Adamu Addissie

Background: The Trust in Oncologist Scale (TiOS) is a tool used to measure cancer patients' self‐reported trust in their oncologists. It has been validated in Dutch, English, Japanese, and Italian. Aims: This study aims to validate the Amharic version of the tool and develop its short form. Methods and Results: A cross‐sectional study design was employed among 197 cervical cancer patients at a tertiary teaching hospital in Ethiopia (February to April 2025). Internal consistency, convergent validity, and the structural validity of both the full scale and short form of the Amharic TiOS were tested. The Amharic TiOS mean score was 69.95 (±9.41, range 34–90), with a mean score of 3.89 (±0.52). Neither the four‐factor nor the one‐factor models fit the full scale. A unidimensional five‐item solution emerged with two possible item sets: (1, 6, 15, 14, and 18) and (1, 3, 15, 14, and 18). To preserve content validity, the second set was selected. This five‐item scale yielded a mean score of 4.01 (±0.57), strong internal consistency ( α = 0.88), and significant correlations with time since diagnosis ( r = 0.20, p < 0.05), perceived levels of shared decision‐making ( r = 0.38, p < 0.001), and health literacy ( r = −0.32, p < 0.01). Conclusion: Unlike the full Amharic scale, the short form demonstrated acceptable psychometric properties and can be used to assess trust in both clinical practice and research settings among cervical cancer patients in Ethiopia.

Introduction: In Ethiopia, according to the GLOBOCAN 2022 report, there were 1,494 cases of esophageal cancer and 1,422 deaths attributed to the disease. The incidence and mortality of esophageal cancer are projected to increase to 3,210 and 3,057 cases by 2040, respectively. Approximately 68.3% of the cases were reported from the Arsi and Bale Zones, which also had the highest disease burden and mortality. Thus, undertaking a thorough study to identify hotspot areas for local preventative and control actions is important. Objective: To assess the spatial clustering of esophageal cancer in Central Oromia, Ethiopia. Methods: A cross-sectional study design was employed to investigate the spatial clustering of esophageal cancer patients. Data were collected from records of 367 patients who visited four hospitals (namely, Tikur Anbessa Specialized Hospital, Adama Hospital Medical College, Asella Teaching and Referral Hospital, and Meda Walabu University General Hospital) between April 3, 2019, and August 25, 2025. The kebele, woreda, and zone of each patient were collected from the records and linked to Ethiopian shapfiles obtained from the Ethiopian Space Science and Geospatial Institute (SSGI). The spatial inequality of esophageal cancer was measured using the Gini coefficient; while spatial autocorrelation was assessed using Moran’s I. The risks within clusters were quantified using relative risk (RR) with its 95% confidence interval, as well as log-likelihood ratio (LLR) and p-values. Results: The annual incidence of esophageal cancer in the study area was 2.60 cases per 100,000 populations [95% CI: 2.34, 2.88]. The Gini coefficient revealed spatial inequality in the distribution of cases at both the district (G = 0.33; 95% CI: 0.24, 0.40) and kebele levels (G = 0.38; 95% CI: 0.33, 0.43). The Moran’s I showd significant positive spatial autocorrelation at the kebele level (I = 0.17, p-value = 0.037). The risk of developing esophageal cancer was high in Robe district [RR = 1.93; 95% CI: 1.43, 2.61; LLR = 6.82; p-value = 0.022], Robe 01 kebele [RR = 7.8; 95% CI: 4.57, 13.31; LLR = 16.35; p-value = 0.000024], and Kula 01 kebele [RR = 9.96; 95% CI: 4.45, 22.32; LLR = 8.35; p-value = 0.034]. In contrast, 17 districts [RR = 0.55; 95% CI: 0.41, 0.73; LLR = 9.31; p-value = 0.0051] and 52 kebeles [RR = 0.55; 95% CI: 0.41, 0.73; LLR = 0.87; p-value = 0.014] were identified as low-risk areas. Conclusion and recommendation: Esophageal cancer showed uneven spatial distribution and significant autocorrelation in the study area. The presence of both high- and low-risk areas indicated significant geographic disparities. Robe district had nearly twice the risk, Robe 01 kebele had more than seven times the risk, and Kula 01 kebele had nearly ten times the risk of developing esophageal cancer compared to other districts and kebeles, respectively. Allocating diagnostic resources to health facilities serving high-risk districts and kebeles, promoting community health education on modifiable risk factors, and investigating individual-level risk factors are required to explain the observed clustering patterns.

Background: Chemotherapy is an essential component of comprehensive cancer care and timely access can improve survival outcomes. The objective of this study was to assess the time to chemotherapy initiation and patient-reported barriers to cancer care among patients from Addis Ababa, Ethiopia. Methods: We conducted a retrospective study using a randomly selected sample of 350 patients with common cancers (breast [ICD-10: C50], cervical [C53], colorectal [C18-20], oesophageal [C15], gastric [C16] and ovarian [C56]) registered at the population-based Addis Ababa City Cancer Registry (AACCR) in 2021. Patients or their relatives were followed-up via questionnaire-based telephone interview and treatment data were extracted from their medical records. The time from pathological diagnosis to initiation of chemotherapy (time to treatment) was calculated. Regression analyses were conducted to identify predictors of chemotherapy initiation and treatment delays. Results: Most patients (71.7%) received chemotherapy and the median time to treatment was 63 days (IQR 36.5 to 128 days). Patients reported considerable barriers to treatment regarding fear, cost and waiting times. Having health insurance (OR 2.70; 95% CI 1.33 to 5.50) and trust in healthcare professionals (OR 1.76; 95% CI 1.16 to 2.68) were associated with higher odds of receiving chemotherapy. Patients with cervical (OR 0.07; 95% CI 0.03 to 0.18), gastric (OR 0.21; 95% CI 0.05 to 0.86) or oesophageal cancer (OR 0.10; 95% CI 0.02 to 0.53) were less likely to initiate chemotherapy compared to breast cancer patients. Longer time to treatment was not associated with any of the assessed characteristics or perceived barriers. Conclusion: Over half of the cancer patients from Addis Ababa wait more than two months to initiate chemotherapy after a pathological diagnosis. Expanding oncology services and health insurance coverage could enhance access to treatment. Health professionals should promote patient trust by appropriately addressing their psychosocial needs, including cancer-related fear, to improve the uptake of treatment and thus clinical outcomes. Implications for practice: Improving access to timely chemotherapy requires coordinated action across multiple levels. Strengthening health system capacity and care coordination is essential to reduce delays, while improving provider-patient communication and integrating psychosocial support can address fear and enhance treatment uptake and adherence. Expanding health insurance coverage may reduce financial barriers but must be accompanied by increased service availability to be effective.

HIV vaccine trials are clinical research studies conducted to assess safety, immunogenicity and efficacy of candidate vaccines for prevention and control of HIV infection or viral replication in in...

Background: While smoking is the dominant global driver of lung cancer, less than a quarter of Ethiopian patients have ever smoked, pointing to locally relevant risk factors. Evidence to guide prevention and early detection in resource-limited settings is scanty. Methods: To address this gap, we conducted a multicenter matched case–control study including 351 histopathologically confirmed primary lung cancer cases and 702 hospital-based controls matched by sex, age (±5 years), and residence. Directed acyclic graphs informed the selection of variables, and multivariable hierarchical conditional logistic regression was used to identify risk factors beyond smoking. Results: The analysis shows that lung cancer was independently associated with low education, wealth, solid-fuel use, occupational exposure, insufficient physical activity, meat-based and processed food dietary patterns, secondhand smoke (SHS), prior tuberculosis, and family history of cancer. Subgroup analysis by sex revealed consistent associations across males and females, but exposure distributions explained sex-specific patterns: smoking, occupational exposure, meat-based diets, and family history were more common among males, whereas SHS, the use of solid fuels, and processed food dietary patterns predominated in females. Conclusions: Lung cancer in Ethiopia appears to be associated with several factors in addition to smoking. Gender-sensitive public health interventions targeting these locally relevant risk factors are essential for effective prevention and early detection.

Traumatic injury has substantial effects on survivors' overall functioning, including at work. In low-income settings, trauma care and rehabilitation services are weak, which can complicate the recovery and return-to-work process of injury survivors. This study aimed to construct a substantive theory on the return to work (RTW) experiences of injury survivors, people who sustained traumatic physical injuries in Ethiopia. A qualitative constructivist grounded theory (CGT) study was conducted, using data collected through in-depth interviews with fourteen adult injury survivors. We followed Charmaz's CGT approach for data coding and analysis. We constructed the core theme, "Synergistic Connectedness," characterized by three subthemes: spiritual-, social-, and self- connection, which catalyzed survivors' lives after injury. Participants' experiences were captured in three progressive, iterative and nonlinear recovery phases: 1) initial response - dealing with the reality; 2) disruptive recovery - negotiating uncertainty and meaning-making; and 3) RTW pathways - navigating capability to adapt, fit, accept or follow a new direction. Each survivor faced unique challenges and had resources to draw on for support, ultimately leading to a resilient recovery process. Spiritual connection is the unique strength of participants that influences their connectedness to self and others. The findings underscore the importance of holistic support in enhancing RTW outcomes after injury.

The burden of cervical cancer (CC) is rising in Ethiopia, yet delays in diagnosis and treatment along care pathways remain a challenge. We aimed to explore

PURPOSE: This study investigates the interplay between T-cell receptor (TCR) immune characteristics and microbiome profiles to explore the relationship between immune diversity and microbial composition in cervical samples from Ethiopia. METHODS: Cervical specimens were collected from patients at Tikur Anbessa Specialized Hospital in Addis Ababa, and rural Butajira, south-central Ethiopia. Patient data, including age, human papillomavirus status, pathology, and TCR immune characteristics, were analyzed with a focus on the interactions between TCR profiles and microbiome compositions in malignant samples. RESULTS: Three distinct TCR profiles were identified: Group 1 (TCR active) exhibited features of active immune engagement, including high diversity, clonal expansion, and repertoire richness. Group 2 (TCR restricted) showed reduced TCR diversity and expansion, suggesting a restricted repertoire. Group 3 (TCR balanced) had moderate diversity and clonal activity. TCR repertoire groups were linked with microbial diversity, with Group 1 (TCR active) showing the highest number of microbes (high operational taxonomic units and microbial diversity). Maximum TCR clonal expansion positivity associated with microbial richness, while Group 3 (TCR balanced) was linked to reduced microbial alpha diversity. Taxonomic analysis revealed specific organisms enriched in TCR repertoire group. CONCLUSION: Variations in TCR profiles are linked to distinct microbial environments in cervical cancer with greater microbial richness in patients with greater maximum productive frequency. These findings underscore the interplay between TCR diversity, microbiome composition, and malignancy, offering insights into the potential implications for microbiome-targeted therapies and prognostic biomarkers in cervical cancer.

PURPOSE: Delays in presentation, diagnosis, and treatment present common challenges in breast cancer care in Ethiopia. However, few interventions have been implemented aimed at addressing the issue in the country. To tackle this problem, we conducted a situational assessment to gather general information on the health care infrastructure and workforce and to explore the potential opportunities and challenges for implementing clinical breast examination (CBE) and patient navigation (PN) intervention in Ethiopia. METHODS: A qualitative study was conducted at six general hospitals. A total of 18 in-depth interviews and nine focus group discussions were conducted based on the Consolidated Framework for Implementation Research (CFIR) approach with regional health officials, medical directors, clinical staff, eligible women, and breast cancer survivors. The data were deductively coded and thematically analyzed. RESULTS: From the five major domains of the CFIR, 17 constructs were developed from the narration of the stakeholders. Several factors were identified as opportunities for implementation: the presence of national breast cancer guidelines, a supportive environment from regional and Ministry of Health, experience of working with the community, teamwork experience, and the existence of a community health extension program. The challenges mentioned included a lack of adequate diagnostic facilities, security issues, limited cancer-trained professionals, staff turnover, negative perceptions about cancer in the community, staff workload, and the need for training and logistics. CONCLUSION: The stakeholders recognized that implementing provider-initiated CBE and navigation is an acceptable and feasible initiative that can be performed in the study hospitals using the existing infrastructure and human resources. Collaboration, community engagement, continuous monitoring, and evaluation are vital for successful implementation.