School of Public Health

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Browsing School of Public Health by Subject "abnormalities"

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    Early detection, referral and outcome of breast abnormalities at selected primary health care facilities in Addis Ababa: A multi-center mixed method study
    (Addis Ababa University, 2024-06) Alebachew,Bethlehem Fiseha; Getachew,Sefonias (MPH, PhD); Genene,Lidya (MPH)
    Background; There are more than 2.3 million cases of breast cancer each year, making it the most common form of cancer. Benign breast conditions, which are not studied well in Ethiopia, together with misdiagnosis and the knowledge gap among health professionals, make the burden even worse. Therefore, this study is crucial in bridging the knowledge gap with this regard. Objective; The aim of this study was to assess the magnitude of patients with breast abnormalities; referral; and professionals’ knowledge about breast cancer early detection work at selected primary health care facilities in Addis Ababa in 2024. Methods; A multi-center, mixed-method study using a multi-stage sampling method was conducted at primary healthcare facilities. The quantitative study, which was a retrospective cross sectional study, was conducted on all case note audits of patients for year 2023 to assess magnitude and patient outcomes. The other quantitative study had a cross-sectional design and a self-administered questionnaire was provided to health care professionals to assess their knowledge about breast cancer early detection work. The data was collected using Open Data Kit. The qualitative study was conducted with phenomenological study approach. The quantitative data was analyzed using STATA version 14 software. Descriptive statistics was done using frequency and percentages. Categorical data analysis and binary logistic regression were also done. Odds Ratio with its 95% Confidence Interval was used as a measure of association. Variables having a p value less than 0.05 in the multivariable model were considered as having significant association with the dependent variable. Results; The prevalence of breast abnormalities at the selected health facilities was 170.31 per 100,000 population among adult population and 109.14 per 100,000 female populations among women 30 and older. Patient delay was more than 30 days in 23.5% (85) of the cases. Only 14.9% (54 of the patients were referred to the next health facilities and physical examination was done only for 20.4% (74) of them. Of the health professionals, 27.6% (137) were knowledgeable (95%CI (0.24, 0.32)). Among trained health professionals, 72.7% (32) had poor knowledge. Work experience (AOR=5.61, 95% CI, (1.32, 23.9)); and risk factor identification (AOR=3.53, 95% CI, (1.66, 7.50)) were factors affecting knowledge of health professionals about breast cancer early detection work. The qualitative findings confirmed and explained the quantitative study findings such as absence of referral feedback, screening services and diagnostic investigations; poor knowledge of health professionals; and patient and healthcare related delays. Conclusions; There is higher prevalence of breast abnormalities among age 30 and above. Only 14.9% (54) of the patients were referred to the next health facility. Absence of diagnostic investigations and referrals with incomplete information together with absence of referral feedbacks deterred the referral experience. Majority of primary healthcare professionals have poor knowledge of breast cancer early detection work resulting in misdiagnosis and negligence. Trainings were given for very few of the health professionals and it was not effective that majority of the trained ones were not knowledgeable.