B. Fred

D.B. Abila

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A n n a l s o f G l o b a l H e a l t hª 2 0 1 7 I c a h n S c h o o l o f M e d i c i n e a t M o u n t S i n a iV O L . 8 3 , N O . 1 , 2 0 1 7I S S N 2 2 1 4 - 9 9 9 6 / $ 3 6 . 0 0NCDS AND SOC I A L DE T ERM INANTS OF HEAL THChildhood Epilepsy Misconceptions In Sudan- A DescriptiveCross-Sectional SudyM. Abdalgadir, I. Noor, S. Nasur; University of Khartoum, Khartoum,SudanBackground: Epilepsy is one of the most prevalent non-communi-cable diseases worldwide. Stigma attached to epilepsy carriesa greater burden than the disease itself. In Sudan, as in manylow- and middle- income countries (LMICs) there is very limitedresearch addressing neurological disorders in general, and epilepsyin particular. Misinformation and misconceptions should be identi-fied and corrected for optimal care and management. This study wasdone to evaluate the knowledge, attitude and practices of motherstoward their epileptic children.Methods: In this descriptive cross-sectional study we conductedquestionnaire-based interviews at Soba University Hospital andFath Alrahman children referral unit in Khartoum, Sudan to assessthe knowledge attitude and practices of Mothers toward theirepileptic children.Findings: Of the 88 interviewed mothers, 57% were secondaryschool educated with an age range of 20 to 49 years old (Mean of27). 41% were aware of the organic nature of the disease, 19%thought it might have a spiritual nature and 40% weren’t aware ofthe nature of the disease. 77.3% thought epilepsy is not a hereditarydisease and 16% thought it’s infectious. Of the 78.4% who thoughtthe disease is curable 71.6% believed in medical treatment alone and28.4% thought spiritual treatment is possible as well. 56.8% of themothers reported good responses to the attack and 43.2% reportedpoor responses. 60% of the mothers stated that epilepsy had a nega-tive effect of their child socially.Interpretation: The level of knowledge about epilepsy amongmothers of epileptic children needs to be raised. Many mothershave significant wrong believes, negative attitudes, and poor prac-tices. There is a need for educational programs to help in theimprovement of the quality of life and prognosis of epileptic chil-dren. The media, as well as, high authorities government organiza-tions should play a major role in increasing the public awareness.Increased awareness and public education could help in reducingthe social stigma.Source of Funding: None.Abstract #: 1.001_NCDAnalyzing the Emergency Triage Logbook Components ofRoad Traffic Accident Victims at AaBET Hospital in AddisAbaba, EthiopiaY. Abebe1, T. Dida1, D. Silvestri2, E. Yisma3; 1St. Paul’s HospitalMillennium Medical College, Addis Ababa, Ethiopia, 2HarvardMedical School, Cambridge, Massachusetts, USA, 3Addis AbabaUniversity, Addis Ababa, EthiopiaBackground: Among African nations, Ethiopia has among thehighest burden of road traffic accidents (RTA). Each year, thecountry loses around 3000 people from RTA. Nevertheless, thereis a paucity of research on RTA victims presenting to urban emer-gency departments (EDs) in Ethiopia.Methods: We conducted a retrospective document review of allpatients presenting due to RTA at Addis Ababa Burn, Emergency,and Trauma (AaBET) Hospital (Addis Ababa, Ethiopia) fromAugust 18, 2015 to March 9, 2016. Selected patient variablesfrom ED triage logbooks were entered into Microsoft Excel. UsingSPSS version 21, we performed descriptive analyses, chi-square testof independence, and binary logistic regressions to describe andunderstand the analysis outputs of the records of RTA victims.Findings: During the study period, AaBET Hospital saw 662RTA victims, comprising 32.1% of all trauma-related patients.Median age was 27 years. Using South Africa Triage Scale triagecolor categories, most patients were assigned lower triage acuity,with 289 (43.7%) patients assigned as Green and 273 (41.2%)patients assigned as Yellow. Of Green (lower triage acuity) victims(n¼289), the majority (54.3%) of them were referred from healthinstitutions. Among RTA victims referred from health institutions(n¼408), 164 (40.2%) were referred without communication tothe receiving facility. RTA patients coming from the scene weresignificantly less likely to arrive by ambulance [Adjusted OR ¼0.3 (95% CI: 0.21-0.43)] as compared to those who were referredfrom health institutions.Interpretation: In Addis Ababa, many patients being referred toa specialized trauma hospital after RTA have low triage acuity.Nevertheless, these referrals place highest demand on limited ambu-lance services, and often occur without clear communicationbetween facilities. Strengthening primary health institutions tomanage low-acuity RTA victims without referral may decreasestrain on pre-hospital transport and trauma center resources, whichmay instead be directed toward RTA patients from the scene andthose suffering from more critical injuries.Source of Funding: St. Pauls’ Hospital Millennium MedicalCollege, Addis Ababa, Ethiopia.Abstract #: 1.002_NCDTrends of Incidence of Childhood and Adolescent Cancers inKampala and Wakiso Districts, Uganda: 2009 to 2014D.B. Abila, B. Fred; Makerere University College of Health Sciences,Kampala, UgandaBackground: Cancer is relatively rare in childhood compared tolater in life. Worldwide, the common malignant diseases of child-hood are leukaemia, lymphomas, central nervous system tumorsand embryonic solid tumors whereas among the adolescents,sarcomas of bone and soft tissue, and tumors of the male and femalegenital tracts. In Africa, the distribution of childhood cancers isquite similar, commonest being Kaposi sarcoma, Burkitt’slymphoma, retinoblastoma, leukaemia and Hodgkin lymphomas.Methods: This was a retrospective cross-sectional study whichinvolved review of cancer patient’s information from Kampala cancerregistry which collects information on cancers diagnosed withinNCDs and Social Determinants of Health A n n a l s o f G l o b a l H e a l t h , V O L . 8 3 , N O . 1 , 2 0 1 7J a n u a r y eF e b r u a r y 2 0 1 7 : 7 1 – 8 772Kampala and part of Wakiso districts and included children (0-14years) and adolescents (15-19 years). The data was analysed usingSPSS.Findings: A total of 752 patients, 71.7% (n¼539) were children(0-14 years) and 29.3% (n¼213) were adolescents (15-19 years)diagnosed with cancer between January, 2009 and December,2014. Among the children, Hodgkin lymphoma was 21%, 12%Kaposi Sarcoma, 9% nephroblastoma, 7% retinoblastoma, 11%unspecified malignancies and 40% others. Among the adolescents,20% were Kaposi Sarcoma, 18% Non-Hodgkin lymphoma, 8%Hodgkin lymphoma, 7% Hodgkin Lymphoma, 6% ChronicMyeloid leukaemia and 41% other malignancies.The age adjusted incidence per one million of childhood malig-nancies were; Non-Hodgkin Lymphoma (26), Kaposi Sarcoma(14.95), Nephroblastoma (9.2). Age Adjusted Incidence Rate ofadolescent malignancies were; Kaposi Sarcoma (10.05), Non-Hodg-kin Lymphoma (4.31), Hodgkin lymphoma (3.59).Retiniblastoma and nephroblastoma were found in only children.Interpretation: Among the children, the findings from this studydiffered from that in countries outside Africa. Haematologicalmalignancies, solid tumors brain tumors were the most commoncases of childhood and adolescent cancers. In Kenya and Rwanda,the most common were Non-Hodgkin lymphoma, leukaemia,Kaposi Sarcoma and nephroblastoma respectively.Among the adolescents, the incidence was quite similar to those inCountries outside Africa, with Non-Hodgkin Lymphoma being themost common. The trends of adolescent cancers in Uganda were quitesimilar to those in other African countries although Kaposi Sarcomawas the most incident which was not the case with other African coun-tries. In Zimbabwe, leukaemia, osteosarcoma, Non-Hodgkinlymphoma and Kaposi sarcoma had the highest incidence rates.Source of Funding: Self funded.Abstract #: 1.003_NCDIdentifying Optimal Waist Circumference Cut-off Points forCentral Obesity in Indigenous GuatemalansM.A. Luna1, R. Asturias-Luna2, A. Rivera-Andrade3, M. Chen4,C. Mendoza-Montano3, D. Burt5, J. González6; 1University of Vir-ginia, Charlottesville, Virginia, USA, 2Universidad Francisco Marro-quin, Guatemala, Guatemala, 3INCAP, Guatemala, Guatemala,4University of Virginia, Charlottesville, USA, 5Virginia, Charlottes-ville, USA, 6University of Virginia, Guatemala, GuatemalaBackground: Risk factors for Cardiovascular Disease (CVD) arenow increasingly prevalent in developing countries. The Interna-tional Diabetes Federation (IDF) has recommended ethnic specificwaist circumference (WC) thresholds, 90 cm for men and 80 cm forwomen from Central and South America based on limited datawhile the AHA and WHO recommends 102 and 88 cm. We aimedto identify the optimal WC cut off points to predict different CVDrisk factors in an indigenous population in Guatemala as an alterna-tive and more cost-effective method to assess risk in a resourcelimited setting.Methods: We conducted a secondary analysis of data from a repre-sentative sample of an indigenous Guatemalan population (n¼350).ROC curve analysis was performed to define optimal WC cut pointsto identify 3 risk factors for men and women. Multivariate logisticregression was used to assess the ability of the newly defined cutpoints to predict the presence of individual and 3 risk factors.We then compared the performance of the newly defined cut pointsto the IDF and WHO cut points for central obesity in ourpopulation.Findings: Out of 350 subjects, 276 had complete data to beincluded in the analysis. Optimal cut-off points for central obesitywere 81 cm for men and 83.5 cm for women. The newly definedcut-offs performed significantly better (AUC 0.77 and 0.68) thanthe WHO (AUC 0.51 and 0.60) and IDF (AUC 0.60 and 0.62)definitions for central obesity. Accuracy was 76.92% and 66.67%,versus 53.85% and 59.69% for WHO, 61.54% and 59.60% forIDF for men and women respectively. Odds ratios of associationbetween the different cutoff points and 3 CVD risk factorswere, 5.854 (3.368,10.175) for our new cut-off point vs 2.245(1.240,4.069) the WHO and 3.476 (1.870,6.462) for the IDFcut-off points.Interpretation: Our new cut-off points for central obesity arebetter predictors of CVD risk factors than the ones recommendedby the IDF and WHO when applied to an indigenous populationin Guatemala. Validating and applying these new cutoffs to otherindigenous populations in Latin America have potential CVDprevention value.Source of Funding: None.Abstract #: 1.004_NCDAwareness and Health-seeking Behavior of Urban Residentsfor NCD in EthiopiaY.T. Bayou, M. Bejiga, H. Tilahun; JSI/SEUHP, Addis Ababa,EthiopiaBackground: In Ethiopia, a double burden of disease is alreadyemerging at the early stage of the epidemiological transition, witha mix of persistent, emerging, and re-emerging infectious diseasesand increasing prevalence of chronic conditions and injuries. Theaim of this study was to assess the knowledge of and attitudestoward health care services and the current practices in healthcarerelated to NCD services in urban settings where JSI’s StrengtheningEthiopia’s Urban Health Program is being implemented.Methods: This is a mixed cross-section study that was conductedin cities and towns in five regional states and two city administra-tions in Ethiopia with the aim of exploring and understandingcommunity awareness, knowledge, attitudes, and current use ofhealth services.Findings: The findings of this study show that about 79% of therespondents had heard about NCDs. The most commonly citedNCDs constituted hypertension (74%), diabetes (73.4%), andcancer (35.5%) among others. However, the community’s level ofawareness about the risk factors associated with NCDs was danger-ously low: dietary problems (49.9%), overweight and obesity(40.4%), physical inactivity (32.4%), and substance abuse includingalcohol and tobacco (30.5%). Surprisingly, only 25% of the respon-dents who heard about NCDs received medical checkup in the last

Trends of Incidence of Childhood and Adolescent Cancers in Kampala and Wakiso Districts, Uganda: 2009 to 2014

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Trends of Incidence of Childhood and Adolescent Cancers in Kampala and Wakiso Districts, Uganda: 2009 to 2014

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