Mapping Evidence on the Burden of Breast, Cervical, and Prostate Cancers in Sub-Saharan Africa: A Scoping Review.

Background: Cancer remains a major public health problem, especially in Sub-Saharan Africa (SSA) where the provision of health care is poor. This scoping review mapped evidence in the literature regarding the burden of cervical, breast and prostate cancers in SSA. Methods: We conducted this scoping review using the Arksey and O'Malley framework, with five steps: identifying the research question; searching for relevant studies; selecting studies; charting the data; and collating, summarizing, and reporting the data. We performed all the steps independently and resolved disagreements through discussion. We used Endnote software to manage references and the Rayyan software to screen studies. Results: We found 138 studies that met our inclusion criteria from 2,751 studies identified through the electronic databases. The majority were retrospective studies of mostly registries and patient files (n = 77, 55.8%), followed by cross-sectional studies (n = 51, 36.9%). We included studies published from 1990 to 2021, with a sharp increase from 2010 to 2021. The quality of studies was overall satisfactory. Most studies were done in South Africa (n = 20) and Nigeria (n = 17). The majority were on cervical cancer (n = 93, 67.4%), followed by breast cancer (67, 48.6%) and the least were on prostate cancer (48, 34.8%). Concerning the burden of cancer, most reported prevalence and incidence. We also found a few studies investigating mortality, disability-adjusted life years (DALYs), and years of life lost (YLL). Conclusions: We found many retrospective record review cross-sectional studies, mainly in South Africa and Nigeria, reporting the prevalence and incidence of cervical, breast and prostate cancer in SSA. There were a few systematic and scoping reviews. There is a scarcity of cervical, breast and prostate cancer burden studies in several SSA countries. The findings in this study can inform policy on improving the public health systems and therefore reduce cancer incidence and mortality in SSA.

Prevalence and factors associated with self-reported HIV testing among adolescent girls and young women in Rwanda: evidence from 2019/20 Rwanda Demographic and Health Survey.

BACKGROUND: HIV/AIDS remains a major public health problem globally. The majority of people living with HIV are from Sub-Saharan Africa, particularly adolescent girls and young women (AGYW) aged 15-24 years. HIV testing is crucial as it is the gateway to HIV prevention, treatment, and care; therefore this study determined the prevalence and factors associated with self-reported HIV testing among AGYW in Rwanda. METHODS: We conducted secondary data analysis on the AGYW using data extracted from the nationally representative population-based 2019/2020 cross-sectional Rwanda Demographic and Health Survey (DHS). We described the characteristics of study participants and determined the prevalence of HIV testing and associated factors using the multivariable logistic regression model. We adjusted all our analyses for unequal sampling probabilities using survey weights. RESULTS: There were a total of 5,732 AGYW, with the majority (57%) aged 15-19 years, 83% were not living with a man, 80% were from rural areas, 29% were from the East region, and 20% had a history of pregnancy. Self-reported HIV testing prevalence was 55.4% (95%CI: 53.7 to 57.0%). The odds of ever having an HIV test were significantly higher for those aged 20-24 years (aOR 2.87, 95%CI: 2.44 to 3.37); with higher education (aOR 2.41, 95%CI:1.48 to 3.93); who were rich (aOR 2.06, 95%CI:1.57 to 2.70); with access to at least one media (aOR 1.64, 95%CI: 1.14 to 2.37); who had ever been pregnant (aOR 16.12, 95%CI: 9.60 to 27.07); who ever had sex (aOR 2.40, 95%CI: 1.96 to 2.95); and those who had comprehensive HIV knowledge (aOR 1.34, 95%CI: 1.17 to 1.54). CONCLUSIONS: We report an unmet need for HIV testing among AGYW in Rwanda. We recommend a combination of strategies to optimize access to HIV testing services, especially among the 15-19 years adolescent girls, including facility-based testing, school and community outreach, awareness campaigns on HIV testing, and home-based testing through HIV self-testing.

Mycotoxin-Linked Mutations and Cancer Risk: A Global Health Issue.

Humans continue to be constantly exposed to mycotoxins, mainly through oral exposure (dietary), inhalation, or dermal contact. Recently, it has been of increasing interest to investigate mycotoxin-linked carcinogenicity. This systematic review was conducted to synthesize evidence of the association between mycotoxin-linked mutations and the risk of cancer, to provide an overview of the data linking exposure to different mycotoxins with human cancer risk, and to provide an update on current research on the risk of cancer associated with human exposure to mycotoxins. PRISMA guidelines were used when conducting the systematic review. PubMed, MEDLINE, and CINAHL electronic databases were comprehensively searched to extract the relevant studies published from inception to May 2022. A total of sixteen relevant studies (4907 participants) were identified and included in this review. Of these, twelve studies were from Asia, while four of the studies were conducted in Africa. The overall meta-analysis result found no significant association, although some of the studies confirmed an association between mycotoxin-linked mutations and primary liver cancer risk. Mainly, the experimental studies have shown associations between mycotoxin-linked mutations and cancer risk, and there is a need for researchers to confirm these links in epidemiological studies in order to guide public health policies and interventions.

Six Main Contributing Factors to High Levels of Mycotoxin Contamination in African Foods.

Africa is one of the regions with high mycotoxin contamination of foods and continues to record high incidences of liver cancers globally. The agricultural sector of most African countries depends largely on climate variables for crop production. Production of mycotoxins is climate-sensitive. Most stakeholders in the food production chain in Africa are not aware of the health and economic effects of consuming contaminated foods. The aim of this review is to evaluate the main factors and their degree of contribution to the high levels of mycotoxins in African foods. Thus, knowledge of the contributions of different factors responsible for high levels of these toxins will be a good starting point for the effective mitigation of mycotoxins in Africa. Google Scholar was used to conduct a systemic search. Six factors were found to be linked to high levels of mycotoxins in African foods, in varying degrees. Climate change remains the main driving factor in the production of mycotoxins. The other factors are partly man-made and can be manipulated to become a more profitable or less climate-sensitive response. Awareness of the existence of these mycotoxins and their economic as well as health consequences remains paramount. The degree of management of these factors regarding mycotoxins varies from one region of the world to another.

Fusarium Mycotoxins, Their Metabolites (Free, Emerging, and Masked), Food Safety Concerns, and Health Impacts.

The genus Fusarium produces a number of mycotoxins of diverse chemical structures. Fusariotoxins are secondary metabolites produced by toxigenic fungi of the genus Fusarium. The important and commonly encountered fusariotoxins are trichothecenes, fumonisins, and zearalenone. Fusarium mycotoxins pose varying toxicities to humans and/or animals after consumption of contaminated grain. They can cause acute or chronic illness and, in some cases, death. For instance, a range of Fusarium mycotoxins can alter different intestinal defense mechanisms, such as the epithelial integrity, cell proliferation, mucus layer, immunoglobulins, and cytokine production. Of recent concern is the occurrence of emerging and masked Fusarium mycotoxins in agricultural commodities, which may contribute to toxic health effects, although the metabolic fate of masked mycotoxins still remains a matter of scientific discussion. These mycotoxins have attracted attention worldwide because of their impact on human and animal health, animal productivity, and the associated economic losses. In this paper, we review Fusarium mycotoxins and their metabolites with the aim of summarizing the baseline information on the types, occurrence, and health impacts of these mycotoxins in order to encourage much-needed research on integrated management of this unavoidable food contaminant as concerns for food safety continues to grow worldwide.

Multi Mycotoxin Determination in Dried Beef Using Liquid Chromatography Coupled with Triple Quadrupole Mass Spectrometry (LC-MS/MS).

Dried beef meat, a locally processed meat from the cow, is vulnerable to contamination by mycotoxins, due to its exposure to the environmental microbiota during processing, drying, and point of sale. In this study, 108 dried beef samples were examined for the occurrence of 17 mycotoxins. Samples were extracted for mycotoxins using solid-liquid phase extraction method, while liquid chromatography coupled with triple quadrupole mass spectrometry (LC-MS/MS) via the dilute and shoot method was used to analyze the mycotoxins. Aflatoxin was found in 66% of the samples (average value of 23.56 µg/kg). AFB1 had a mean value of 105.4 µg/kg, AFB2 mean value of 6.92 µg/kg, and AFG1 and AFG2 had an average mean value of 40.49 µg/kg and 2.60 µg/kg, respectively. The total aflatoxins exceed the EU (4 µg/kg) permissible level in food. The α-Zea average mean value was 113.82 µg/kg for the various selling locations. Also, cyclopiazonic acid had an average mean value of 51.99 µg/kg, while some of the beef samples were contaminated with more than nine different mycotoxins. The occurrence of these mycotoxins in dried beef is an indication of possible exposure of its consumers to the dangers of mycotoxins that are usually associated with severe health problems. This result shows that there are mycotoxin residues in the beef sold in Ekiti State markets.

Variation of Fusarium Free, Masked, and Emerging Mycotoxin Metabolites in Maize from Agriculture Regions of South Africa.

The presence of mycotoxins in cereal grain is a very important food safety issue with the occurrence of masked mycotoxins extensively investigated in recent years. This study investigated the variation of different Fusarium metabolites (including the related regulated, masked, and emerging mycotoxin) in maize from various agriculture regions of South Africa. The relationship between the maize producing regions, the maize type, as well as the mycotoxins was established. A total of 123 maize samples was analyzed by a LC-MS/MS multi-mycotoxin method. The results revealed that all maize types exhibited a mixture of free, masked, and emerging mycotoxins contamination across the regions with an average of 5 and up to 24 out of 42 investigated Fusarium mycotoxins, including 1 to 3 masked forms at the same time. Data obtained show that fumonisin B1, B2, B3, B4, and A1 were the most prevalent mycotoxins and had maximum contamination levels of 8908, 3383, 990, 1014, and 51.5 µg/kg, respectively. Deoxynivalenol occurred in 50% of the samples with a mean concentration of 152 µg/kg (max 1380 µg/kg). Thirty-three percent of the samples were contaminated with zearalenone at a mean concentration of 13.6 µg/kg (max 146 µg/kg). Of the masked mycotoxins, DON-3-glucoside occurred at a high incidence level of 53%. Among emerging toxins, moniliformin, fusarinolic acid, and beauvericin showed high occurrences at 98%, 98%, and 83%, and had maximum contamination levels of 1130, 3422, and 142 µg/kg, respectively. Significant differences in the contamination pattern were observed between the agricultural regions and maize types.

Occurrence of filamentous fungi in maize destined for human consumption in South Africa.

One-hundred maize samples were analyzed for fungal contamination using conventional and molecular methods. The percentage incidence of different genera isolated revealed the predominance of Fusarium (82%), Penicillium (63%), and Aspergillus species (33%) compared to other genera. Fusarium occurred in 90% and 74% of small scale and commercial samples, respectively, while Penicillium occurred in small scale and commercial samples at an incidence rate of 64% and 62%, respectively. However, among the species, Fusarium verticilloides have the highest incidence of 70% and 76% in commercial and small-scale maize, respectively, while Penicillium digitatum has 56% total incidence. Aspergillus fumigatus (27%) were also the most dominant of these genera. Fungal genera isolated included Alternaria and Cladosporium although occurring at a lower incidence level of 30%, 32% and 16%, 20%, respectively, in small-scale and commercial samples. The results emphasize that farmers and consumers should be alerted to the danger of fungal contamination in maize.