Maternal Death Surveillance System Evaluation at Addis Ababa City Administration, Ethiopia, 2018
Kefyalew Amene Bogale,
Tesfahun Abye Meshesha,
Abiy Girmay
Issue:
Volume 8, Issue 4, December 2020
Pages:
64-73
Received:
21 July 2020
Accepted:
4 August 2020
Published:
23 November 2020
Abstract: Introduction: Public health surveillance is an ongoing, systematic collection, analysis, interpretation, and dissemination of data regarding a health-related event for use in public health. Maternal Death Surveillance and Response (MDSR) is form of continuous surveillance linking the health information system to quality improvement processes from local to national levels. Ethiopia has been implementing Maternal Death Surveillance and Response for the last four years. The aim of evaluating Maternal Death Surveillance and Response system at Addis Ababa City Administration was to evaluate the performance and identify gaps of existing system in city administration 2018. Methods: A descriptive cross-sectional study design was used to evaluate Maternal Death Surveillance and Response system at Addis Ababa City Administration, which was conducted from March 12-23/2018. Purposive sampling technique was used to select 13 study units. Primary data was collected using structured questionnaire and crosschecked with available documents. Data was analyzed using Microsoft Office Excel, 2016. Result: Only 67% of study units had appropriate denominator and the denominator at city level was 1168157 (34.6% of total population). All study units had maternal death review committee and the action threshold used by all study units was one maternal death. A total 52 maternal death notifications received by the region from Sept/2016 to Aug/2017, giving case detection rate of 13% of national plan for the city. All notifications were true maternal deaths. Cause of death identified for 50 (96.15%) of deaths and only findings from 7 (14%) deaths used for action. No separate budget was allocated for Maternal Death Surveillance and Response system at all levels. MDSR system implementation at private health facilities was almost neglected and overall average attribute measurement for the system was 63%. Conclusion: Maternal Death Surveillance and Response system establishment objectives will not be achieved by current level of implementation and detection. Data utilization and attributes value was very low. Lack of separate budget affects the system implementation.
Abstract: Introduction: Public health surveillance is an ongoing, systematic collection, analysis, interpretation, and dissemination of data regarding a health-related event for use in public health. Maternal Death Surveillance and Response (MDSR) is form of continuous surveillance linking the health information system to quality improvement processes from l...
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Combined Application of Anticancer Vaccines of IEPOR Series and Doxorubicin in Rats with Transplanted Walker Carcinosarcoma
Olena Kruts,
Volodymyr Konovalenko,
Volodymyr Bazas,
Sergii Konovalenko,
Gennadii Didenko,
Oleksandr Lytvynenko,
Anna Artamonova,
Oksana Gerashchenko
Issue:
Volume 8, Issue 4, December 2020
Pages:
74-78
Received:
26 October 2020
Accepted:
11 November 2020
Published:
4 December 2020
Abstract: Anticancer xenogeneic vaccine – is an agent, containing antigens of embryonic origin that underwent biotransformation under the action of cytotoxic proteins of В. subtilis B-7025. Anticancer efficacy of the vaccine is implemented by breaking immune system tolerance to own tumor antigens due to the antigenic similarity between tumor and embryonic proteins. The experiments were conducted in Wistar female rats (age 2.5 months and weight 200-220 g, bred at the animal house of R. E. Kavetsky Institute of Experimental Pathology, Oncology and Radiobiology). The care and use of the experimental animals have been performed in accordance with generally accepted international rules for conducting experiments in experimental animals. As an experimental tumor model, we have used Walker carcinosarcoma. In preclinical and clinical trials, success has been demonstrated in the use of a combination of anticancer vaccines with chemotherapy to achieve a synergistic effect, even if the dose and schedule of administration of the agents needed to be optimized. It has been shown that some drugs (doxorubicin, cyclophosphamide, docetaxel) induce immunological death of tumor cells, increase the expression of tumor-associated antigens, HLA-peptide complexes, thus sensitizing the tumor in vaccine-induced T-cell killing. It was determined that simultaneous administration of anticancer vaccines (regardless of the antigenic composition) and Doxorubicin resulted in a significant increase of survival and average lifespan of the experimental animals. The treated animals at the end of the experiment presented with increased cytotoxicity of lymphocytes and macrophages (both direct and antibody-dependent), suggesting a reduced level of immunosuppression in experimental animals. In the group of rats, receiving Dox, the serum had no effect on the activity of lymphocytes. These data suggest that during the development of tumor the serum accumulates humoral factors, capable of blocking lymphocyte activity. Yet, as a result of additional activation (due to anticancer vaccines), the conditions are provided when the inhibitory activity of humoral factors is eliminated. The combined application of chemo- and biotherapy based on anticancer vaccines of IEPOR series is an efficient and rather perspective method of inhibition of malignant tumor process. The optimal scheme of the combined therapy was developed that involved the administration of anticancer vaccines together with the application of chemotherapeutic agents. The augmentation of antitumor effect can be explained by the reduction of immunosuppressive activity of blood serum towards the effector cells of antitumor immunity, resulting from the additional signal to the immune system - use of anticancer vaccines.
Abstract: Anticancer xenogeneic vaccine – is an agent, containing antigens of embryonic origin that underwent biotransformation under the action of cytotoxic proteins of В. subtilis B-7025. Anticancer efficacy of the vaccine is implemented by breaking immune system tolerance to own tumor antigens due to the antigenic similarity between tumor and embryonic pr...
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Effectiveness of Late Line Palliative Chemotherapy by Specialised Approach to Cancer of Unknown Primary: A Case Report
Itaru Sato,
Naoki Nakaya,
Yoko Obara,
Natumi Kurosaka,
Souichirou Ueno,
Hideo Nakajima
Issue:
Volume 8, Issue 4, December 2020
Pages:
79-81
Received:
20 November 2020
Accepted:
4 December 2020
Published:
11 December 2020
Abstract: Background: Cancers of unknown primary (CUPs) are defined as histologically confirmed metastatic tumours whose primary site cannot be identified during standard pretreatment evaluation. No specific regimen can be recommended as standard of care. Taxanes and platinum-based regimens are commonly used in the first-line treatment of CUPs, but there is no specific regimen for after second-line treatment. In general, late line chemotherapy is not recommended, but we experienced a rare case of CUPs with disseminated disease that showed improvement with fifth-line palliative chemotherapy by specialised approaches based on the reconsideration of histologic type of cancer. We report a rare case in which palliation was achieved by late line chemotherapy based on pathological review. Case: The case was a 65 year-old man. Transverse colectomy and peritoneal metastasectomy were performed for CUPs. The chemotherapy was continued for 3 years afterwards, and the fourth treatment was not effective. The pathological reexamination was carried out in examining the 5th line treatment, and the chemotherapy (pazopanib) was started under the diagnosis of epithelioid sarcoma. The tumor did not shrink, but the antipyretic effect on tumor fever was achieved, resulting in palliation of symptoms. Conclusions: In general, late line chemotherapy for CUPs is not recommended, but palliative chemotherapy based on pathologic profile may be effective and relieve symptoms of CUPs.
Abstract: Background: Cancers of unknown primary (CUPs) are defined as histologically confirmed metastatic tumours whose primary site cannot be identified during standard pretreatment evaluation. No specific regimen can be recommended as standard of care. Taxanes and platinum-based regimens are commonly used in the first-line treatment of CUPs, but there is ...
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