Mr Mitiku Teshome Hambisa

Background: In estimating the global burden of cancer, adolescents and young adults with cancer are often overlooked, despite being a distinct subgroup with unique epidemiology, clinical care needs, and societal impact. Comprehensive estimates of the global cancer burden in adolescents and young adults (aged 15¿39 years) are lacking. To address this gap, we analysed results from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019, with a focus on the outcome of disability-adjusted life-years (DALYs), to inform global cancer control measures in adolescents and young adults. Methods: Using the GBD 2019 methodology, international mortality data were collected from vital registration systems, verbal autopsies, and population-based cancer registry inputs modelled with mortality-to-incidence ratios (MIRs). Incidence was computed with mortality estimates and corresponding MIRs. Prevalence estimates were calculated using modelled survival and multiplied by disability weights to obtain years lived with disability (YLDs). Years of life lost (YLLs) were calculated as age-specific cancer deaths multiplied by the standard life expectancy at the age of death. The main outcome was DALYs (the sum of YLLs and YLDs). Estimates were presented globally and by Socio-demographic Index (SDI) quintiles (countries ranked and divided into five equal SDI groups), and all estimates were presented with corresponding 95% uncertainty intervals (UIs). For this analysis, we used the age range of 15¿39 years to define adolescents and young adults. Findings: There were 1·19 million (95% UI 1·11¿1·28) incident cancer cases and 396 000 (370 000¿425 000) deaths due to cancer among people aged 15¿39 years worldwide in 2019. The highest age-standardised incidence rates occurred in high SDI (59·6 [54·5¿65·7] per 100 000 person-years) and high-middle SDI countries (53·2 [48·8¿57·9] per 100 000 person-years), while the highest age-standardised mortality rates were in low-middle SDI (14·2 [12·9¿15·6] per 100 000 person-years) and middle SDI (13·6 [12·6¿14·8] per 100 000 person-years) countries. In 2019, adolescent and young adult cancers contributed 23·5 million (21·9¿25·2) DALYs to the global burden of disease, of which 2·7% (1·9¿3·6) came from YLDs and 97·3% (96·4¿98·1) from YLLs. Cancer was the fourth leading cause of death and tenth leading cause of DALYs in adolescents and young adults globally. Interpretation: Adolescent and young adult cancers contributed substantially to the overall adolescent and young adult disease burden globally in 2019. These results provide new insights into the distribution and magnitude of the adolescent and young adult cancer burden around the world. With notable differences observed across SDI settings, these estimates can inform global and country-level cancer control efforts. Funding: Bill & Melinda Gates Foundation, American Lebanese Syrian Associated Charities, St Baldrick's Foundation, and the National Cancer Institute.

Background. The prevalence of mental health problems including depression is increasing in severity and number among higher institution students, and it has a lot of negative consequences like poor academic performance and committing suicide. Identifying the prevalence and associated factors of mental illness among higher institution students is important in order to administer appropriate preventions and interventions. In Ethiopia, only a few studies tried to report associated factors of depression among university students. Objective. The objective of this study was to determine the prevalence and factors associated with depressive symptoms among Haramaya University students, Ethiopia. Methods. Institution-based, cross-sectional study design was conducted among 1040 students. A standard, self-administered questionnaire was used to get data from a sample of randomly selected 1040 undergraduate university students using a multistage systematic random sampling technique. The questionnaire used was the Beck Depression Inventory (BDI) scale which is a self-report 21-item scale that is used to assess the presence of depressive symptoms. All 21 items are rated on a three-point scale (0 to 3). Each question is scored on a 0 to 3 scale, and total scores range from 0 to 63, with higher scores reflecting greater levels of depressive symptoms. The questionnaire has been well validated as a measure of depressive symptomatology with scores 1-13 indicating minimal depressive symptoms, 14-19 showing mild depressive symptoms, 20-28 showing moderate depressive symptoms, and 29-63 indicating severe depressive symptoms. Logistic regression analysis was used to identify variables independently associated with depressive symptoms after we dichotomized the depressive symptoms screening tool to "yes/no" depressive symptoms. This means students who did not report any depressive symptoms were given "no" depressive symptoms and who reported at least one (=1) depressive symptoms were given "yes" (depressive symptoms). Results. A total of 1022 (98.3%) out of 1040 students participated in this study. The mean age of participants was 20.9 years (SD±2.17), and the majority of them (76.0%) were male students. Prevalence of depressive symptoms among undergraduate students was 26.8% (95% CI: 24.84, 28.76). Among those who had reported depressive symptoms: 10%, 12%, 4%, and 1% of students reported minimal, mild, moderate, and severe depressive symptoms, respectively. Multivariable logistic regression analysis in the final model revealed that being a first-year student (AOR 6.99, 95% CI: 2.31, 21.15, p value < 0.001), being a second-year student (AOR 6.25, 95% CI: 2.05, 19.07, p value < 0.001), and being a third-year student (AOR 3.85, 95% CI: 1.26, 11.78, p value < 0.018) and being divorced/widowed (AOR 5.91, 95% CI: 1.31, 26.72, p value < 0.021), current drinking alcohol (AOR 2.53, 95% CI: 1.72,3.72, p value < 0.001), current smoking cigarettes (AOR 1.71, 95% CI: 1.02, 2.86, p value < 0.042), and current use of illicit substances (AOR 2.20, 95% CI: 1.26, 3.85, p value < 0.006) were independently associated with depressive symptoms. Having no religion and currently chewing Khat were statistically significantly associated with depressive symptoms in the binary logistic regression analysis but not in the final model. Conclusions. The prevalence of depressive symptoms among university students in this study is high relative to the general population. Sociodemographic factors year of study and current substance use were identified as associated factors of depressive symptoms. Recommendations. This finding suggests the need for the provision of mental health services at the university, including screening, counseling, and effective treatment. Families need to closely follow their students' health status by having good communication with the universities, and they have to play their great role in preventing...