13 research outputs found
Predictors of survival among breast cancer patients in Ethiopia: a systematic review and meta-analysis
No full textIntroductionBreast cancer remains a significant public health issue, with delayed medical attention often leading to advanced stages and poorer survival rates. In East Africa, evidence on the prevalence and factors contributing to the delayed presentation of breast cancer is limited. As a result, this study aims to assess the pooled prevalence of delayed breast cancer presentation and identify contributing factors in East Africa.MethodsWe conducted a systematic review of observational studies from East Africa using PubMed, Google Scholar, Embase, Cochrane Library, Hinari, and Mednar databases. The Newcastle Ottawa 2016 Critical Appraisal Checklist assessed methodological quality. Publication bias was evaluated using a funnel plot and Egger’s test, and heterogeneity was examined with the I-squared test. Data were extracted with Microsoft Excel and analyzed using Stata 11.ResultsThe pooled prevalence of delayed presentation among breast cancer patients in East Africa was 61.85% (95% confidence interval, 48.83%–74.88%). Significant factors contributing to delayed presentation included visiting traditional healers (adjusted odds ratio, 3.52; 95% CI, 1.43–5.59), low educational levels (adjusted odds ratio, 3.61; 95% CI, 2.39–4.82), age > 40 years (adjusted odds ratio, 1.87; 1.03, 2.71), absence of breast pain (adjusted odds ratio, 2.42; 1.09, 3.74), distance >5 km away from home to health institution (adjusted odds ratio, 2.89; 1.54, 4.24), and rural residence (adjusted odds ratio, 3.33; 95% CI, 2.16–4.49).ConclusionThis meta-analysis’ findings demonstrated that over half of breast cancer patients in East Africa delayed detection. Significant factors associated with delayed presentation include age over 40 years, illiteracy, rural residence, use of traditional healers, distance >5 km from a health facility, and absence of breast pain. Healthcare stakeholders and policymakers must be focused on raising awareness and educating people to encourage early detection and prompt therapy
Knowledge, attitudes, and practices regarding breast cancer screening and associated factors among female undergraduate students at Bonga University, Ethiopia
No full textAbstract Breast cancer is a leading cause of cancer-related deaths among women worldwide. Screening aims to detect precancerous lesions and early-stage carcinomas in asymptomatic women, helping to reduce morbidity and mortality. Methods such as breast self-examination (BSE), clinical breast examination (CBE), and mammography play a vital role in early detection. However, in low-resource settings like Ethiopia, awareness and practice of these screening methods remain limited. Female university students represent a key group for prevention, yet little is known about their screening behaviors. This study aims to assess the knowledge, attitudes, and practices towards breast cancer screening, along with associated factors, among female regular undergraduate students at Bonga University. A cross-sectional study was conducted at Bonga University from March 11 to 12, 2020, involving 399 female undergraduate students selected through simple random sampling. Participants were invited to complete a structured questionnaire in a private, designated room to ensure confidentiality and reduce peer influence during data collection. Data were entered and analyzed using IBM SPSS version 22.0 (IBM Corp., Armonk, NY, USA). Bivariate logistic regression was initially performed to examine associations between the dependent and independent variables. Variables with a p-value < 0.25 in the bivariate analysis were included in the multivariable logistic regression model. Statistical significance was determined at a p-value < 0.05 with a 95% confidence interval. The study revealed that 211 participants (52.9%) demonstrated inadequate knowledge, 222 (55.6%) exhibited negative attitudes, and 319 (79.9%) reported poor practices regarding breast cancer screening. Factors significantly associated with limited knowledge included the absence of a family history of breast cancer (AOR = 4.5; 95% CI: 2–10), being a first-year student (AOR = 4; 95% CI: 1.3–3.3), rural residency, and being a second-year student (AOR = 2; 95% CI: 1.2–3.3). Negative attitudes were significantly associated with being unmarried (AOR = 7.1; 95% CI: 1.6–32), first-year student status (AOR = 7.5; 95% CI: 2.6–21.5), second-year student status (AOR = 6.5; 95% CI: 1.9–22), and the perception of not being at risk for breast cancer (AOR = 2.6; 95% CI: 1.07–6). Poor screening practices were significantly linked to the absence of a family history of breast cancer (AOR = 5.2; 95% CI: 2.2–12.2), being a first-year student (AOR = 5.5; 95% CI: 2.3–12.7), and belonging to a younger age group (AOR = 8.4; 95% CI: 1.6–42.5). The study revealed that a significant proportion of students at Bonga University had inadequate knowledge, negative attitudes, and poor practices related to breast cancer screening. Key contributing factors included lack of family history, younger age, rural residence, and first-year student. These findings underscore the need for targeted awareness campaigns, particularly among younger and rural students. Collaboration between Bonga University, health professionals, and local media is essential to improve knowledge and promote early detection through breast cancer screening
Delayed presentation of breast cancer patients and contributing factors in East Africa: Systematic review and meta-analysis
No full textDelayed presentation of breast cancer patients and contributing factors in East Africa: Systematic review and meta-analysis.
No full textIntroductionBreast cancer remains a significant public health issue, with delayed medical attention often leading to advanced stages and poorer survival rates. In East Africa, evidence on the prevalence and factors contributing to the delayed presentation of breast cancer is limited. As a result, this study aims to assess the pooled prevalence of delayed breast cancer presentation and identify contributing factors in East Africa.MethodsWe conducted a systematic review of observational studies from East Africa using PubMed, Google Scholar, Embase, Cochrane Library, Hinari, and Mednar databases. The Newcastle Ottawa 2016 Critical Appraisal Checklist assessed methodological quality. Publication bias was evaluated using a funnel plot and Egger's test, and heterogeneity was examined with the I-squared test. Data were extracted with Microsoft Excel and analyzed using Stata 11.ResultsThe pooled prevalence of delayed presentation among breast cancer patients in East Africa was 61.85% (95% Confidence Interval: 48.83%-74.88%). Significant factors contributing to delayed presentation included visiting traditional healers (Adjusted Odds Ratio: 3.52; 95% CI: 1.43-5.59), low educational levels (Adjusted Odds Ratio: 3.61; 95% CI: 2.39-4.82), age>40 years (Adjusted Odds Ratio 1.87; 1.03, 2.71), absence of breast pain (Adjusted Odds Ratio 2.42; 1.09, 3.74), distance >5km away from home to health institution (Adjusted Odds Ratio 2.89; 1.54, 4.24), and rural residence (Adjusted Odds Ratio: 3.33; 95% CI: 2.16-4.49).ConclusionThis meta-analysis's findings demonstrated that over half of breast cancer patients in East Africa delayed detection. Significant factors associated with delayed presentation include age over 40 years, illiteracy, rural residence, use of traditional healers, distance greater than 5 km from a health facility, and absence of breast pain. Healthcare stakeholders and policymakers must be focused on raising awareness and educating people to encourage early detection and prompt therapy
Survival status of women with cervical cancer in Sub-Saharan Africa: a systematic review and meta-analysis, 2024
No full textBackgroundDespite the availability of vaccination and early treatment, cervical cancer remains a significant public health concern globally, particularly in Sub-Saharan Africa, where access to screening and treatment is often limited.MethodsIn this study, researchers conducted a survey of four international databases—Medline/PubMed, Scopus, Web of Science, and Henare—along with Google Scholar to search for gray literature. The keywords used for searching the international databases included “Uterine Cervical Neoplasms [Mesh],” “Survival OR Survival Analysis OR Survival Rate,” and “Sub-Saharan countries” (including the names of specific countries). Six researchers independently screened and extracted data from the articles. All studies published in English were included without restriction and assessed for quality using the adapted Newcastle–Ottawa Scale for cohort and cross-sectional studies. The results of this systematic review were reported in accordance with the PRISMA checklist.ResultsOut of the 2,180 articles initially identified, 23 were deemed eligible and reported on the survival status of patients with cervical cancer in Sub-Saharan Africa. This study assessed the multi-year survival rates (1, 2, 3, 4, and 5 years) of patients with cervical cancer. Based on the random-effects model, the overall pooled 1-year survival was 65.0% [95% confidence interval (CI), 52–78] with I² = 99.31 and p-value < 0.001. The 2-year survival rate was 60% (95% CI, 46–74) with I² = 99.12 and p-value < 0.001, the 3-year survival was 48% (95% CI, 35–62) with I² = 98.45 and p-value < 0.001, the 4-year survival was 42.9% (95% CI, 32.7–53.1) with I² = 96.80 and p-value < 0.001, and the 5-year survival was 35% (95% CI, 27–44) with I² = 98.74 and p-value < 0.001.ConclusionsThis systematic review and meta-analysis found that the survival rates for patients with cervical cancer in Sub-Saharan Africa are much lower than the global averages. The results show that the 5-year survival rate can be as low as 35%, highlighting serious challenges in managing cervical cancer in this region. To address this issue, collaboration among governments, healthcare providers, and international organizations is essential to enhance the availability and quality of care. Future research should focus on developing effective early detection and treatment strategies and monitoring long-term survival outcomes
Men’s knowledge of obstetrics danger sign and associated factors in low-income countries: a systematic review and meta-analysis
No full textAbstract Obstetric danger signs refer to unexpected signs that arise during pregnancy, childbirth, or the postpartum period, indicating potential complications that require immediate medical attention. Globally, approximately 15% of pregnant women experience such complications, contributing to an estimated 287,000 maternal deaths annually—equivalent to nearly 800 deaths each day. This review evaluates the literature on men’s knowledge of obstetric danger signs, a critical factor in enhancing maternal health outcomes. We performed a comprehensive search for articles using PubMed, Web of Science, Scopus, Hinari, and Google Scholar databases. To identify relevant studies, we employed search terms such as “knowledge,” “awareness,” “information,” “recognition,” “pregnancy danger signs,” “obstetric danger signs,” “obstetric warning signs,” and “labor complications,” combined with “low-income countries.” six reviewers independently screened the articles and extracted data. The included articles in the review are cross-sectional studies, conducted in low-income countries and published in English, with no restrictions of publication years. Study quality was evaluated using a Newcastle-Ottawa Scale. The study was reported following the PRISMA checklist and the protocol was registered in the International Prospective Register of Systematic Reviews (PROSPERO) (protocol ID: CRD42024488979). Of the 366 articles initially screened by title and abstract, 13 studies met the inclusion criteria. All the included studies assessed men’s knowledge of obstetric danger signs during pregnancy, and childbirth, while only ten assessed their knowledge during the postpartum period. The pooled random-effects meta-analysis indicated that men’s knowledge of obstetric danger signs was 36.96% during pregnancy, 40.86% during childbirth, and 35.84% during the postpartum period, with an overall knowledge level of 37.29% based on the summarized random-effects meta-analysis. Key factors influencing men’s knowledge included urban residence, educational attainment, access to antenatal care, participation in the health development army, and previous experience with obstetric complications. In low-income countries, men’s knowledge of obstetric danger signs remains notably low, potentially hindering their ability to seek timely obstetric care for their partners during complications. Addressing this gap requires strengthening counseling services during antenatal care, expanding community meetings, and enhancing community-based health education on obstetric danger signs
Prevalence of molecular markers of chloroquine resistance in malaria parasites in East Africa: A systematic review and meta-analysis
No full textBackground: Malaria is a serious global public health problem, which is caused by genus Plasmodium. Resistance of the human malaria parasite to antimalarial drugs is a public health concern in malaria endemic countries. Chloroquine is resistant for both P. vivax and P. falciparum. Chloroquine resistance is understood throughout all of Africa's P. falciparum endemic regions. Molecular markers play a crucial role in tracking and understanding the prevalence of antimalarial drug resistance. Currently, there is inadequate information on the prevalence of molecular markers of chloroquine resistance in malaria parasites. Objective: This systematic review and meta-analysis aimed to determine the pooled prevalence of molecular markers of chloroquine resistance in malaria parasites in East Africa. Methods: Systematic search was performed to retrieve articles from PubMed, Scopus, Science Direct, and the Google Scholar search engine. Twenty potential studies that provided important data on markers of chloroquine resistance in malaria parasites were systematically reviewed and analyzed. Five antimalarial drug resistance markers of chloroquine resistance were extracted separately into Microsoft Excel and analyzed using STATA 17.0. The Inverse of variance (I2) was done to evaluate heterogeneity across studies. The funnel plot and the Egger's test were used to determine the existence or absence of publication bias. A trim-and-fill meta-analysis was carried out to generate a bias-adjusted effect estimate. A random effect model was used to determine the pooled prevalence of molecular markers associated with chloroquine resistance in malaria parasites. Subgroup analysis was performed based on country and year of publication. Results: A total of 20 studies were included for this systematic review and meta-analysis. The molecular markers like K76T, 76T, N86Y, Y184F, and 86Y were selected for meta-analysis. From this meta-analysis, the pooled prevalence of K76T, 76T, N86Y, Y184F, and 86Y was 34.5%, 47.3%, 43.8%, 58.3%, and 29.2%, respectively. After adjusting for publication bias, the estimated pooled prevalence of K76T, 76T, N86Y, Y184F, and 86Y were 34.5%, 47.3%, 43.8%, 58.3%, and 29.2%, respectively. Meta-analysis showed a significant difference in all molecular marker prevalence like K76T and 86Y among studies on year of publication except 76T, N86Y, and Y184F. In addition, the meta-analysis showed a significant difference in all molecular marker prevalence like K76T, 76T, N86Y, Y184F, and 86Y among studies at the country level. Conclusions: The findings of this systematic review and meta-analysis concerning the molecular markers of chloroquine resistance of malaria parasites in East Africa revealed a significant prevalence of antimalarial drug resistance markers of chloroquine. As a result, continued surveillance and monitoring of the prevalence of molecular markers of chloroquine resistance, identification and limitation of drug-resistant malaria parasite strains, and development of new antimalarial treatments are required to guide malaria treatment policies, interventions, control, and elimination of malaria worldwide
Epidemiology and associated factors of abnormal uterine bleeding among reproductive-age women: evidence from Woldia City, Northeast Ethiopia
No full textAbstract Abnormal uterine bleeding (AUB) is a common concern among reproductive-age women, significantly affecting productivity, quality of life, and social interactions. In Ethiopia, research on abnormal uterine bleeding is limited, and the factors influencing its occurrence are not well understood. This study aimed to assess the prevalence of, abnormal uterine bleeding, and its associated factors among reproductive-age women in Woldia City, Ethiopia. A community-based cross-sectional study was conducted in Woldia City from May 3 to June 30, 2023. A total of 1,200 reproductive-age women participated in the study. A simple random sampling technique was used to recruit participants. A pre-tested, structured interviewer-administered questionnaire was used to collect data, which were entered into Epi Data 6.4 and analyzed using Statistical Package for the Social Sciences (SPSS) version 26.0. Descriptive statistics were calculated, and binary logistic regression was used to assess associations. Variables with a p-value < 0.05 at 95% CI in multivariate logistic regression were considered significant. A total of 1200 women participated, with a response rate of 97.4%. Of the participants, 36.5% (95% CI: 33.8–39.3%) reported AUB, with heavy menstrual bleeding being the most common pattern. Statistically significant associations were found between AUB and late reproductive age (AOR = 4.11, 95% CI: 2.99–5.63), regular smoking (AOR = 1.78, 95% CI: 1.04–3.05), hypertension (AOR = 2.25, 95% CI: 1.13–4.47), and high-stress levels (AOR = 4.69, 95% CI: 3.57–6.19). This study found a high prevalence of AUB, with heavy menstrual bleeding as the predominant pattern. Advanced age, hypertension, regular smoking, and high-stress levels were significantly associated with AUB. Women should adopt healthier lifestyles, including managing blood pressure, reducing stress, and quitting smoking to help prevent Abnormal uterine bleeding
Determinants of birth preparedness and complication readiness practice among reproductive-age women in Africa a systematic review and meta-analysis
No full textAbstract Background Safe motherhood programs must include both readiness for complications and childbirth. Birth preparedness and complication readiness (BPCR) is a comprehensive approach that helps resolve delays in deciding to seek care for obstetric problems. Objectives To identify the determinants of BPCR practice among reproductive age group women in Africa. Design Systematic Review and Meta-Analysis. Data sources and methods Preferred Reporting Items for Systematic Reviews and meta-analysis (PRISMA) were followed and databases such as MEDLINE, PubMed, Scopus, Hinari, Google Scholar, and Web of Science were used to find the available studies. Adjusted Odds Ratio (AOR) with 95% Confidence Interval (CI) was used to identify associated factors. I2 statistics, funnel plot, and Egger test were used to assess the studies’ heterogeneity and publication bias. Results In this review, a total of 32 studies with 17,787 sample sizes were included. Knowledge of BPCR (AOR = 2.12, 95% CI: 1.44, 3.13), knowledge of danger signs during pregnancy (AOR = 1.60; 95% CI: 1.37, 1.88), Knowledge of labor and delivery danger signs (AOR = 1.44; 95% CI: 1.28, 1.62), Knowledge of postpartum danger signs (AOR = 1.40; 95% CI: 1.21, 1.63), urban residency (AOR = 1.32; 95% CI: 1.03, 1.70), Antenatal Care follow-up (AOR = AOR = 1.52;95% CI:1.42, 1.63), history of stillbirth (AOR = 1.59; 95% CI: 1.36, 1.86), parity (AOR = 1.76; 95% CI: 1.16, 2.66) and secondary or higher educational status (AOR = 1.51: 95% CI: 1.35, 1.68) were the determinants of BPCR practice. Conclusion BPCR practice among African women of reproductive age has been greatly affected by antenatal care visits, urban residency, knowledge of danger during pregnancy, labor, and postpartum, history of stillbirth, primiparity, and secondary or higher education. Focused interventions that address the identified factors may enhance BPCR practices and maternal health outcomes in Africa
Uptake of cervical cancer screening and its associated factors in Africa: an umbrella review of systematic reviews and meta-analyses
No full textAbstract Background Cervical cancer poses a major public health burden in low- and middle-income countries, especially in Africa, despite being largely preventable through HPV vaccination and screening. This umbrella review synthesizes findings from systematic reviews and meta-analyses to identify factors influencing screening uptake, offering evidence to guide targeted interventions and policy responses across the continent. Method This umbrella review synthesized evidence from systematic reviews and meta-analyses on cervical cancer screening uptake and associated factors among African women. The protocol was registered in PROSPERO (CRD42025639740). A systematic search across five electronic databases, guided by the PICO framework, identified studies reporting prevalence, facilitators, or barriers. After duplicate removal, studies underwent title, abstract, and full-text screening. Data on study characteristics, screening prevalence, and associated factors were extracted. Quality was assessed using AMSTAR-2. A random-effects model in R software was used to estimate pooled prevalence and associated factors. Heterogeneity was evaluated via the I² statistic (> 75% indicating substantial variation), and publication bias was examined using funnel plots and Egger’s regression test. Result This umbrella review included 11 systematic reviews comprising 214 cross-sectional studies with a total sample of one hundred forty-three thousand women across Africa. The pooled cervical cancer screening uptake was 19% (95% CI: 12–25%), with substantial heterogeneity (I² = 99.9%, p < 0.001). Key factors associated with higher uptake included formal education, employment in the public sector, knowledge of cervical cancer, perceived risk and severity, prior sexually transmitted infections, and getting healthcare providers’ advice. Conclusion Cervical cancer screening uptake remains low across Africa, with increased uptake linked to formal education, knowledge, perceived susceptibility, and provider advice. These findings call for targeted, multi-level interventions to improve health literacy, awareness, and provider engagement. Policymakers should strengthen health systems and implement culturally appropriate, community-based strategies to expand access. Given the high heterogeneity (I² = 100%), findings should be interpreted cautiously. Future research should prioritize context-specific, evidence-based approaches to overcome barriers and ensure equitable screening uptake
