Experience of Initial Symptoms of Breast Cancer and Triggers for Action in Ethiopia

Objective. This study assessed the initial experiences, symptoms, and actions of patients in Ethiopia ultimately determined to have breast cancer. Methods. 69 participants in a comprehensive breast cancer treatment program at the main national cancer hospital in Ethiopia were interviewed using mixed qualitative and quantitative approaches. Participants' narratives of their initial cancer experience were coded and analyzed for themes around their symptoms, time to seeking advice, triggers for action, and contextual factors. The assessment was approved by the Addis Ababa University Faculty of Medicine Institutional Review Board. Results. Nearly all women first noticed lumps, though few sought medical advice within the first year (average time to action: 1.5 years). Eventually, changes in their symptoms motivated most participants to seek advice. Most participants did not think the initial lump would be cancer, nor was a lump of any particular concern until symptoms changed. Conclusion. Given the frequency with which lumps are the first symptom noticed, raising awareness among participants that lumps should trigger medical consultation could contribute significantly to more rapid medical advice-seeking among women in Ethiopia. Primary care sites should be trained and equipped to offer evaluation of lumps so that women can be referred appropriately for assessment if needed

Social and cultural dimensions of hygiene in Cambodian health care facilities

<p>Abstract</p> <p>Background</p> <p>The frequency of bloodborne pathogen healthcare-associated infections is thought to be high in developing Southeast Asian Countries. The underlying social-cultural logics contributing to the risks of transmission are rarely studied. This report provides some insights on the social and cultural factors that shape hygiene practices in Cambodian health care settings.</p> <p>Methods</p> <p>We conducted qualitative surveys in various public and private health facilities in Phnom Penh, the capital city and in provinces. We observed and interviewed 319 participants, health care workers and patients, regarding hygiene practices and social relationships amongst the health care staff and with patients. We also examined the local perceptions of hygiene, their impact on the relationships between the health care staff and patients, and perceptions of transmission risks. Data collection stem from face to face semi-structured and open-ended interviews and focus group discussions with various health care staffs (i.e. cleaners, nurses, midwives and medical doctors) and with patients who attended the study health facilities.</p> <p>Results</p> <p>Overall responses and observations indicated that hygiene practices were burdened by the lack of adequate materials and equipements. In addition, many other factors were identified to influence and distort hygiene practices which include (1) informal and formal social rapports in hospitals, (2) major infection control roles played by the cleaners in absence of professional acknowledgment. Moreover, hygiene practices are commonly seen as an unessential matter to be devoted to low-ranking staff.</p> <p>Conclusion</p> <p>Our anthropological findings illustrate the importance of comprehensive understanding of hygiene practices; they need to be considered when designing interventions to improve infection control practices in a Cambodian medical setting.</p

Injections: A fatal attraction?

The abuse of injections in the developing world has reached alarming proportions in recent years. Formal as well as informal health providers administer far too many injections to clients who perceive this form of treatment as superior to all other forms of medicine administration. Often sterilization procedures are less than adequate or non-existent, thereby increasing the risk of spreading HIV and infectious diseases to all segments of the population. Very little is at present known about why injections are so popular or the extent to which they are administered in the various health care sectors in developing countries. This article gives an overview of the present state of knowledge and highlights the need for further information in order to address the problem appropriately. It is suggested that the quest for injections may be seen as part of some general trends of change in the developing world. The article also indicates some of the important areas for further research.injections developing countries HIV-infection informal health sector culture