Audit of deaths from cervical cancer in a Palliative Care centre, Central-East Malawi [Retracted

Abstract

BACKGROUND: Cervical cancer is the most common cancer in sub-Saharan countries despite gains in the north of the continent in terms of prevention, early detection, and successful treatment. Palliative care, as the remaining option, in most advanced cases, is not widespread. Therefore, this death audit describes characteristics of deaths occurring due to cervical cancer. METHODS: A retrospective study of deaths was carried out at Ndi Moyo Palliative Care Centre between the inauguration and April 15th, 2010 using a case-review. RESULTS: Most of our participants were older than 50 years of age (67.6%), illiterate, from within Salima district (86.4%), unemployed (81%), with a high parity (6+) and were HIV positive (40.5%). The most common symptoms on admission were pain (55.5%), haemorrhage (35.1%), watery discharge (18.9%), urinary symptoms and weakness with 10.8% each; and were dying mainly at home (78.4%). Non-steroidal anti-inflammatory (91.8%), antibiotics (89.1%) and opioids (51.3%) were the common drugs prescribed. Poly-pharmacy and overuse of antibiotics contrasting and non-steroidal anti-inflammatory with relative medium use of opioids were found. CONCLUSION: The study demonstrates that palliative care at the centre occurs for poor, HIV reactive, multi gravid patients receiving a high burden of pills with medium to high use of antibiotics. Further research on each of the identified facts and expansion of palliative care, in terms of human capacity and availability of opioids for terminal patients, are needed. Sensitization of women, training of STI providers, reduction of pills burden to essentials drugs and strengthen of screening programs must be promoted