Epidemiological and clinicopathological profile of endometrial cancer in Gabon

Introduction: L'objectif général de notre travail était d'apporter une description épidémiologique et clinicopathologique du cancer de l'endomètre au Gabon. Patients et méthode: Cette étude descriptive et rétrospective a été réalisée à l'Institut de Cancérologie de Libreville chez les patientes atteintes du cancer de l'endomètre sur une période de 7 années (de janvier 2012 à octobre 2018). Résultats: Cette étude a inclus 32 patientes et les résultats obtenus ontmontré que ce cancer au Gabon est plus fréquent chez la femme multipare, que histologiquement le type 1 est le plus souvent rencontré et que ce cancer est de haut grade de malignité. De ce travail ressort également la difficulté du suivi des patientes. Conclusion: Le cancer de l'endomètre étant un cancer souvent d'emblée de mauvais pronostic, il est d'intérêt de mettre en place une stratégie de prévention et de management adapté.Mots clés: cancer, endomètre, étude clinicopathologique, suivi, Gabon Abstract:Introduction:The general objective of our work was to provide an epidemiological and clinicopathological description of endometrial cancer in Gabon.

Introduction: The general objective of our work was to provide an epidemiological and clinicopathological description of endometrial cancer in Gabon. Epidemiological and clinicopathological profile of... Patients and method: This descriptive and retrospective study was carried out at Cancer Institute of Libreville in patients with endometrial cancer over a period of 7 years (from January 2012 to October 2018) . Results: This study included 32 patients and the results obtained showed that this cancer in Gabon is more frequent in multiparous women, that histologically type 1 is most often encountered and that this cancer is of high grade malignancy. This work also shows the difficulty of following up patients. Conclusion: As endometrial cancer is often a cancer with a poor prognosis , it is interest to put in place an appropriate prevention and management strategy.

Strengthening access to long-acting reversible contraception within postabortion care in Tanzania: A pre-post evaluation

Postabortion care services provide lifesaving treatment for abortion-related complications and addresses women's needs by offering family planning (FP) counseling and voluntary access to contraception. Between 2016 and 2020, the Government of Tanzania sought to strengthen its PAC program by enhancing FP counseling and clients' access to a wide range of contraceptive options.The project team conducted a pre-post evaluation in 17 public sector healthcare facilities in mainland Tanzania and 8 in Zanzibar. It comprised structured client exit interviews (CEIs), completed first in 2016 (n=412) and again in 2020 (n=484). These data complemented an evaluation that used routine service statistics to demonstrate the intervention's effects on client-reported outcomes. Primary outcomes of the CEIs reflected client experience and satisfaction with services, and researchers compared prepost differences using chi-square tests. There were improvements in numerous indicators, including client waiting times, recall of emergency procedure counseling, contraceptive uptake, and satisfaction with the quality of overall counseling and FP information and services; however, triangulation of CEI data with service statistics indicated that some outcomes, though still improved since baseline, attenuated. Strengthening the FP component of PAC is feasible in Tanzania and Zanzibar, but strategies to sustain quality improvements over time are needed. (Afr J Reprod Health 2022; 26[5]: 28-40)

After-action review of rabies and anthrax outbreaks multisectoral response in Tanzania, challenges and lessons

After-action review uses experiences gained from past events to adopt best practices, thereby improving future interventions. In December 2016 and late 2018, the government of Tanzania with support from partners responded to anthrax and rabies outbreaks in Arusha and Morogoro regions respectively. The One Health Coordination Desk (OHCD) of the Prime Minister's Office (PMO) later coordinated after-action reviews to review the multi-sectoral preparedness and response to the outbreaks. To establish and describe actions undertaken by the multi-sectoral investigation and response teams during planning and deployment, execution of field activities, and outbreak investigation and response, system best practices and deficiencies. These were cross-sectional surveys. Semi-structured, open and closed-ended questionnaire and focus group discussions were administered to collect information from responders at the national and subnational levels. It was found that the surveillance and response systems were weak at community level, lack of enforcement of public health laws including vaccination of livestock and domestic animals and joint preparedness efforts were generally undermined by differential disease surveillance capacities among sectors. Lack of resources in particular funds for supplies, transport and deployment of response teams contributed to many shortfalls. The findings underpin the importance of after-action reviews in identifying critical areas for improvement in multi-sectoral prevention and control of disease outbreaks. Main sectors under the coordination of the OHCD should include after action reviews in their plans and budget it as a tool to continuously assess and improve multi-sectoral preparedness and response to public health emergencies.

Delays in HIV-1 infant polymerase chain reaction testing may leave children without confirmed diagnoses in the Western Cape province, South Africa

Background: Early diagnosis and confirmation of HIV infection in newborns is crucial for expedited initiation of antiretroviral therapy. Confirmatory testing must be done for all children with a reactive HIV PCR result. There is no comprehensive data on confirmatory testing and HIV PCR test request rejections at National Health Laboratory Service laboratories in South Africa.Objective: This study assessed the metrics of routine infant HIV PCR testing at the Tygerberg Hospital Virology Laboratory, Cape Town, Western Cape, South Africa, including the proportion of rejected test requests, turn-around time (TAT), and rate of confirmatory testing.Methods: We retrospectively reviewed laboratory-based data on all HIV PCR tests performed on children ≤ 24 months old (n = 43346) and data on rejected HIV PCR requests (n = 1479) at the Tygerberg virology laboratory over two years (2017­2019). Data from sample collection to release of results were analysed to assess the TAT and follow-up patterns.Results: The proportion of rejected HIV PCR requests was 3.3%; 83.9% of these were rejected for various pre-analytical reasons. Most of the test results (89.2%) met the required 96-h TAT. Of the reactive initial test results, 53.5% had a follow-up sample tested, of which 93.1% were positive. Of the initial indeterminate results, 74.7% were negative on follow-up testing.Conclusion: A high proportion of HIV PCR requests were rejected for pre-analytical reasons. The high number of initial reactive tests without evidence of follow-up suggests that a shorter TAT is required to allow confirmatory testing before children are discharged.

Abortion Incidence and Postabortion Care in Rwanda

Abortion is illegal in Rwanda except when necessary to protect a woman's physical health or to save her life. Many women in Rwanda obtain unsafe abortions; and some experience health complications as a result. To estimate the incidence of induced abortion; we conducted a national sample survey of health facilities that provide postabortion care and a purposive sample survey of key informants knowledgeable about abortion conditions. We found that more than 16;700 women received care for complications resulting from induced abortion in Rwanda in 2009; or 7 per 1;000 women aged 15-44. Approximately 40 percent of abortions are estimated to lead to complications requiring treatment; but about a third of those who experienced a complication did not obtain treatment. Nationally; the estimated induced abortion rate is 25 abortions per 1;000 women aged 15-44; or approximately 60;000 abortions annually. An urgent need exists in Rwanda to address unmet need for contraception; to strengthen family planning services; to broaden access to legal abortion; and to improve postabortion care. (StudieS in Family Planning 2012; 43[1]: 11-20)

Quality of Post-Abortion Care in Public Health Facilities in Ethiopia

Background: Comprehensive quality Post Abortion Care (PAC) is one of the important strategies to save lives where access to safe abortion is restricted by Law and services are inaccessible. Objective: The objective of the study was to assess the status of quality of PAC in health facilities of Amhara and Oromiya regional states. Methods: The study was cross-sectional by design and was conducted from November 2002 to March 2003. Patient interview; provider interview and direct service delivery observation were utilized to capture different aspects of care. Eleven health facilities (five in Oromiya and six in Amhara Regions); 103 post-abortion patients and 87 health service providers were included in the study. Results: although facilities were found to be prepared to manage abortion complications; some patients were delayed from receiving services because of require- ment to pay before getting services; and to buy drugs and supplies from other sources. Patient-provider interaction was generally satisfactory as viewed by the respondents. Majority (88.3) of patients felt that PAC services maintained confidentiality. Patients were not informed about the steps of each procedure. Nearly two-third of service providers informed the patients about the cause of their problem; but only 50.5of them told the outcome of treatment. Information provision regarding important precautions and warning signs was uniformly very low in all study facilities. Only 53.4of patients left the facilities counseled about family planning and 44.7with contraceptives. But; 84.5of women do not plan pregnancy within three months following the abortion. Great majority of the patients responded that they were satisfied with services they have obtained. Dissatisfaction included maltreatment by service providers; and inconvenient setup of service delivery. Patient assessment was principally based on last menstrual period and bimanual pelvic examination in most of the facilities. Service providers do not usually stick to infection prevention and universal precautions. Conclusion: the study has shown areas of improvement for better services to respond to various needs of the postabortion patients