Oncology

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Adherence to ‘Choosing Wisely Africa’ Guidelines in Breast Cancer Care: A Cross-Sectional Survey of Public Hospitals in Addis Ababa, Ethiopia
(Addis Ababa University, 2025-07-12) Veronica Afework; Endale Anberber,; Girmaye Tamirat
Background: Breast cancer is the most common malignancy among women in Ethiopia, yet disparities exist in access to evidence-based care. The Choosing Wisely Africa (CWA) initiative provides recommendations to promote high-value breast cancer care, but hospital-level adherence in Ethiopia remains poorly documented. Objective: To assess hospital adherence to CWA guidelines in breast cancer care in Addis Ababa, focusing on multidisciplinary team (MDT) use, diagnostic staging, histopathology services, and neoadjuvant therapy provision. Methods: A descriptive cross-sectional survey was conducted among ten hospitals providing breast cancer care in Addis Ababa, comprising three teaching tertiary hospitals and seven non-teaching secondary hospitals. A structured questionnaire captured data on MDT practice, vi staging investigation, histology confirmation, and neoadjuvant therapy. Descriptive statistics were used to summarize adherence to CWA guidelines. Results: Two of the three teaching hospitals reported regular MDT meetings, access to mammography, ultrasound, and histopathology services, and routine provision of neoadjuvant therapy when indicated. In contrast, none of the non-teaching hospitals had an MDT, mammography, or histopathology diagnosis based on core needle biopsy. Neoadjuvant therapy was available only in one non-teaching hospital, which was reported to treat fewer than 25% of eligible patients, primarily due to long waiting times. Adherence to the CWA guidelines was substantially higher in teaching hospitals (66.7%), while none of the non-teaching hospitals attained it, resulting in an overall adherence of 20%. Conclusion: This study highlights important disparities in hospital-level adherence to CWA recommendations in Ethiopia. Strengthening MDT implementation, diagnostic services, and neoadjuvant treatment capacity in secondary hospitals is critical to ensuring equitable and evidence-based breast cancer care.
Survival Outcomes in Patients with Brain Metastases Treated with Whole Brain Radiotherapy
(Addis Ababa Uinverstiy, 2025) Henok Tesfaw; Munir Awol
Introduction: Brain metastases are the most common intracranial tumors in adults and are associated with poor prognosis. In low resource settings such as Ethiopia, whole brain radiotherapy (WBRT) remains the primary treatment option for most patients due to limited access to stereotactic radiosurgery and neurosurgical services. However local evidence regarding survival outcomes and prognostic factors following WBRT is scarce. Objective : To assess overall survival and identify prognostic factors influencing survival among patients with brain metastases treated with whole brain radiotherapy at Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia. Methods : A retrospective study was conducted among adult patients with radiologically confirmed brain metastases who received WBRT between April 2020 and April 2024. Data were extracted from medical records and radiotherapy logs using a standardized checklist. Overall survival was estimated using the Kaplan Meier method and group comparisons were performed using the log rank test. Univariable and multivariable Cox proportional hazards regression analyses were employed to identify independent predictors of survival. Results : A total of 70 patients were included in the analysis. The median overall survival from initiation of WBRT was 4.7 months (95% CI: 3.7–5.7). The 6 month and 12month overall survival rates were 38% and 14%, respectively. On multivariable analysis, Karnofsky Performance Status (KPS) ≥70 was independently associated with improved survival, while delays in initiating WBRT beyond four weeks from diagnosis of brain metastases were associated with significantly worse survival outcomes. Conclusion : Survival outcomes for patients with brain metastases treated with WBRT at Tikur Anbessa Specialized Hospital remain poor. Performance status and timely initiation of radiotherapy are key determinants of survival. Strengthening early diagnosis, streamlining referral pathways and improving access to timely radiotherapy may improve outcomes in this resource limited setting.
Treatment Patterns and Survival of Patients With Oral Cavity Cancer: A Retrospective Analysis at Tikur Anbessa Specialized Hospital, 2022–2024
(Addis Ababa Uinverstiy, 2025) Woldemariam Beka; Yonas Dandana
Oral cavity cancer is an important cause of morbidity and mortality globally, with a Disproportionate burden and late presentation in low- and middle-income countries. There is limited published data in the field from Ethiopia. This study aimed to describe the clinical and pathological characteristics, treatment patterns, and survival of oral cavity cancer patients treated at Tikur Anbessa Specialized Hospital (TASH), the country’s major tertiary oncology referral center. Methods: A retrospective study was conducted on all adult patients with primary oral cavity squamous cell carcinoma registered between January 1, 2022, and December 31, 2024, at Tikur Anbessa Specialized Hospital. Data were extracted from electronic medical records, patient charts, and radiotherapy registries. Descriptive statistics and Kaplan-Meier survival analysis were used to analyze the data, and multivariable Cox regression was used to identify independent predictors of survival. Results: The study population had a median age of 50 years (interquartile range [IQR]: 42–58), with a male-to female ratio of 2:1. The median duration of symptoms was six months (interquartile range [IQR]: 3-12), and 43% of patients presented with oral ulcers. Most patients presented with advanced disease, with 75 (82.4%) having clinical T3–T4 tumors and 66% being node-positive. The majority had Grade 1 cancer, and higher-grade tumors were associated with a higher N stage. The oral tongue was the most frequently affected subset, Accounting for 58 (63.7%) cases. Most participants had good performance status (71, 78%), and comorbidities were uncommon (15, 16%). Treatment was multimodal in 20 (22.0%), single modality in 28 (30.8%), and palliative in 31 (34.1%). Surgery was performed in 38 (41.8%) patients, curative radiotherapy in 31 (34.1%), and concurrent chemotherapy in 19 (20.7%). The median survival was 15.5 months, with 1- and 3-year survival rates of 57.8% and 32.4%, respectively. Advanced stage at presentation and lack of multimodality treatment were identified as independent predictors of poor survival. Conclusion: The study shows that patients with oral cavity squamous cell carcinoma present at advanced stage. Overall survival is low and influenced by disease stage and access to curative treatment, underscoring the need for early detection, timely intervention, and improved treatment delivery in resource-limited settings.
Treatmet Outcome and Pattern of Radiotherapy Utilization of Pediatrics Rhabdomyosarcoma at Tikur Anbessa Specialized Hospital; Ethiopia 5 Year Retrospective Study
(Addis Ababa University, 2025-12-01) Samson Zerihun; Adugna Fekadu
Background: Rhabdomyosarcoma is the Most Common Pediatric Soft Tissue Sarcoma. In Low Income Countries RMS Treatment Is Challenging Unlike Improved Outcome in His. Unable To Get Timely Radiotherapy Access and Being Higher Stage Presentation for Surgery Is Main Determinate Factor for Inferior Outcome of Pediatric RMS In Sub-Saharan Countries Including Ethiopia. This Study Is Expected to Provide Valuable Insights About Current Pattern of RT Utilization and Treatment Outcomes. Objective: The Study Aim was to Assess Treatment Outcomes and Pattern of Radiation Therapy Utilization, In Pediatrics RMS At TASH Between January 2021 and September 2025 Methods: Retrospective Cohort Study Was Conducted from January 2021 to September 2025 and 94 Eligible Patients Were Included. Data Collected from the Radiotherapy System and Chart of The Patients. Analysis Was Performed Using SPSS Version 25 Software and Kaplan-Meier Method Was Used to Estimate Survival. Cox Proportional Hazards Regression Analysis Was Done to Identify Independent Prognostic Factors Associated to Survival Result: All Eligible 94 Patients Chart Analyzed, This Study Showed Majority of Them Are Embryonal Histology, Head and Neck Site, 44.7% Of Patients Received Radiotherapy With 33% Interruption and Delayed Interval from Chemotherapy. Estimated 24-Month Survival Time Is 18% And EFS 35%. Surgery And Radiotherapy Was Significantly Associated Independent Factor for Event Free Survival. Conclusion: Children With RMS Present with Locally Advanced Stage. There Is Low Access of Local Treatment and RT Is Given After Delayed Time of Recommendation and Interruption. This Result Lower Local Control and Poor Survival.
Treatment Outcomes and Prognostic Factors in Patients with Locally Advanced Cervical Cancer Treated with Definitive Concurrent Chemoradiotherapy: A Four Years Prospective Study in Tash Oncology Center, Addis Abeba, Ethiopia
(Addis Ababa University, 2025-12-07) Elsabet Abnew; Sonia Worku
Background: Locally Advanced Cervical Cancer Continues to Be a Major Cause of Morbidity and Mortality Among Women, With Concurrent Chemoradiation (CCRT) Being the Recommended Treatment for Locally Advanced Disease. However, Prospective Data on Treatment Outcomes and Prognostic Factors Remain Limited in Ethiopia Specially in the LINAC Era. Methods: A Prospective Study of Locally Advanced Cervical Cancer Patients Who Received Definitive CCRT From January 2022 to July 2025 Was Employed. Survival Outcome Was Estimated by Using Kaplan-Meier Curves. Univariant And Multivariant Cox Proportional Model Was Employed to Evaluate the Effect of Various Factors On RR, DFS And OS. Results: Between January 1/2022 and July1/2025, A Total Of 167 Patients Diagnosed with Locally Advanced Cervical Cancer Managed with Curative-Intent Radiotherapy Were Enrolled. The Median Age of Patients Was 53.5 Year (IQR 45–62). In This Study 66.5% Of Patients Received a Brachytherapy Boost While an EBRT Boost Was Used In 18.5% Of Cases. Concurrent Chemotherapy Was Administered In 64.5% Of Patients. Of 167 Patients, 118 (70.7%) Achieved Complete Response (CR) At 3 Months. Among The 118 Patients Analysed, 69.5% Experienced No Recurrence During the Follow-Up Period. Recurrence Was Observed In 30.5%. The 2-Year Overall Survival (OS) Was 73%, And The 2-Year Disease Free Survival (DFS) Was 71% Based on the Kaplan–Meier Estimates. Late Radiation-Induced Adverse Events Were Documented In 82 Patients (49.1%). No Late Toxicity Was Reported For 59 Patients (35.3%), While the Status Was Unknown or Not Assessable For 26 Patients (15.6%). Conclusion: This Prospective Study Shows That Definitive Radiotherapy with Concurrent Chemotherapy and Brachytherapy Provides Clinically Meaningful Response Rates, Survival Outcomes, And Manageable Toxicity Profiles for Patients with Locally Advanced Cervical Cancer Treated at Tikur Anbesa Specialized Hospital in the LINAC Era. The Observed Two-Year Overall and Disease-Free Survival Rates Align with Existing Evidence Supporting of Concurrent Chemoradiotherapy as the Standard of Care in This Setting.
Treatment Outcomes and Prognostic Factors in Patients with Locally Advanced Cervical Cancer Treated with Definitive Concurrent Chemoradiotherapy: A Four Years Prospective Study in Tash Oncology Center, Addis Abeba, Ethiopia
(Addis Ababa University, 2025-12-07) Elsabet Abnew; Sonia Worku
Background: Locally Advanced Cervical Cancer Continues to Be a Major Cause of Morbidity and Mortality Among Women, With Concurrent Chemoradiation (CCRT) Being the Recommended Treatment for Locally Advanced Disease. However, Prospective Data on Treatment Outcomes and Prognostic Factors Remain Limited in Ethiopia Specially in the LINAC Era. Methods: A Prospective Study of Locally Advanced Cervical Cancer Patients Who Received Definitive CCRT From January 2022 to July 2025 Was Employed. Survival Outcome Was Estimated by Using Kaplan-Meier Curves. Univariant And Multivariant Cox Proportional Model Was Employed to Evaluate the Effect of Various Factors On RR, DFS And OS. Results: Between January 1/2022 and July1/2025, A Total Of 167 Patients Diagnosed with Locally Advanced Cervical Cancer Managed with Curative-Intent Radiotherapy Were Enrolled. The Median Age of Patients Was 53.5 Year (IQR 45–62). In This Study 66.5% Of Patients Received A Brachytherapy Boost While an EBRT Boost Was Used In 18.5% Of Cases. Concurrent Chemotherapy Was Administered In 64.5% Of Patients. Of 167 Patients, 118 (70.7%) Achieved Complete Response (CR) At 3 Months. Among The 118 Patients Analyzed, 69.5% Experienced No Recurrence During the Follow-Up Period. Recurrence Was Observed In 30.5%. The 2-Year Overall Survival (OS) Was 73%, And The 2-Year Disease Free Survival (DFS) Was 71% Based on the Kaplan–Meier Estimates. Late Radiation-Induced Adverse Events Were Documented In 82 Patients (49.1%). No Late Toxicity Was Reported For 59 Patients (35.3%), While the Status Was Unknown or Not Assessable For 26 Patients (15.6%). Conclusion: This Prospective Study Shows That Definitive Radiotherapy with Concurrent Chemotherapy and Brachytherapy Provides Clinically Meaningful Response Rates, Survival Outcomes, And Manageable Toxicity Profiles for Patients with Locally Advanced Cervical Cancer Treated at Tikur Anbesa Specialized Hospital in the LINAC Era. The Observed Two-Year Overall and Disease-Free Survival Rates Align with Existing Evidence Supporting of Concurrent Chemoradiotherapy as the Standard of Care in This Setting.
Treatment Outcome of FOLFOX Versus Carboplatin–Paclitaxel as First Line Therapy for Advanced Squamous Cell Carcinoma of the Esophagus At TASH, Addis Ababa Ethiopia: A Comparative Retrospective Study.
(Addis Ababa University, 2025-12-01) Ikram Musa; Mathewos Assefa; Sonia Worku
Background: Esophageal Squamous Cell Carcinoma (ESCC) Is One of the Most Common Sub-Types of Esophageal Cancer in Sub-Saharan Africa. The Majority of Patients Present with Unresectable or Metastatic Disease Usually Accompanied with Malnourishment and Poor General Condition. FOLFOX And Carboplatin/Paclitaxel Are Used as First-Line Therapy for Advanced Diseases. Howev Er, There Is No Data on the Comparative Effectiveness and Safety of These Regimens Africa. Objective: To Compare the Treatment Outcome of FOLFOX Versus Carboplatin–Paclitaxel as First-Line Therapy for Advanced Squamous Cell Carcinoma of the Esophagus. Methods: Patients With Stage IV Esophageal Squamous Cell Carcinoma Treated Between Febru Ary 2023- February 2025 Who Met the Inclusion and Exclusion Criteria Who Were Included. Data Was Analyzed Using Descriptive Statistics, Kaplan-Meier Curves, Log-Rank Tests, And Multivariable Analysis to Compare Outcomes Between Treatment Groups. Results: A Total Of 55 Patients with Stage IV Esophageal Squamous Cell Carcinoma Were Include Ed, With A Median Age Of 56 Years. Thirty Patients (54.5%) Received Carboplatin–Paclitaxel And 25 (45.5%) Received FOLFOX. The Overall Response Rate Was Higher with Carboplatin–Paclitaxel Than FOLFOX At Both Mid-Cycle (67.9% Vs. 47.8%) And End-Cycle Assessments, With Greater Mean Tumor Reduction (66.3% Vs. 49.4%, P = 0.038). The Median Overall Survival (OS) For the Entire Cohort Was 9 Months (95% CI: 7.2–10.3), With A 1-Year OS Of 45%. Median OS Was 9.0 Months for Carboplatin–Paclitaxel And 8.0 Months For FOLFOX, With No Significant Difference Between Regimens (P = 0.286). Treatment-Related Toxicities Occurred In 52.7% Of Patients, Pre-Dominantly Hematologic. Grade 3–4 Neutropenia Was Observed In 10.9%. Severe Hematologic Toxicities Were More Common with Carboplatin–Paclitaxel (16.7% Vs. 4.0%), Whereas Peripheral Neuropathy Occurred More Frequently with FOLFOX (8.0% Vs. 0%).
Survival outcome and Treatment patterns in non-metastatic esophageal cancer patients who underwent curative intent treatment atTikur Anbesa Specialized Hospital, Ethiopia, A3-year retrospective study
(Addis Ababa Uinverstiy, 2025) Woinshet Zegey; Damena Teshome
Background: Esophageal cancer is among the leading causes of cancer-related morbidity and mortality worldwide, with a particularly high prevalence in East Africa. Due to the non-symptomatic nature of the disease at an early stage, patients usually present at an advanced stage. They are either treated with multimodality therapy with curative intent or just palliation of the symptoms once the disease is metastatic. In Ethiopia, most patients are diagnosed at advanced stages, with a substantial proportion being non-metastatic cases that remain eligible for curative treatment. These patients may therefore undergo curative-intent therapies, including surgery, chemoradiotherapy, radiotherapy, or a combination of these modalities. However, local data on treatment patterns and survival outcomes for these patients are lacking. Objective: To evaluate the survival outcome and treatment patterns of non-metastatic esophageal cancer patients treated with curative intent treatment at Tikur Anbesa Specialized Hospital (TASH), Ethiopia, between 2022 and 2025. Methods: A retrospective study was conducted by reviewing the medical records of patients diagnosed with non-metastatic esophageal cancer at TASH during the study period. Data on demographic characteristics, clinical characteristics, treatment modalities, and follow-up outcomes were extracted. Statistical analysis included descriptive summaries of treatment patterns, Kaplan–Meier survival estimates, and the log-rank test. A Cox proportional hazards model was used to identify predictors of survival outcome. Results: One hundred nineteen (119) patients who underwent curative-intent treatment for esophageal cancer at TASH over 3 years were included. The mean age was 51.9 years (SD: 12). Most study participants were females (65, 54.6%) and most of the patients (41, 34.5%) were from the Oromia region. As per the treatment patterns 57 (47.9%) received surgery alone 19 (16%) received CMT…(surgery with NAT/adjuvant therapy) and 43 (36.1%) received definitive RT/CRT. Of those who received CMT, 6 (5%) received surgery and CRT, 5 (4.2%) received surgery and RT, and 8 (6.8%) received surgery and chemotherapy. The median survival was 17 months, 95% CI (14.8, 19.1) The one-year, two-year, and three-year survival rates were 67.8%, 36.6%, and 14.5%, respectively. In the multivariable Cox proportional hazards model, patients who developed treatment related or postoperative complications had a significantly higher hazard of death compared with those without complications (HR=5.97; 95% CI: 2.85–12.5; p<0.001). Conclusion: In Ethiopia, the treatment pattern of non-metastatic esophageal cancer is heterogeneous and not in line with the standard treatment recommendation. And the median survival and the 3-year survival rate are low. Treatment related Complications are a significant determinant of poor survival.
Clinical characteristics, treatment pattern and survival of patients with biliary tract cancer: A five-year retrospective cohort study at Tikur Anbessa Specialized Hospital, Ethiopia.
(Addis Ababa Uinverstiy, 2025) Aklilu Sinte; Wondemagegnehu Tigeneh; Sonia Worku
Biliary tract cancers (BTCs); including intrahepatic and extrahepatic cholangiocarcinoma and gallbladder cancer—are rare but aggressive malignancies with rising global incidence and mortality. In low- and middle-income countries like Ethiopia, biliary tract cancer often presents at an advanced stage contributing to poor outcomes. To date, no published studies in Ethiopia have investigated treatment patterns and survival outcomes for biliary tract cancer patients Objectives: This study aims to investigated the clinical characteristics, treatment patterns and survival of biliary tract cancer patients at Tikur Anbessa Specialized Hospital from January 01, 2020 to September 01, 2025 in Addis Ababa; Ethiopia. Methods: A retrospective cohort study was conducted by reviewing medical records of adult patients diagnosed with biliary tract cancer from January 1, 2020 and September 01,2025. Data on demographics, clinical characteristics, treatment modalities (surgery, radiotherapy, chemotherapy), and survival was collected using standardized data collection tools. All data was analyzed by using SPSS version 25. Descriptive statistics was used to describe demography, clinical characteristics ,treatment modalities and survival pattern. Survival was estimated using Kaplan-Meier analysis. Uni-variant was performed to identify association of predictive factors (patient, disease and treatment related) with survival. Results: A total of 50 patient were analyzed; the median age of diagnosis was 55.61years old with SD±12.77. Female patient accounted 56%. About 38% of the patient had underlying comorbidities, 70% of the patient presented with abdominal pain, in 90% of the patient diagnosis was made with tissue confirmation, 54% the patient had elevated CA19.9. CT scan was done for most of the patients. The most common site was gallbladder cancer accounting 44%, 68% presented with metastasis and the rest were locally advanced and adenocarcinoma was the frequent histologic type(68%). Surgery was done for 17 patients and of this 6patient achieved complete resection. The most common first line systemic therapy was chemotherapy in 82% with cisplatin plus gemcitabine. About 22%(11) patient were found to have progressive disease following any first line therapy and 7 patients started second line systemic therapy with FOLFOX. By the time of data analysis about 70% patient were died with median overall survival of 6 month (95% CI, 4.85- 7.14 months),and 1- 2-, and 3-year overall survival of 28.6%, 11.4% and 2.9% respectively. Patient with underlying medical illness(Hypertension), first line chemotherapy with cisplatin plus gemcitabine who completed or received 6cyce and who achieved partial response had better median and overall survival. Conclusions: The survival outcomes of biliary tract cancer patients was very poor. Doublet chemotherapy is the commonest patterns of treatment. Being hypertensive and receiving 6 cycles of doublet systemic chemotherapy were associated with improved survival
The Prognostic Value of Neutrophil to Lymphocyte Ratio in Sespsis Among Adult Emergency Patients at Tikur Anbessa Specialized Hospital (TASH) And Zewditu Memorial Hospital (ZMH) , Addis Ababa, Ethiopia
(Addis Ababa University, 2025-12-12) Awetahegn Ephrem; Birhanu Tesfaye; Gedefaw Tigabu
Background: - Sepsis Is Life-Threatening Condition Resulting from a Deregulated Immune Response to Infection with High Morbidity and Mortality Particularly in Low- And Middle-Income Countries Such as Ethiopia. The Significant Burden of Sepsis in Ethiopian Emergency Departments Underscores the Need for Improved Diagnostic Tools and Treatment Strategies. The Neutrophil-To Lymphocyte Ratio (NLR) Has Emerged as a Promising Biomarker That May Predict Clinical Outcomes in Sepsis, Yet Its Utility Is Ethiopian Context Remains Unexplored. Objective: - The Prognostic Value of Neutrophil to Lymphocyte Ratio in Sepsis Among Adult Emergency Patients at Tikur Anbessa Specialized Hospital (TASH) Addis Ababa and Zewditu Memorial Hospital (ZMH), Ethiopia Multicenter Prospective Cross-Sectional Study Methods: - The Study Was Conducted at TASH & ZMH In the Emergency Department. The Research Design Used for This Study Is Institutional-Based Prospective Cross-Sectional Study Design, Which Involves Collecting Data at Over 3 Months Period from Selected Sepsis Patients After Diagnosis by SOFA Guideline Admitted at the Emergency. The Data Were Collected from Aug 15- November 30, 2025, Through A Standard Checklist and Laboratory Results by a Data Collector. Results: Among The Study Population, 58% Recovered While 42% Died. Non-Survivors Had Higher WBC Counts, Neutrophil Percentages, And Markedly Elevated NLR At Admission (24.52) Compared to Survivors (14.1). NLR After Treatment Remained Significantly Higher in Non-Survivors (28.99 Vs. 11.46). ROC Analysis Showed That NLR Had a Moderate Predictive Accuracy with an AUC Of 0.713 (95% CI: 0.618–0.808; P=0.000). Conclusion: The Findings Align with Extensive Literature (21–30) Showing That Elevated NLR Is Consistently Associated with Poor Prognosis, Severity, And Increased Risk of Death. Routine NLR Monitoring May Enhance Early Risk Stratification and Guide Timely Clinical Interventions in Sepsis Care. Work Plan – The Total Research Work from Title Selection to Presentation Was Completed In 6 Months
Prevalence of Chondromalacia Patella and Its Association with Patellofemoral Joint Morphology among Adults in Ethiopia at Pioneer Diagnostic Center: An Institution-Based Cross-Sectional MRI Study.
(Addis Ababa University, 2025) Seid Mohammed; Hiwot Gezahegn; Bemnet Taye; Mesfin Mulugeta; Moges Zenebe; Daniel Admassie
Background Chondromalacia patella (CP) is characterized by chondral damage of the patellar articular surface, ranging from cartilage softening to fissuring and full-thickness loss. It is a frequent cause of anterior knee pain, and has been associated with altered patellofemoral joint morphology and abnormal tracking. Despite its clinical importance, there is limited evidence from sub-Saharan Africa, and as far as our knowledge, no study from Ethiopia has yet examined the burden of CP or its morphological associations using magnetic resonance imaging (MRI). Objective The primary objective of this study is to determine the prevalence and severity of CP on knee MRI among adult patients. In addition, we aim to evaluate patellofemoral morphological and tracking parameters and investigate their association with CP. Material and methods An institution-based retrospective cross-sectional study was conducted, in which 333 knee MRI examinations were systematically sampled and reviewed. Each MRI was assessed for the presence and grading of chondromalacia patella, along with measurements of standard patellofemoral morphological parameters. To ensure reliability, both intra-observer and interobserver agreement were evaluate Results Chondromalacia patella was identified in 189 cases (59.8%). Both intra-observer and interobserver reliability demonstrated strong agreement. Chondromalacia patella showed a significant correlation with both sex and age. Among the patellofemoral morphological parameters assessed, only patellar height index and patellar tilt demonstrated significant associations with CP. The patellar height index was higher in the CP group (1.256 ± 0.233) compared with the non-CP group (1.19 ± 0.202) (p = 0.007). Similarly, the patellar tilt angle was greater in the CP group (11.45 ± 6.72°) than in those without CP (10.02 ± 6.22°) (p = 0.047). Conclusion Chondromalacia patella is a common pathology in our study population. Patellar height index and patellar tilt significantly influence the risk of patellar cartilage degeneration.
Treatment Outcome and Associated Factors Among Colorectal Cancer Patients in Tikur Anbessa Hospital, Ethiopia: A Prospective Cohort Study
(Addis Ababa University, 2023-01) Tessema,Girum; Assefa,Mathewos(Ass.Prof.); Getachew,Assefa(Ass.Prof.); Jemal,Ahmedin( D.V.M,PHD)
Background: Colorectal cancer (CRC) is the third most common cancer death in both sexes worldwide. Several studies revealed that advanced-stage at diagnosis and treatment delay negatively affects patient outcome. However, in Ethiopia, the treatment outcome, the time to diagnosis, and initiation of treatment have not been well studied before. Therefore, this study aimed to evaluate the treatment outcome and the prognostic factors of CRC patients at Tikur Anbessa Specialized Hospital. Methods and Materials: An institution-based prospective cohort study was carried out on 209 CRC patients at the Oncology Center of Tikur Anbessa Specialized Hospital (TASH) and those who met the eligibility criteria were included in our study from January 2020 to September 2022. Patient interval, diagnosis interval, and treatment interval of more than 30, 14, and 30 days were used to categorize patient, diagnosis, and treatment delays respectively. Simple descriptive analysis using frequency, proportion, mean with SD, and the median was applied for sociodemographic and clinical characteristics. For overall survival and progression-free survival, the Kaplan-Meier curve is applied. To see the one to one association between dependent and independent variables, we used bivariate cox analysis and a p value of < 0.25 used for further analysis. To find the prognostic indicators for survival, multivariate cox regression is performed, and a statistically significant value is P < 0.05. Result: The mean age of CRC diagnosis was 49.38(SD=15) years. More than half of the patients were male 119(56.9%). More than three fourth of the patients (79.4%) presented with advanced stage. Delay in a patient, diagnosis, surgery, and chemotherapy (CT) were seen in 93.8%, 81.2%, 75.4%, and 85.4% of patients respectively. Overall mortality is 67.46% (95% CI: 61.0, 74.0) and the 1-year overall survival (OS) is 63.16% (95% CI: 56.23, 69.29). The median OS is 17 months and the median progression free survival (PFS) is 11 months. On multivariate cox regression, the poor prognostic factors for overall survival are; Age >40 (HR=1.53, 1.02 - 2.29, P 0.040), Lower level of education (high school & below), (HR=2.20, 1.24-3.90, P 0.007), poor performance status (HR=1.60, (1.03 - 2.48, P 0.035), Hgb ≤ 12.5 g/dl (HR=1.55,1.03-2.08, p 0.035), T-4 disease (HR=6.05, 2.28-16.02, p 0.000) and metastases at diagnosis (HR= 8.53, 3.77-19.25, p 0.000). Conclusion: The overall survival rate of CRC patients’ is very poor. The advanced stage upon presentation, poor functional status, and a lack of timely treatment initiation are all key contributors to poor survival. Few patients were diagnosed and treated in a reasonable timeframe. We recommend that to improve CRC cancer awareness in the community, health professionals to avoid overlooking CRC in symptomatic patients and improve access to diagnostics and timely treatment. The health sector should prioritize the expansion of cancer centers with the goal of cure.
Assessment of GI-Related Quality of Life Among Cervical and Endometrial Cancer Patients Who ReceivedCurative Radiotherapy at Black Lion Specialized Hospital, Addis Ababa,Ethiopia.
(Addis Ababa University, 2023-12) Ahmed,Hamza; Awol,Munir (MD, Ass.Prof.)
Background: Radiation related GI symptoms such as radiation proctitis, enteritis or colitis is a relatively common yet less researched side effect of gynecologic radiotherapy. Beyond the symptoms, affected patients will have significantly low quality of life and impairment of activities of daily living. Objective: The aim of this study was to assess the symptoms prevalence, quality of life of patients who took radiotherapy for cervical and endometrial cancer, identify associated factors among patients who completed curative gynecologic radiotherapy at TASH radiotherapy center between June 2023 and November 2023. Methods: A hospital-based cross-sectional study was conducted on 68 Patients who took combined intracavitary and EBRT between June 2023 and November 2023 for cervical and endometrial cancer and fulfill the inclusion criteria for the study. Quality of life was assessed based on EORTC-QLQ-PRT-20 questionnaire and analyzed accordingly. Mann-Whitney U test and Spearmans Correlation test were used and statistical significance was determined at P value less than 0.05 Result: The mean age of the study participants was 52 years and 48 of the 68 patients (70%) reported at least one abnormal symptom. The mean symptom score for bowel and gas, leakage, bowel control, pain and emotion were 32.0, 3.4 ,6.8 ,8.0 and 13.8. Non parametric tests showed significant association between pain score and bladder volume, pain score and number of cycles,bowel control and total rectal EQD2 and bowel gas with maximum rectal diameter and pain score with Period after RT completion (acute vs chronic) Conclusion: GI related quality of life of uterine and cervical cancer patients after radiotherapy is significantly affected and better patient care and follow ups are needed.
Survival Outcomes of Vulvar Cancer Patients at Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia: A retrospective Cohort Study, 2024
(Addis Ababa University, 2024-10-13) Binyam Esayas; Esayas Berhanu
Vulvar cancer is a rare condition, representing only 4% of gynecological malignancies, with an estimated 26,800 new cases worldwide. According to data from the Addis Ababa City Cancer Registry (AACCR) in 2012, the age-standardized incidence of vulvar cancer was 1.4 cases per 100,000 women annually in Addis Ababa (1,2,3). In Ethiopia, there are few studies that have evaluated the survival outcomes of patients with vulvar cancer.
Risk factors for fatigue among cancer patients attending cancer center of Tikure Anbessa Specialized Hospital in Addis Ababa, Ethiopia, 2023: unmatched case-control study
(Addis Ababa University, 2023-06) Kumsa,Lenjisa; Tadele,Niguse (Ass.Prof.); Bizuwork,Keteme
Background:Even though cancer-related fatigue (CRF) is a highly prevalent and distressing symptom, its risk factors are mostly under assessed and reliable information on the causes of fatigue in the Ethiopian population is scarce and needs further investigation Objective: To investigate the possible risk factors for fatigue among cancer patients attending the Tikure Anbessa Specialized Hospital in Addis Ababa, Ethiopia. Material and Methods: From January 2023 to May 2023, an institution-based, unmatched case-control study was conducted at Tikure Anbessa Specialised Hospital (TASH) in Addis Abeba, Ethiopia, on 110 cases (cancer patients who received chemotherapy) and 220 controls (cancer patients who did not receive chemotherapy). Face-to-face interviews with potential study participants were used to choose them using a systematic random sampling technique. The fatigue evaluation scale was used to measure exhaustion. In order to fit a binary logistic regression (bi-variable and multi-variable) model, SPSS version 26 software was utilised. The strength and direction of the link were determined using an adjusted odds ratio with respect to the 95% confidence interval, and statistical significance was proclaimed at a p- value of <0.05. Results: This study found that the prevalence of fatigue were 77.2% cases,22.8% controls,95% CI: (73.1–81.1%) The mean ± standard deviation (SD) of the ages of the participants was 45.6±14.4 years, (74 =63.3%)cases and (96 = 43.6%) controls had a history of repeated admission, 51 (46.4%)cases and 88 (40%) controls with stage three cancer, alcohol consumption 81 (73.6%), 15 (13.6%), and 14 (12.7%) of the case 162 (73.6%), 37 (16.8%), and 21 (9.5%) of the controls, having depression (AOR: 2.83 (1.57, 5.10), chemotherapy use (AOR: 3.61 (2.10, 4.61), In contrast to this ,not having a history of anemia (0.68 (0.40, 1.14)),and anxiety(AOR: 0.24 (0.14, 0.40)). Conclusions and Recommendation:In this study, having depression and chemotherapeutic use increased the odds of sustaining fatigue symptoms. incontrast,not having anemia and anxiety reduced the odds of developing fatigue. Therefore, cancer patients with chemotherapy usersand those who had depression. Nurse shall consider fatigue as one of the vital sign in cancer patients and incorporate in vital sign sheet format. Furthermore, education programs on fatigue, etiology and treatment shall be given for the patients recommend that the focus of any action be on each of the identified relevant factors in order to reduce the burden of fatigue.
Realationship Between Nutritional Status and Quality of Life of Cervical Cancer Patients in Public Hospitals,Addis Ababa,Ethiopia,2023.
(Addis Ababa University, 2023-12) Tesfaye,Hiwot; Getahun,Negalign(Ass.Prof.); Tewfik,Nete(Bsc,Msc)
Awareness of Colorectal Cancer Warning Symptoms and Associated Factors among Adult Gastrointestinal Tract Outpatient Department Attendants in Tikur Anbesa Specialized Hospital
(Addis Ababa University, 2023-05) Zerihun,Tizita; Mulugeta,Tefera (BSN, MSN, Asst.Prof.); Tewfik,Nete(BSN, MSN)
Introduction: Colorectal cancer prevention and control measures should include public awareness creation about colorectal cancer sign and symptoms which has great role in early detection and effective treatment. Awareness of colorectal cancer warning symptom is not well known in Ethiopia particularly in Addis Ababa. Therefore, for effective intervention to control colorectal cancer there was a need to study about awareness of colorectal cancer warning symptoms in Addis Ababa Ethiopia. Objective: To assess awareness of colorectal cancer warning symptoms and associated factors among adult gastrointestinal tract outpatient department attendant at Tikur Anbesa Specialized Hospital, in Addis Ababa Ethiopia, 2023. Methods: This institution based cross-sectional study was conducted among 410 adult gastrointestinal tract outpatient department attendants at Tikur Anbesa Specialized Hospital from February 20/2023 to March 20/2023. Study participants were selected by using systematic sampling technique with 9 intervals. The response rate was 97.3%. Data was collected using ODK data collection tool and exported to SPSS version 7 for analysis. Bivariable logistic regression was used to select candidate variables at p-value <0.2 and Multivariable logistic regression was also used to identify significant variables associated with the outcome variable at and p-value <0.05. Model fitness was tested with Hosmer and Lemeshow goodness of fit (P-value=0.13). Result: One hundred twenty-four (30.2%) of the study participants had good awareness of colorectal cancer warning symptoms. Ever had any type of cancer AOR=3.64, 95%CI: 1.61- 8.28), regular health checkup (AOR=2.17, 95%CI: 1.05-4.49), being relative or friend with bowel cancer patient (AOR=5.28, 95%CI: 1.92-14.52), heard about colorectal cancer warning symptoms (AOR=3.25, 95%CI: 1.59-6.64) were significant variables associated with CRC warning symptoms. Conclusion and Recommendation: Nearly one third of study participants had good awareness of colorectal cancer warning symptoms. Factors associated with colorectal cancer warning symptoms include cancer history, health checkups, Friends/relatives of bowel cancer patients, heard about colorectal cancer warning symptoms. Hence, additional efforts are needed to raise awareness of colorectal cancer warning symptoms by considering the above important factors.
Dosimetrice valuation of Palliative Hypo fractionated Radiotherapy and its effect on clinical Outcome Inpatients With Vertebral Bone Metastasis Treated at Tikur Anbessa Specialized Hospital,Oncology Center, Addis Ababa,Ethiopia:An Institution -Based Retrospective Cross-Sectional Study.
(Addis Ababa University, 2023-12) Gulilat,Addis; Dandena,Yonas(Ass.Prof.); Belay,Eskadmas(PhD)
Thepurposeofthisstudywastoevaluatedosimetricparametersofthree-dimensional conformalradiotherapy(3D-CRT)andanalyzeitseffectonclinicaloutcomesincludingpain controlandtoxicity.Assessmentofthetreatmentplansinthestudywascarriedoutbasedon reporteddosimetricparameters,whereaspatientreportedpainscoreandtoxicitywereusedfor assessingresponse. Methods:Aninstitution-basedretrospectivecrosssectionalstudywasconductedfrom June– Sept2023.ThedatawascollectedusingKobotoolboxandwasexportedtoSPSSversion26 foranalysis.Statisticaltestsandanalysiswasconducted.Variablesweretastedfor significancep-value<0.05,andifp<0.02multiplelogisticregressionsanalysiswasdoneto determinetheeffectoffactorsontheoutcomevariableandtocontroltheconfoundingfactors. Atotalof97participantswhofulfilledtheinclusioncriteriawereselectedfrom thosepatients treatedusingHypofractionatedradiotherapy(HEBRT)from June1-Sep1,2023.Theywere retrospectivelyevaluatedat2monthsafterforRTpainandtoxicity.PatientreportedPain responsewascalculatedaccordingtointernationalstandardsofpainindexwhichtooktheuse ofanti-painintoaccount;calculatingdailyoralmorphineequivalentdose(OMED). Dose–volumehistogramsforPTV,(V95%,Dmean,Dmin,Dmax,CIandHI),andDoseexposure forOARswasassessed,(lungs,kidney,esophagusandbowl/intestine)dependingonwherethe spinallesionwaslocated,thenresultswerecomparedwithstandardrecommendations.In addition,effectofdosimetryonpainresponseandacutetoxicitywasassessed. Results:Theoverallpainresponsewas63%withcompleteresponse(CR)rateof24.7%.Only 43(44.7%)ofpatientshadreceivedtherecommended95-107%ofprescribeddose.About twentyfivepercent(24.7%)ofpatientshadDmax>110%,thelargestbeing117%.Acutetoxicity wasseenin36(37.1%)ofpatientsfrom these23.4%wassevere.Theconformityindexwas foundtobeb/n1-2in97%ofthecases.Incontrary,homogeneityindexwasdifferentfrom zero in100%ofthecases.OfpatientswhosemeandosewasmeasuredlungDmeanwas>13GYin 2(4.4%)patientswhilekidneyDmeanwas>18GY(EQD2)in1(1.5%).Thereasonforpoor coverage,highDmaxdoseandhighmeandoseforOARsmaybethewrongassumptionof consideringallpalliativepatientsasshortterm survivors,andadvancedpresentationwith diffusevertebralmetastasisresultingdifficultyonplanoptimization. Conclusion:Adeviationfrom recommendedvaluewasseeninD95%,Dmax,DmeanandHI.This suggestsasthereshouldbemoreefforttooptimizeplansandstrictlyevaluatetheDVH.Lack ofsignificancerelationonmultivariateanalysismaybeduetosamplesizeandthosecasesthat hadtoxicitymighthavemissedduetoearlydeath
Health Related Quality Life (HRQoL) Among Patients with Childhood Leukemia in Tikur Anbessa Specialized Hospital,Addis Ababa,Ethiopia,2023.
(Adiss Ababa University, 2023) Kelbessa, Megertu; Ayalew, Yohannes(Ass. Prof.); Dugassa, Boka
Background:There has been a paradigm shift in health service delivery to a more holistic approach, which considers Health Related Quality of Life (HRQoL) and overall functioning. HRQoL is a multidimensional construct that encompasses physical functioning as well as psychosocial aspects of emotional and social functioning. Childhood Leukemia is among threats to HRQoL to the patients and parents of the children, which trigger extensive studies on the subject. Objective:The study objectives were twofold. Primarily, the statuses of HRQoL of childhood leukemia patients in TASH were assessed. Secondly, factors affecting HRQoL among childhood leukemia patients in TASH were examined. Method:The study employed mixed research approach where descriptive design and explanatory research design concurrently utilized. Questionnaire distributed to sample of 422 respondents with 100% response rate. Data were analyzed through descriptive analysis, regression analysis and correlation analysis. Result:The study revealed that, f 422 patients (57% males) with leukemia; their ages ranged from 5 to 14 year (Mean = 8.58, Standard Deviation = 2.56). Age and gender had a significant and positive relationship with HRQoL of childhood leukemia in TASH. Male children were found to be more exposed to the disease, while an increase image improves physical functioning aspect HRQoL. Addiction free habit of parents had a positive relationship with HRQoL and school functioning at p < 0.05. Chemotherapy morbidity however worsens physical wellbeing of the patients. All other correlations were statistically non-significant. The current findings added to HRQoL research, and provided an impetus for more research in the area of HRQoL for children with leukemia in Ethiopia
Survival status and prognostic factors among breast cancer women at selected hospitals in southern Ethiopia, 2023.
(Addis Ababa University, 2023) Desta,Bitsiet; Argaw,Zeleke(Ass. prof.), Dugussa,Boka(Lecturer)
Introduction: Breast cancer is the major cause of morbidity and mortality worldwide, particularly in countries with limited resources. Patients in developing countries, particularly Ethiopia, are less likely to survive due to delayed diagnosis and advanced- stage presentations. Several studies have been conducted on the prognostic factors among breast cancer patients in Ethiopia, but they cannot consider neutrophils to lymphocytes as the prognostic factor. Objective: To assess the survival status and prognostic factors among Breast Cancer womenat selected hospitals in southern Ethiopia,2023. Methods: A retrospective cohort studywas conducted among 507 randomly selected breast cancer women in selected hospitals in southern Ethiopia.Two trained BSc nurses collected the data using an open data kit (ODK).Descriptive statistics were summarized using tables and graphs. The bivariable and multivariable Weibull regression modelswere used to identify the prognostic factors. The final model fitness was investigated using the Cox-Snail residual test, and the Schoenfeld residuals test was used to examine the proportional hazards assumption. Results:The overall survival of breast cancer women at the end of two and three years was 54.5% and 23.9%, respectively. An excellent and good Nottingham prognostic score (AHR: 0.26, 95% CI: 0.12, 0.53) and (AHR: 0.39, 95% CI: 0.18, 0.81), chemotherapy (AHR: 0.59, 95% CI: 0.36, 40.93), metastasis (AHR: 1.89, 95% CI: 1.31, 2.74), advanced stages (AHR: 1.73, 95% CI: 1.19, 2.51), hormone therapy (AHR: 0.64, 95% CI: 0.44, 0.92), and lower neutrophil to lymphocyte ratio (AHR: 0.68; 95% CI: 0.47; 0.97) were the prognostic factors of breast cancer women. Conclusion: This study revealed that the breast cancer survivorship rate was lower than that of an earlier study from Ethiopia. An increased ratio of neutrophils to lymphocytes at the time of diagnosis and a poor NPI were linked to a worse chance of survival for breast cancer women; this indicated that promoting early diagnosis of breast cancer and treatment could be important to improve the survival of breast cancer patients.

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