000			05798nam a22003137a 4500
001			CUHAS/MMED/6000247/T/18
003			CUHAS/MMED/6000247/T/18
005			20240423163754.0
008			231123b |||||||| |||| 00| 0 eng d
028			_bWurzburg Road 35, BMC Premises, Post Code: 33102:
028			_b P. O. Box 1464, Mwanza – Tanzania:
028			_bPhone: +255 28 298 3384:
028			_bFax: +255 28 298 3386:
028			_bEmail: vc@bugando.ac.tz:
028			_b www.bugando.ac.tz
035			_aCUHAS/MMED/6000247/T/18
040			_bEnglish _cDDC
041			_aEnglish
100			_aSalustia Aloyce Bugingo _d[Female] _eCUHAS/MMED/6000247/T/18
245			_aMortality within Ninety Days of Hemoglobin Correction Among Newly Diagnosed Solid Cancer Patients with Anaemia at Bugando Medical Centre Mwanza.
260			_aMwanza, Tanzania: _bCatholic University of Health and Allied Sciences [CUHAS – Bugando] : _c2023
300			_a86 Pages
300			_a Includes References and Appendices
520			_2 Abstract: Background: Anaemia is a common finding in cancer that is caused by several factors. Cancer-related low hemoglobin adversely affects the quality of life, worsens disease status, impairs treatment outcomes, and is associated with reduced overall survival. Anemia is a clinical status distinguished by a decreased erythrocyte mass with subsequent low hemoglobin and hematocrit counts. Mortality due to low hemoglobin levels among cancer patients is reported to be significantly high within the first 90 days of therapy. This could be due to tissue hypoxia which reduces the drugs delivered to the cells and hence interferes with the disease's response to therapy. A study conducted on 90 days' survival in solid cancer patients at Bugando medical center, reported a mortality rate of 11.8 % with a majority of deaths occurring among patients with low hemoglobin at baseline. This suggests a clinically significant association between survival and low hemoglobin level. Early hemoglobin correction was potential for treatment efficiency and increases survival rate. Currently, low hemoglobin correction in solid cancer patients at Bugando medical center depends on the attending physician's decision. This practice may contribute to disease progression and poor survival. Anemia-related mortality was found to be common in this population. Urgent restoration is important for potential local tumor control and survival at Bugando medical center. Objective: To determine ninety days’ mortality following Hb correction among newly diagnosed solid cancer patients with anaemia receiving oral iron supplement plus or minus red blood cells at Bugando medical center. Methodology: It was a hospital-based interventional longitudinal study in newly diagnosed solid cancer patients with hemoglobin levels ≤11.9 g/dl who planned to receive cancer treatment for curative intent. Both inpatient and outpatient attending at oncology department Bugando medical center between December 2022 and June 2023 were involved. A total of 236 patients were enrolled in the study aged 18 years and above. Face-to-face interviews were conducted using structured questionnaires, history taking and physical examination and a review of medical records for cancer type and cancer stage were done by the principal investigator. Venous blood was collected at baseline for a complete blood picture. Hemoglobin correction was done to all patients with hemoglobin ≤ 11.9 g/dl. For patients with hemoglobin level < 8g/dl were given using oral iron supplement plus red blood cells transfusion for Hb correction. Cancer therapy was given to all patients who maintained hemoglobin ≥ 8g/dl. Furthermore, all patients were followed for 90 days for mortality assessment starting from the day of hemoglobin correction. STATA version 15.0 software was used for data analysis. Results: Of 236 patients who participated in this study; 144 (61.02%) were female, and 140 (59.32%) were aged ≤ 60 years and majority were from the lake zone 94.92%. The prevalence of anaemia was 88.7%, with a median hemoglobin 10 [9-11], and about 71.61% of patients had mild anaemia. The commonest cancer types anatomically were gynecological 54 (22.88%) and gastrointestinal cancers 51(21.61%). Breast, genital and reproductive cancers were the second most 31(13.14%) and 30(12.51%), respectively. Among specific cancer subtypes, cancer of the cervix was 53 (22.45%) has high prevalent in all cancer followed by breast cancer 31(13.14%), prostate cancer 26 (11.2%), hepatocellular carcinoma 16 (6.78%) and esophageal cancer16 (6.78%). Majority of anaemic patients (92.80%) received oral iron supplement for hemoglobin correction and a total of 25 (10.7%) patients died within 90 days of following hemoglobin correction. Cancer stage (OR; 1.97; 95% CI 1.04-3.74; p-value =0.037), poor performance status (OR; 2.54; 95% CI 1.11-5.74; p value=0.026), multiple comorbidities (OR;6.01; 95% CI 2.10- 17.18; p-value = 0.001) were factors associated with mortality. Conclusion. We have observed a high prevalence of anaemia in solid cancer patients, cervical, breast cancer, prostate cancer and gastrointestinal cancer remained the dominant among all solid cancer types. Mortality within 90 days of therapy was slightly lower than that reported by the previous study, blood transfusion, and an oral iron supplement might have a positive effect on Hb dynamics and maintained Hb level ≥ 8/g/dl pretherapy. Poor performance status, cancer stage, and comorbid conditions showed a statistically significant association with 90 days' mortality.
600			_xInternal Medicine
700			_a Beda Mnamala Likonda _9292007
700			_aEveline T. Konje
942			_2ddc _cMP
999			_c18786 _d18786