Lived Experiences of Adult Cancer Patients Undergoing Chemotherapy Treatment at University of Gondar Specialized Hospital, North West Ethiopia, 2021.

Cancer is a global public health problem and it exposes patients with a wide range of physical, psychological, social, and financial problems. Experiences, feelings and thoughts patients have during the course of the disease are the determining factors of disease management. However, most of the studies analyzing cancer patients' experiences have been performed only in high-income countries and the situation for cancer patients in Ethiopia is largely unknown. This study aimed to explore the lived experiences of adult cancer patients undergoing Chemotherapy treatment at University of Gondar specialized Hospital, Ethiopia. A phenomenological study design was conducted among adult cancer patients undergoing chemotherapy treatment at University of Gondar specialized Hospital. In-depth interview was conducted with 13 participants by using purposive sampling technique from March 15 to April 15, 2021. The data collection process facilitated by using semi-structured Amharic interview guide. After transcription and translation, data were analyzed by using a thematic analysis method. The ATLAS.ti software version 9 was used for coding and categorization. The result was reported using narrative and mentioned indirect quotation. The findings of the study revealed four main themes: "psychological discomfort," "functional status impairment," "experiences about chemotherapy treatment," and "coping mechanism." The findings revealed that being diagnosed with cancer is the most traumatic experience and affect all aspect of a patient life. Despite the side effects, the treatment gives hope for a new life. Social and spiritual supports have importance in coping the negative effects of living with cancer. Therefore, health care providers should provide psychosocial care to cancer patients from there diagnosis and in there treatment in dealing with this difficult process.

Prospects for tuberculosis elimination in Ethiopia: feasibility, challenges, and opportunities.

To end the global tuberculosis (TB) epidemic and eliminate TB, countries around the world committed to significantly expanding the scope of their efforts, including rapid uptake of new tools, interventions, and strategies, and envisioned a world free of TB. Between 2010 and 2020, Ethiopia experienced a 5% average annual decline in TB incidence. However, at that current rate, ending the TB epidemic (<10 TB cases/100,000 population) may not be possible soon. As a high TB and TB/HIV burden country, Ethiopia's TB epidemic is characterized by a high rate of transmission in the general population and hard-to-reach areas and progression of latent TB infection (LTBI) rather than cross-border migration. Studies suggest that a combination of interventions, such as intensive household screening with TB preventive therapy, has the potential to significantly decrease the incidence of TB. The feasibility of reducing the population-level TB incidence by a combination of interventions in Ethiopia is unknown. Based on the World Health Organization's TB elimination framework and the END TB strategic documents and previously published reviews in TB elimination we conducted a narrative review to summarize and estimated the effect of a combined intervention package (community-based TB screening for active case finding and TB and LTBI prevention and treatment among high-risk groups like household and close contacts). The projected annual decline of TB incidence was above 16%. With this level of impact and nationwide scale-up of the interventions, Ethiopia aligns well with ending the TB epidemic before 2035 and shifting toward TB elimination in the foreseeable future. In the Ethiopia setting, we recommend future studies generating evidence on the impact of the combination intervention package to reduce TB incidence in Ethiopia, which is aiming to shift from control to TB elimination.

Control and Prevention of Epizootic Lymphangitis in Mules: An Integrated Community-Based Intervention, Bahir Dar, Ethiopia.

From 2010 to 2017, as part of a wider animal welfare program, The Donkey Sanctuary piloted an integrated, community-based model for the control and prevention of epizootic lymphangitis (EZL) in cart mules in Bahir Dar, Ethiopia. Stakeholders included muleteers, service providers, and transport and animal health regulatory authorities. Interventions included muleteer education, wound prevention, harness improvement, animal health professional training, treatment of early EZL cases, euthanasia for advanced cases, and review of transport services and traffic guidelines. The project followed a participatory project management cycle and used participatory learning and action tools to facilitate stakeholder engagement and ownership. Participatory and classical epidemiology tools were employed to raise and align stakeholder understanding about EZL for effective control and prevention and to evaluate the progress impact of the model through annual prevalence surveys. During the intervention, the annual prevalence of EZL reduced from 23.9% (102/430) (95%CI: 19.8%-27.0%) in 2010 to 5.9% (58/981) (95% CI: 4.4%-7.4%) in 2017, and wound prevalence from 44.3% in 2011 to 22.2% in 2017; trends in the reduction of the prevalence maintained in the face of a mule population that increased from 430 in 2010 to ~1,500 in 2017. While non-governmental organization (NGO)-led interventions can facilitate change by trialing new approaches and accessing new skills and resources, sustainable change requires community ownership and strengthening of service provision systems. To this effect, the project raised muleteer competence in mule husbandry and EZL prevention strategies; strengthened veterinary competence; facilitated more mule-friendly traffic, transport, and waste disposal guidelines and practices; supported mule-community bylaws to control EZL; and established a supportive network between stakeholders including trusting relationships between muleteers and veterinary services. To advance the intervention model in other endemic areas, we recommend elucidation of local epidemiological factors with other stakeholders prior to the intervention, early engagement with veterinary and transport service regulatory authorities, early development of bylaws, exploration of compensation or insurance mechanisms to support euthanasia of advanced cases, and additional social, economic, and epidemiological investigations. In line with the OIE Working Equid Welfare Standards, we suggest that integrated community-based interventions are useful approaches to the control and prevention of infectious diseases.