The global burden of adolescent and young adult cancer in 2019 : a systematic analysis for the Global Burden of Disease Study 2019

Background In estimating the global burden of cancer, adolescents and young adults with cancer are often overlooked, despite being a distinct subgroup with unique epidemiology, clinical care needs, and societal impact. Comprehensive estimates of the global cancer burden in adolescents and young adults (aged 15-39 years) are lacking. To address this gap, we analysed results from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019, with a focus on the outcome of disability-adjusted life-years (DALYs), to inform global cancer control measures in adolescents and young adults. Methods Using the GBD 2019 methodology, international mortality data were collected from vital registration systems, verbal autopsies, and population-based cancer registry inputs modelled with mortality-to-incidence ratios (MIRs). Incidence was computed with mortality estimates and corresponding MIRs. Prevalence estimates were calculated using modelled survival and multiplied by disability weights to obtain years lived with disability (YLDs). Years of life lost (YLLs) were calculated as age-specific cancer deaths multiplied by the standard life expectancy at the age of death. The main outcome was DALYs (the sum of YLLs and YLDs). Estimates were presented globally and by Socio-demographic Index (SDI) quintiles (countries ranked and divided into five equal SDI groups), and all estimates were presented with corresponding 95% uncertainty intervals (UIs). For this analysis, we used the age range of 15-39 years to define adolescents and young adults. Findings There were 1.19 million (95% UI 1.11-1.28) incident cancer cases and 396 000 (370 000-425 000) deaths due to cancer among people aged 15-39 years worldwide in 2019. The highest age-standardised incidence rates occurred in high SDI (59.6 [54.5-65.7] per 100 000 person-years) and high-middle SDI countries (53.2 [48.8-57.9] per 100 000 person-years), while the highest age-standardised mortality rates were in low-middle SDI (14.2 [12.9-15.6] per 100 000 person-years) and middle SDI (13.6 [12.6-14.8] per 100 000 person-years) countries. In 2019, adolescent and young adult cancers contributed 23.5 million (21.9-25.2) DALYs to the global burden of disease, of which 2.7% (1.9-3.6) came from YLDs and 97.3% (96.4-98.1) from YLLs. Cancer was the fourth leading cause of death and tenth leading cause of DALYs in adolescents and young adults globally. Interpretation Adolescent and young adult cancers contributed substantially to the overall adolescent and young adult disease burden globally in 2019. These results provide new insights into the distribution and magnitude of the adolescent and young adult cancer burden around the world. With notable differences observed across SDI settings, these estimates can inform global and country-level cancer control efforts. Copyright (C) 2021 The Author(s). Published by Elsevier Ltd.Peer reviewe

Enhancing utilization of health facility-based delivery among attendees of focused antenatal care in Addis Ababa, Ethiopia

The purpose of this study was to propose women-centered guidelines to enhance the utilization of health facility-based delivery among attendees of FANC in Addis Ababa, Ethiopia. A qualitative exploratory and descriptive research design was used to achieve the aims and objectives of the study. The design was contextual in nature.The study was conducted in three phases, using purposively selected attendees of FANC who participated in individual and focus group interviews in phases I and II respectively. Data were analyzed by means of thematic analysis. In phase III of the study, the findings of the first two phases and literature were used as the basis for the development of guidelines to enhance the utilization of health facility-based delivery services among attendees of FANC in Addis Ababa, Ethiopia. From the analysis of individual interview data, four (4) themes emerged, namely, perceived benefits of home delivery, knowledge deficit about health facility-based delivery, poor access to health care facilities and inadequate resources. These themes were identified as rich and detailed account of the perspectives of facility-based and home delivery among attendees of FANC in Addis Ababa, Ethiopia. Two (2) themes emerged from the analysis of focus group interviews data, namely provision of quality, respectful and dignified midwifery care and increased awareness of FANC. These themes were identified as the rich and detailed account of the views of, and recommendations made by attendees of FANC on measures needed to enhance the development of women-centred guidelines to enhance the utilization of health facility-based delivery services. The recommended measures addressed the negative perceptions of health facility-based delivery among attendees of FANC, with the aim of decreasing home deliveries and increasing the number of institutional deliveries. The study recommends that the Ministry of Health, Addis Ababa Health Bureau and the health facilities use the proposed guidelines to enhance the utilization of health facility-based delivery.Health StudiesD. Litt. et Phil. (Health Studies

Premarital Sexual Practice among Unmarried First Year Undergraduate Students in Alkan University College in Addis Ababa, Ethiopia

BACKGROUND Premarital sexual practice among unmarried College students has markedly increased recently in Ethiopia. College students are recognized as one of the age groups most affected by sexually transmitted infections including HIV. However, little has been explored about the magnitude of premarital sexual activity and predisposing factors in the circumstance of private higher education institutions in Ethiopia. OBJECTIVE To investigate the magnitude of premarital sexual practice and predisposing factors among unmarried undergraduate first year students in Alkan University College in Addis Ababa, Ethiopia. METHODS A cross-sectional survey of college students was conducted in April-May 2013. Study participants were selected by stratified random sampling. A self-administered questionnaire was completed by 207 unmarried first year undergraduate students, and was analyzed using SPSS V.16.0. Multi-variate logistic regression was used to see association between variables. Results were summarized in frequencies and percentages and presented in tables. RESULTS A total of 207 students took part in the survey. The mean age of respondents was 21.8 ±2.0 years. More than half of survey respondents (60.9%) reported that they have had premarital sex. Multi-variate logistic regression analysis showed that male respondents were more than seven times to ever have sexual intercourse as compared to female respondents (AOR= 7.6; 95%CI: 4.51, 34.87). However, age less than 18 years was found to be protective against premarital sexual practice (AOR=0.42.; 95%CI: 0.27- 0.73). Compared to respondents who do not use alcohol, those who are alcohol users after joining college were 3.8 times (AOR 3.05, 95% CI: 1.51- 4.32) as likely to begin premarital sex. Similarly, ever chewing khat after joining college was found to be positively associated with premarital sex in this study. (AOR=2.60.; 95%CI: 0.62-1.43). CONCLUSION A significant number of students had started pre marital sexual activity that might predispose them to varied sexual and reproductive health problems. Hence, sex education & targeted behavioural change interventions are recommended

Assessment of Level of Knowledge and Practice of Nursing and Midwifery Students on HIV Post Exposure Prophylaxis in Hawassa University, Ethiopia

Background: Nurses, midwives and other health care workers are at risk from Human Immunodeficiency Virus (HIV) and other blood borne infections in the workplace. Post exposure prophylaxis of HIV is the only way to reduce risk of HIV after potential exposure to needle pricks, blood and body fluids.Objectives: The objective of this study is to assess the level of knowledge and practice of nursing and midwifery students regarding post exposure prophylaxis for HIV in Hawassa University, College of Medicine and Health Science in Ethiopia Methods: Institution- based cross-sectional descriptive study was conducted from October to December 2013. A total of 185 students (comprising of 136 nursing and 49 midwifery) who were eligible for the survey were involved in the study. Data was collected using pretested self-administered questionnaires. Data was entered and analyzed by Statistical package for Social Science (SPSS) version 20. Associations of selected variables with HIV PEP use were assessed using chi-square test. A p-value of &lt;0.05 has been considered as statistically significant. The results were presented in frequency tables and percentages.Results: A total of all 185 students belonging to 2rd, 3rd and 4th years of nursing / midwifery students participated in the survey. The mean age of respondents was 21.04 ± 1.59 years. Among all of the respondents, 54 (29.2) were exposed to HIV risky conditions and of these exposed respondents, the most 32(59.3%) started PEP. The main reasons reported as a cause of exposure to HIV risk conditions in the work place were; lack of protective barriers 43 (79.7%) followed by lack of knowledge on standard precautions 10 (18.5 %). Students of final year were more likely to Practice PEP (p=0.01) as compared to students studying in 2nd year and 3rd year. However, post exposure prophylaxis use was not&nbsp; associated with gender and professional category (P&gt;0.05)Conclusion and Recommendations: The present study revealed that the level of knowledge and practice of Nursing and midwifery students regarding post-exposure prophylaxis against HIV was inadequate. Accessible PEP centre with proper guideline is recommended so that their practice towards utilization of PEP can be enhanced.</p

Congenital Anomalies and Associated Factors among Newborns in Bishoftu General Hospital, Oromia, Ethiopia: A Retrospective Study

Background. Congenital anomalies affect millions of babies worldwide with prevalence of 3%, and it is estimated that, globally, 303,000 newborns die within the first 4 weeks of life due to this problem. Objective. This study aimed to assess congenital anomalies and their associated factors among newborns in Bishoftu General Hospital, Oromia Regional State, Ethiopia. Setting. Bishoftu General Hospital, Oromia, Ethiopia. Study Design . A retrospective cross-sectional study was employed. Participants. All birth records from September 14, 2018, to March 14, 2019, were reviewed. A census method was applied for this study. The data were collected from birth registration books through structured checklist. We used Statistical Package for the Social Sciences (SPSS) version 24.0 for data analysis. Crude and adjusted odds ratio with 95% confidence interval was computed. Statistical significance was set at P < 0.05. Result. Out of 2,218 live births, 23 newborns were diagnosed with congenital malformations, making the prevalence rate of 1% (i.e., 10/1000 live births in the specified time period). Maternal age above 35 years (AOR = 6.5; 95% CI = 2.4–18), birth order above 3 (AOR = 8.4; 95% CI = 3.4–20.7), birth weight less than 2.5 kg (AOR = 0.3; 95% CI = 0.1–0.9), and singleton pregnancy (AOR = 6.4; 95% CI = 2–18.9) had a significant association with the incident of congenital anomalies, while iron folate use before and/or during early pregnancy and urban residence (AOR = 0.3; 95% CI = 0.1–1) had a protective effect against congenital anomalies (AOR = 0.036; 95% CI = 0.008–0.15). Conclusion. The findings of this study showed that there is a burden of congenital anomalies in the study area. Sustainable surveillance and registry systems are thus required for intervention programs and it is crucial to include them under Ethiopian demographic health survey (EDHS) report

Human Papillomavirus Knowledge, Perception, and Willingness to Receive Vaccination Among Female University Students in Addis Ababa University, Ethiopia, 2022: A Cross-Sectional Study

Background Cervical cancer is considered a leading cause of morbidity and mortality among females worldwide. Human papillomavirus is a highly prevalent sexually transmitted infection associated with increased cancer risks. Effective human papillomavirus vaccines are recommended for females in the adolescent years, but uptake has been less than optimal. Objective The objective of the study is to assess human papillomavirus knowledge, perception, and willingness to receive vaccination among female students in Addis Ababa University, Addis Ababa, Ethiopia, in 2022. Methods Institutional-based cross-sectional study was applied. The data were collected from 7 February to 15 April 2022. A total of 398 female students were recruited, and a multistage sampling technique was used to select the study participants. The data were entered into EpiData version 4.6 and analyzed using SPSS version 25. Bivariate and multivariable logistic regression analyses were used to determine the associations of variables. Results In this study, 161 (41%) of the students had good knowledge. About 226 (57.5%) had a more favorable perception regarding human papillomavirus and its vaccine, and 30% of the respondents were willing to receive the vaccine. The year level of study, having a history of sexual intercourse, having a family history of vaccination, and perception toward human papillomavirus and its vaccine were factors associated with students’ willingness to receive the human papillomavirus vaccine. Conclusion Educational programs are required to aware female students in Ethiopia considering their poor knowledge of human papillomavirus and its vaccine and the willingness of the students to receive the vaccine and related diseases. The inclusion of the HPV vaccine in the national immunization program that is in line with the World Health Organization’s recommendation should be considered as 118 (30%) of the participants show willingness to be vaccinated worldwide