, Alemayehu; Hirpa, Selamawit; Assefa, Mathewos; Pace, Lydia E.; Kantelhardt, Eva Johanna; Jemal, Ahmedin

doi:10.1136/bmjopen-2018-027034

Cited by 12 publications

(11 citation statements)

References 47 publications

(32 reference statements)

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“…Phenomenological method is useful in studying participants’ lived experiences of a phenomenon, which in this case is the experience of breast cancer diagnosis, from patients, family members and health care providers’ perspective [17]. This study was conducted as a baseline to a broader ongoing follow-up study in Addis Ababa documenting the experiences of women with breast cancer from recognition of symptoms to diagnosis, treatment, and survivorship, and end of life [18].…”

Section: Methodsmentioning

confidence: 99%

Perspectives of patients, family members, and health care providers on late diagnosis of breast cancer in Ethiopia: A qualitative study

et al. 2019

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Background Most women with breast cancer in Ethiopia are diagnosed at an advanced stage of the disease, but the reasons for this have not been systematically investigated. This study, therefore, aimed to explore the main reasons for diagnosis of advanced stage breast cancer from the perspective of patients, family members, and health care providers. Methods A qualitative study with in-depth interviews was conducted with 23 selected participants at Tikur Anbessa Specialized Hospital, Oncology Clinic using a semi-structured interview guide. These participants were 13 breast cancer patients, 5 family members, and 5 health care providers. Data were transcribed into English, coded and analyzed using thematic analysis. Results Awareness about the causes, risk, initial symptoms, early detection methods, and treatment of breast cancer were uncommon, and misconceptions about the disease prevailed among breast cancer patients and family members. There was a sense of hopelessness and uncertainty about the effectiveness of conventional medicine amongst patients and family members. Consequently, performing spiritual acts (using holy water) or seeking care from traditional healers recurred amongst the interviewees. Not taking initial symptoms of breast cancer seriously by the patients, reliance on traditional medicines, competing priorities, financial hardship, older age, fear of diagnosis of cancer, and weak health systems (e.g., delay in referral and long waiting period for consultation) were noted as the main contributors to late diagnosis. In contrast, persuasion by family members and friends, higher educational attainment, and prior experience of neighboring women with breast cancer were mentioned to be facilitators of early diagnosis of breast cancer. Conclusions The causes of late diagnosis of breast cancer in Ethiopia are multi-factorial and include individual, cultural, and health system factors. Interventions targeting these factors could alleviate the misconceptions and knowledge gap about breast cancer in the community, and shorten waiting time between symptom recognition and diagnosis of breast cancer.

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Section: Methodsmentioning

confidence: 99%

Perspectives of patients, family members, and health care providers on late diagnosis of breast cancer in Ethiopia: A qualitative study

et al. 2019

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“…This paper is part of an ongoing broader project described in detail in the published protocol 18. Briefly, the methods are summarised as follows.…”

Section: Methodsmentioning

confidence: 99%

“…A cross-sectional study was conducted based on data drawn from an ongoing follow-up study in Addis Ababa 18. A baseline survey was conducted among a cohort of 441 newly diagnosed female patients with breast cancer ages ≥18 years (diagnosed from 1 January 2017 to 30 June 2018) of Addis Ababa city.…”

Section: Methodsmentioning

confidence: 99%

Time intervals experienced between first symptom recognition and pathologic diagnosis of breast cancer in Addis Ababa, Ethiopia: a cross-sectional study

et al. 2019

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ObjectivesThis study aimed to estimate the magnitude of patient and diagnostic delays and associated factors among women with breast cancer in Addis Ababa.DesignThis is a cross-sectional study.Settings and participantsAll women newly diagnosed with breast cancer in seven major healthcare facilities in Addis Ababa (n=441) were included in the study.Main outcomes and measuresPatient interval (time from recognition of first symptom to medical consultation) and diagnostic interval (time from first consultation to diagnosis). Patient intervals >90 days and diagnostic intervals >30 days were considered delays, and associated factors were determined using multivariable Poisson regressions with robust variance.ResultsThirty-six percent (95% CI [31.1%, 40.3%]) of the patients had patient intervals of >90 days, and 69% (95% CI [64.6%, 73.3%]) of the patients had diagnostic intervals of >30 days. Diagnostic interval exceeded 1 year for 18% of patients. Ninety-five percent of the patients detected the first symptoms of breast cancer by themselves, with breast lump (78.0%) as the most common first symptom. Only 8.0% were concerned about cancer initially, with most attributing their symptoms to other factors. In the multivariable analysis, using traditional medicine before consultation was significantly associated with increased prevalence of patient delay (adjusted prevalence ratio (PR) = 2.13, 95% CI [1.68, 2.71]). First consultation at health centres (adjusted PR = 1.19, 95% CI [1.02, 1.39]) and visiting ≥4 facilities (adjusted PR = 1.24, 95% CI [1.10, 1.40]) were associated with higher prevalence of diagnostic delay. However, progression of symptoms before consultation (adjusted PR = 0.73, 95% CI [0.60, 0.90]) was associated with decreased prevalence of diagnostic delay.ConclusionsPatients with breast cancer in Addis Ababa have prolonged patient and diagnostic intervals. These underscore the need for public health programme to increase knowledge about breast cancer symptoms and the importance of early presentation and early diagnosis among the general public and healthcare providers.

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“…However, breast and cervical cancer are among the most common types of cancer in most east African countries, including Ethiopia. The mortality rate is comparable to that of other regions of the continent and significantly higher than that of the majority of developed countries [ 1 , 3 ]. The age-standardized BC mortality rates in East Africa and Ethiopia are 17.9 per 100,000 women and 22.9 per 100,000 women, respectively [ 1 , 5 ].…”

Section: Introductionmentioning

confidence: 90%

Breast Self-Examination Knowledge and its Determinants among Female Students at Addis Ababa University, Ethiopia: An Institution-Based Cross-Sectional Study

Getu

Abebe

Tlaye

et al. 2022

BioMed Research International

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Introduction. Breast self-examination is a noninvasive, low-cost screening method for breast cancer detection. A thorough awareness of breast self-examination enables the early detection of breast abnormalities and dramatically lowers breast cancer complications and mortality. The purpose of this study was to investigate the level of knowledge about breast self-examination and its associated factors among female students at Addis Ababa University, Ethiopia. Methods. An institution-based cross-sectional study design was employed. The final calculated sample size was 407, and participants were recruited using a proportionate stratified random sampling approach. For data entry and coding, EPI Data 3.1 statistical software was utilized, and for data analysis, SPSS version 18 was employed. The data was described using descriptive analysis. Bivariate and multivariate logistic regression analyses were performed to determine the strength of the association between the predictor and the outcome variables. A 95% confidence interval and a p-value of less than 0.05 were used to declare statistical significance. Results. The findings of this study revealed that 49.9% of respondents possessed good breast self-examination knowledge. Previously, urban residents were about two times more likely to have good knowledge of BSE than their rural counterparts (AOR =2.16, 95% CI (1.18–39.91), p =0.011). The odds of having good BSE knowledge were about three times more likely among those who had a good attitude than those who had a poor attitude (AOR =3.17, 95% CI (2.02–4.74), p <0.001). Those who knew someone with a diagnosis of breast cancer were almost three times more likely to have good knowledge than those who did not know (AOR =2.95, 95% CI (1.77-4.91), p <0.001). Conclusion. According to the findings of this survey, less than half of the students who participated had good knowledge of breast self-examination. This justifies raising awareness about breast self-examination among female students.

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Breast and cervical cancer patients’ experience in Addis Ababa city, Ethiopia: a follow-up study protocol

Cited by 12 publications

References 47 publications

Perspectives of patients, family members, and health care providers on late diagnosis of breast cancer in Ethiopia: A qualitative study

Perspectives of patients, family members, and health care providers on late diagnosis of breast cancer in Ethiopia: A qualitative study

Time intervals experienced between first symptom recognition and pathologic diagnosis of breast cancer in Addis Ababa, Ethiopia: a cross-sectional study

Breast Self-Examination Knowledge and its Determinants among Female Students at Addis Ababa University, Ethiopia: An Institution-Based Cross-Sectional Study

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