Introduction The costs associated with cancer diagnosis, treatment and care present enormous financial toxicity. However, evidence of financial toxicity associated with cancer in low- and middle-income countries (LMICs) is scarce. Aim To determine the prevalence, determinants and how financial toxicity has been measured among cancer patients in LMICs. Methods Four electronic databases were searched to identify studies of any design that reported financial toxicity among cancer patients in LMICs. Random-effects meta-analysis was used to derive the pooled prevalence of financial toxicity. Sub-group analyses were performed according to costs and determinants of financial toxicity. Results A total of 31 studies were included in this systematic review and meta-analysis. The pooled prevalence of objective financial toxicity was 56.96% (95% CI, 30.51, 106.32). In sub-group meta-analyses, the objective financial toxicity was higher among cancer patients with household size of more than four (1.17% [95% CI, 1.03, 1.32]; p = 0.02; I2 = 0%), multiple cycles of chemotherapy (1.94% [95% CI, 1.00, 3.75]; p = 0.05; I2 = 43%) and private health facilities (2.87% [95% CI, 1.89, 4.35]; p < 0.00001; I2 = 26%). Included studies hardly focused primarily on subjective measures of financial toxicity, such as material, behavioural and psychosocial. One study reported that 35.4% (n = 152 of 429) of cancer patients experienced high subjective financial toxicity. Conclusions This study indicates that cancer diagnosis, treatment and care impose high financial toxicity on cancer patients in LMICs. Further rigorous research on cancer-related financial toxicity is needed.

IntroductionPersons with disabilities have the same sexual and reproductive health (SRH) needs as the abled people but they often face barriers to SRH information and services which are necessary for healthy and safe relationships, protection from HIV and other sexually transmitted infections (STIs). This study sought to access the SRH services among adolescents with disabilities in four Special Needs Schools in Ghana.MethodsThe study adopted a cross-sectional study design with a quantitative approach to data collection between the months of January to March, 2018. A structured and pretested questionnaire was used to collect data from adolescents with disabilities from selected schools in Ghana. Both descriptive and inferential statistics were performed using chi-square test and multivariate logistic regression.ResultsMajority of participants had hearing disability (52.1%). The average age at menarche among females was 13 years whiles the age at which puberty was attained among boys was 14 years. School teachers were the major source of information on SRH for the respondents (63.7%) followed by parents (12.2%). A majority (67.1%) of respondents had good knowledge of SRH. Factors which were significantly associated with knowledge level were age (p=0.026), religion (p=0.034), sources of information (p<0.001), guardians (p=0.049).ConclusionThe majority of participants had good knowledge of SRH, although their knowledge of contraceptive and access were poor. Only condoms were mostly known. There is the need for increased awareness on the availability of other contraceptives methods and the removal of barriers to contraceptive methods.

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Radiation and radioactive isotopes form part of our natural environment. Elevated levels of these radioactive isotopes in the environment can pose a threat to our health. A greater proportion of the natural radiation is from the radioactive gas radon. Although it cannot be detected by human senses, radon and its progenies are of health concern as it can cause lung cancer when inhaled over a period of time. This study sought to provide baseline indoor radon data, the life time risk of lung cancer and its interpretation within a suburb of Ghana. Solid State Nuclear Track Detector (LR-115 type II) was deployed in 82 homes within a suburb for a period of three months (September 2017-January 2018). Indoor radon concentration (IRC) for the suburb was within the range of 4.1-176.3 Bq m −3 . With mean 57±39 Bq m −3 . The mean radon exposure to the dwellers was recorded as 0.12±0.08 WLMy −1 resulting in 0.7±0.5 mSvy −1 effective dose to the lung with an excess lifetime cancer risk of 0.39±0.26%. There was a positive correlation between indoor radon concentration and the building type and the association was significant with a P value of 0.047.