Patterns of Care of Cancers and Radiotherapy in Ethiopia

Abstract

PURPOSE Radiotherapy (RT) is an essential component of cancer treatment. There is a lack of RT services in sub-Saharan Africa as well as limited knowledge regarding clinical practices. The purpose of this study was to identify and describe the patterns for RT treatment in Ethiopia. METHODS AND MATERIALS We performed a retrospective analysis of 1,823 patients treated with cobalt RT at a large referral hospital in Addis Ababa, Ethiopia, from May 2015 through January 2018. Paper charts were reviewed for patient and treatment characteristics. Descriptive statistics were computed using SPSS (IBM, Armonk, NY). RESULTS Among patients treated for cancer, 98% (n = 1,784) were adults, 78% (n = 1,426) were female, 5% (n = 85) were HIV positive, 30% (n = 555) were from Addis Ababa, and the median age was 48 years (interquartile range [IQR], 38-58 years). Cervical cancer was the most frequent cancer treated (47%, n = 851), followed by breast cancer (15%, n = 274) and head and neck cancer (10%, n = 184). Seventy-three percent of patients (n = 1,339) presented at a late stage, and 62% (n = 1,138) received palliative RT. The wait times were the shortest for patients receiving palliative treatment (median, 0 days; IQR, 0-15 days; n = 1,138), whereas wait times were longer for patients receiving curative treatment (median, 150 days; IQR, 60-210 days; n = 685). Three percent of patients (n = 56) had documented grade 3 or 4 acute toxicity; of these, 59% (n = 33) were patients with head and neck cancer. CONCLUSION Cervical cancer accounted for half of patients treated; thus, a majority of patients were adult females. Most patients had advanced-stage cancer, and goals of care were palliative. Wait times were long for patients with curative-intent cancer as a result of low capacity for RT services.

Practice of Oncology in Low- income Setting: A Review of Four Years Activities in Togo

“…The mean age in our study was 52.73±14.33years. This mean age is similar to that reported in Ghana [9]and Ivory Coast [10] but higher than those reported in Nigerian [11] and Ethiopian patients [12].…”

“…The majority of patients in the study were female. This feminine predominance has already been reported in Togolese patients by Amégbor [7] and has also been observed in other studies in Africa [9,12,15]. This can be explained by the large proportion of breast and cervix cancer in our patients.…”

Radiotherapy Practice for Treatment of Bone Metastasis in Ethiopia

“…The methods have been described previously. 7 Inclusion of all patients treated during the study period was not considered feasible because of difficulty locating paper charts from incomplete registration data in an overcrowded file room.…”

“…Priority is given to palliative patients; thus, the median waiting time for curative-intent therapy is 5 months. 7 The purpose of this study was to describe and highlight the current patterns of palliative RT for symptomatic bone metastasis in a large and populated country in sub-Saharan Africa with severely limited RT capacity to advise institutional guidelines for the most effective and cost-efficient regimens.…”

Cancer care and COVID-19: tailoring recommendations for the African radiation oncology context

“…Moreover, treatment decision to omit, delay or modify radiotherapy protocols requires a careful balance of risks, benefits and health-seeking behaviour of the population, especially in the African context with low health literacy, reduced uptake of adequate pain medication and access to other palliative care options. Majority of radiotherapy departments in Africa are faced with a shortage of adequate radiotherapy facilities and skilled human resources resulting in long waiting lists which could be as long as a median of 110 days in a south Africa or 150 days in Ethiopia for curative cases [11,12]. Large numbers of patients, most of them travelling long distances, are crowded waiting to be admitted into the facility, only a few can be admitted in at a time or cannot be accompanied by family.…”