Background: Cancer has been the leading cause of death worldwide with its various enormous socio-economic impacts. Hence, early palliative care implementation is a potent addition to oncology for the treatment of physical, mental, and psychological pain in cancer patients. Therefore, this article aims to assess the prevalence of patients requiring palliative care and its associated factors among admitted cancer patients. Methods: A cross-sectional study was conducted among cancer patients who were admitted to oncology wards during the data collection period at St. Paul Hospital, Ethiopia. The Palliative Care Indicators Tool in Low-Income Settings (SPICT-LIS) was used to determine the need for palliative care. The collected data was entered into EpiData version 3.1 and exported to Statistical Package for the Social Sciences (SPSS) version 26 for analysis. A multivariable logistic regression was used to analyze the predictors of palliative care need. Results: A total of 301 cancer patients were included in this study, with a mean age of 42 years (SD=1.38). The prevalence of palliative care needs among the patients in this study was 10.6% (n=32). The study revealed that the need for palliative care increases as the age of the patient increases and suggested that cancer patients who were above 61 years old were two times (AOR=2.39 95% CI=0.34– 16.55) more likely to need palliative care than others. Male patients had a significantly higher requirement for palliative care compared to female patients (AOR=5.31, 95% CI=1.68– 11.79). Conclusion: The manuscript describes the palliative care needs of patients with cancer admitted to St. Paul Hospital in Ethiopia. The study revealed that the health status of a significant number of cancer patients in the hospital was deteriorating. Hence, the hospital administrators and the oncology ward staff are recommended to pay attention to the identified factors.

The coronavirus disease 2019 (COVID-19) pandemic has provided a great lesson for the globe about the necessity and significance of pandemics-related preparedness in all settings. Public health emergency operation centers play critical roles in preparing for and responding to public health events and emergencies by coordinating and pooling resources. In this article, we aimed to share lessons learnt from the public health response to the louse-borne relapsing fever (LBRF) outbreak coordinated by the emergency operation center established to respond to the COVID-19 pandemic in Jimma, Ethiopia. After the major waves of COVID-19 outbreaks in Ethiopia were over, Jimma University Medical Center (JUMC) reported clusters of louse-borne relapsing fever cases from Jimma Main Prison. Accordingly, Jimma Emergency Operation Center (JEOC) established for the COVID-19 pandemic was immediately alerted and effectively coordinated the overall response. As a result, the outbreak was contained within the prison without spreading to the community and the outbreak ended within a shorter period compared to previous LBRF outbreaks in Ethiopia. This indicates the necessity of establishing and sustaining public health emergency operation centers to prepare for and combat potential future public health emergencies.

Louse-borne relapsing fever (LBRF) remains a cause of sporadic illness and occasional outbreaks in Ethiopia and other east African countries in overcrowded and unhygienic settings. In this article, we present clinical profiles and treatment outcome of patients treated as confirmed or probable cases of LBRF at Jimma Medical Center (JMC) in southwest Ethiopia. Patients treated as confirmed or probable cases of LBRF at JMC during a period of May–July 2022 were prospectively followed during their course of hospital stay. All patients were evaluated with blood film for hemoparasites, complete blood count, and liver enzymes on hospital presentation. They were followed with daily clinical evaluation during their hospital stay. Thirty-six patients were treated as cases of LBRF. All patients except one were from Jimma Main Prison in Jimma Town, Ethiopia. All the patients were male with mean age of 28.7 years (SD = 12.7). The diagnosis of LBRF was confirmed by detection of B. recurrentis in blood film of 14 (38.9%) of the patients; the rest were treated as presumptive case of LBRF. Fever, reported by all patients, and an acute onset epistaxis, 30 (83.3%), were the major reasons for healthcare visits. Twenty-two (61.1%) patients were having thrombocytopenia with a platelet count < 150,000/μL; nine (25%) of which had severe forms (<50,000/μL). All patients were treated with oral doxycycline and discharged with improvement after a mean length of hospital stay of 4.25 days (SD = 0.77), range 2–6 days. Public health emergency was activated within two days of the first cases and helped in delousing all the cases and their contacts. LBRF remains a public health problem in Ethiopia in settings with poor personal hygiene. Patients with LBRF may present with severe thrombocytopenia and life-threatening bleeding. Early detection and treatment initiation prevents outbreak propagation and improves treatment outcome.

Kaposi sarcoma is a tumor commonly associated with human herpesvirus 8 (HHV-8) infection and is more prevalent in individuals with immunosuppression, such as those with HIV/AIDS, organ transplant recipients, or other conditions causing immune dysfunction. It typically presents as purple patches or nodules commonly affecting the skin or mucous membrane of the gastrointestinal tract, and can spread to the lymph nodes and lungs. This case report describes an 18-year-old male with vertical HIV infection, managed on a regimen of dolutegravir/lamivudine/tenofovir (DTG/3TC/TDF), and with a recent CD4 count of 627cells/mm³and recent viral load of 378 copies/ml, presented with exacerbation of shortness of breath, productive cough with blood-tinged sputum, and a diffuse skin rash. The patient also had tongue swelling with purple discoloration, as well as swelling of the entire left leg and right arm. On physical examination, the patient appeared acutely ill with marked respiratory distress. Notable findings included a bluish, exophytic mass with irregular borders involving the posterior tongue and the hard palate. There was also non-tender, soft, multiple submental and supraclavicular lymphadenopathy, bilateral crackles on lung auscultation, and widespread, patchy, nodular skin lesions. A high-resolution computed tomography (CT) scan of the lungs was suggestive of Kaposi sarcoma that was confirmed with skin biopsy. The patient was treated initially with antibiotics, and supplemental oxygen, while continuing anti-retroviral therapy. The case underlines that though epidemic Kaposi sarcoma is often a disease of immunosuppressed people caused by retroviral infection, there is still the possibility in those with high CD4 counts despite viral load remains low. A high level of suspicion in high-risk patients presenting with characteristic skin lesions is critical for early diagnosis and prompt initiation of available treatment options for a better patient outcome.

Key Clinical Message: Understand the importance of considering alternative diagnosis in patients presenting with atypical features. Understand the importance of considering common presentations of rare cases. Underscoring the critical importance of timely recognition and appropriate management of potentially life‐threatening condition.