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BACKGROUND: Colorectal cancer (CRC) is the third most common cancer worldwide. Mortality for CRC is improving in high income countries, but in low and middle income countries, rates of disease and death from disease are rising. In Sub-Saharan Africa, the ratio of CRC mortality to incidence is the highest in the world. This study investigated the nature of CRC treatment currently being offered and received in Nigeria. METHODS: Between April 2013 and October 2017, a prospective study of consecutively diagnosed cases of CRC was conducted. Patient demographics, clinical features, and treatment recommended and received was recorded for each case. Patients were followed during the study period every 3 months or until death. RESULTS: Three hundred patients were included in our analysis. Seventy-one percent of patients received a recommended surgical operation. Of those that didn't undergo surgery as recommended, 37% cited cost as the main reason, 30% declined due to personal reasons, and less than 5% absconded or were lost to follow up. Approximately half of patients (50.5%) received a chemotherapy regimen when it was recommended, and 4.1% received radiotherapy when this was advised as optimal treatment. With therapy, the median overall survival for patients diagnosed with stage III and stage IV CRC was 24 and 10.5 months respectively. Overall, we found significantly better median survival for patients that received the recommended treatment (25 vs 7 months; P < .01). CONCLUSIONS: A number of patients were unable to receive the recommended treatment, reflecting some of the burden of untreated CRC in the region. Receiving the recommended treatment was associated with a significant difference in outcome. Improved healthcare financing, literacy, training, access, and a better understanding of tumor biology will be necessary to address this discrepancy.
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INTRODUCTION: Little is known about the biology, molecular profile and hence optimal treatment of African Nigerian breast cancer. The aim of this work, therefore, was to characterize the histology and molecular profile of Nigerian breast cancer. METHODS: Breast carcinomas from women at 6 centres of similar tribal origin in Nigeria were reviewed and assembled into tissue microarrays (TMAs), and sections were stained for hormone receptors, i.e. estrogen receptor (ER)α, ERß1, ERß progesterone receptor (PR) and androgen receptor, cyclin D, HER2, Ki67 and cytokeratins (CKs), i.e. CK5/6 and CK14 (basal) and CK18 and 19 (luminal). RESULTS: A total of 835 tumours were analysed. The mean age at diagnosis was 48.62 ± 12.41 years. The most common histological subtype was ductal NST (no-special-type) carcinoma (87.3%). Over 90% of the tumours were grade 2 or 3. The predominant molecular phenotype was the non-basal, triple-negative type (47.65%) followed by the HER2-positive group (19.6%). The percentage of ER-, PR- and HER2-positive tumours was 22.4, 18.9 and 18.8%, respectively. CONCLUSION: Nigerian breast cancer predominantly has a high-grade, triple-negative profile. It occurs at a younger age and bears similarities at the molecular level to pre-menopausal breast cancer in white women, with remarkably lower levels of ERß expression. The early presentation and histological and molecular phenotype may explain the poor prognosis, and tailoring treatment strategies to target this unique profile are required.
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Neoplasias de la Mama/etnología , Neoplasias de la Mama Triple Negativas/etnología , Adulto , Factores de Edad , Biomarcadores de Tumor , Neoplasias de la Mama/genética , Neoplasias de la Mama/metabolismo , Neoplasias de la Mama/patología , Femenino , Humanos , Inmunohistoquímica , Queratinas/análisis , Persona de Mediana Edad , Nigeria , Fenotipo , Pronóstico , Receptor ErbB-2/análisis , Receptor ErbB-2/genética , Receptores Androgénicos/análisis , Receptores Androgénicos/genética , Receptores de Estrógenos/análisis , Receptores de Estrógenos/genética , Receptores de Progesterona/genética , Análisis de Matrices Tisulares , Neoplasias de la Mama Triple Negativas/diagnóstico , Neoplasias de la Mama Triple Negativas/genética , Neoplasias de la Mama Triple Negativas/patologíaRESUMEN
INTRODUCTION: The last decade witnessed a remarkable rise in the prevalence of several malignant diseases in Nigeria. Whether Urologic malignancies (UM) have followed the same trend remains to be studied. The pattern of UM diagnosed in a Nigerian tertiary hospital is hereby presented. Our aim was to determine the pattern and prevalence of histologically diagnosed UM in Obafemi Awolowo University Teaching Hospitals Complex. Ile-Ife, Nigeria. MATERIALS AND METHODS: A 10-year retrospective review of all patients diagnosed with UM was carried out between January 2005 and December 2014. Data was obtained from the patients' case files and the Ife-Ijesha Cancer registry. Information obtained included demographic characteristics, site of origin and histology. Data was analysed with Statistical package for Social sciences (SPSS) Version 20. RESULTS: A total of 4675 malignancies were histologically confirmed during the study period. UM accounted for 420 (8.9%) of total malignancies. Prostate cancer was the commonest UM with 315 (75%) cases. Others include renal tumours 62(14.8%), bladder tumours 29 (6.9%), testicular tumours 13(3.1%) and scrotal tumour 1(0.2%). UM were commoner in males (348, 88.8%) than females (47, 11.2%) and accounted for 13.8% and 2.18% of all tumours in males and females respectively. CONCLUSION: This study revealed a rising prevalence of UM most especially Prostate and Renal Cancers among other malignancies in Ile-Ife.
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OBJECTIVE: The aim of this study was to determine the seroprevalence of Hepatitis B surface antigenaemia among the health care workers at the Federal Medical Centre, Ido-Ekiti, Nigeria. DESIGN AND METHOD: The study was carried out on all the staff members in the employment of the Federal Medical Center, Ido Ekiti, Nigeria as at 30th April 2003. Data were collected by administering a set of questionnaire to every member of staff. Blood samples (3mls) were taken from the left cubital fossa of all the respondents and Hepatitis B surface antigen status determined using the agglutination kits manufactured by Biotech Laboratories USA. RESULTS: A total of 420 staff members were screened. 168 (40%) were males while 252 (60%) were females. Only 18 were found to be positive for Hepatitis B surface antigen giving a prevalence of 4.3%. 9 (50%) of those that were positive for Hepatitis B surface antigen were ward maids/attendants, 6 (33%) were nurses, 2 (11%) were administrative staff and 1 (6%) was a health record staff. CONCLUSION: Health care workers are at increased risk of having hepatitis B infection. Health education should be carried out routinely in our hospitals to raise the awareness level among the hospital staff and standard safety measures such as sharps policy should be adopted in the handling of blood products and sharps.
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Personal de Salud , Antígenos de Superficie de la Hepatitis B/inmunología , Hepatitis B/epidemiología , Estudios Seroepidemiológicos , Adulto , Anciano , Concienciación , Femenino , Educación en Salud , Conocimientos, Actitudes y Práctica en Salud , Política de Salud , Hepatitis B/transmisión , Hospitales , Humanos , Masculino , Persona de Mediana Edad , Nigeria/epidemiología , Política Organizacional , Factores de Riesgo , Encuestas y CuestionariosRESUMEN
BACKGROUND: Schistosomiasis is a chronic granulomatous inflammation that affects many systems in the body including the gastrointestinal tract. This study was carried out by reviewing all cases of schistosomal appendicitis, and documents any association with acute appendicitis. OBJECTIVE: To review all cases of schistosomal appendicitis and document any possible asspciation with acute appendicitis. DESIGN: A retrospective study. SETTING: Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Nigeria, 1991 to 2004. SUBJECTS: Eight hundred and forty three specimen of appendicectomy were reviewed. Thirty five of them were diagnosed as schistosomal appendicitis. RESULTS: The involvement of the vermiform appendix by schistosomiasis found in 35/843 (4.2%) cases of all the appendicectomy specimen received in our histopathology laboratory between 1991 and 2004 shows that 23 of the cases (65.7%) had histologically proven acute appendicitis while the remaining 12 cases (34.3%) were schistosomiasis without active inflammation. The appendiceal wall oviposition is associated with submucosal fibrosis, narrowing of the lumen and subsequent acute suppurative inflammation in 17 cases while there were active granulomas with tissue eosinophilia in six cases. CONCLUSION: This finding has demonstrated that though the frequency of appendix involvement is low considering the endemicity of schistosomiasis in our environment, however acute appendicitis may be caused by schistosomiasis.
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Apendicitis/diagnóstico , Apéndice/patología , Parasitosis Intestinales/diagnóstico , Esquistosomiasis/diagnóstico , Adolescente , Adulto , Apendicitis/parasitología , Apendicitis/cirugía , Diagnóstico Diferencial , Enfermedades Endémicas , Femenino , Humanos , Parasitosis Intestinales/complicaciones , Masculino , Persona de Mediana Edad , Nigeria , Estudios Retrospectivos , Esquistosomiasis/complicacionesRESUMEN
BACKGROUND: The acquired immunodeficiency syndrome (AIDS) is of major public health concern worldwide more so in sub-Saharan Africa where there is an upsurge in the incidence of the disease. Reports from developed countries have shown that a close link exists between the human immunodeficiency virus (HIV) and pulmonary tuberculosis. No such study has ever been carried out in Ile-Ife, Nigeria. OBJECTIVE: The study was designed to determine the prevalence of HIV infection among randomly selected tuberculosis patients seen in a Nigerian chest clinic using third generation ELISA kits that detect HIV-1 and HIV-2 strains. RESULTS: Of the 79 subjects with confirmed active tuberculosis, 12.7% tested positive for HIV antibodies compared with 2.0% of subjects without tuberculosis designated as the control group--a value that is statistically significant (p < 0.05). Farmers, artisans and students contributed a large proportion of the seropositive sera. Although the seroprevalence rate of 12.7% is low compared with the rates from eastern and southern African countries, this value was threefold higher than 5.2% value reported in metropolitan Lagos--suggesting concern about the spread of HIV in a semi-urban centre such as Ile-Ife. CONCLUSION: This study suggests that a close link exists between active tuberculosis and HIV infection in Ile-Ife, Nigeria which underscores the urgent need to monitor tuberculosis patients as the increase in the rate of new cases may indicate the spread of HIV infection. The study also recommends that an aggressive public awareness programme be undertaken to enlighten communities about the risk of TB/HIV infection.
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Infecciones Oportunistas Relacionadas con el SIDA/epidemiología , Anticuerpos Anti-VIH/aislamiento & purificación , Infecciones por VIH/complicaciones , Seroprevalencia de VIH , Tuberculosis Pulmonar/complicaciones , Infecciones Oportunistas Relacionadas con el SIDA/inmunología , Adolescente , Adulto , Anciano , Estudios de Casos y Controles , Distribución de Chi-Cuadrado , Niño , Ensayo de Inmunoadsorción Enzimática , Femenino , Infecciones por VIH/epidemiología , Humanos , Masculino , Persona de Mediana Edad , Nigeria/epidemiología , Ocupaciones , Distribución Aleatoria , Tuberculosis Pulmonar/epidemiología , Tuberculosis Pulmonar/inmunologíaRESUMEN
BACKGROUND: Geographic pathology is an accepted basis for unravelling trends of disease patterns. Proper documentation at the initial stage assists in establishing a foundation data. The authors are not aware of a documented pattern of malignant neoplasm in Ekiti State. OBJECTIVE: The aim of this study is to update the available literature on malignant neoplasms and compare our findings with previous work done by other investigators. METHODS: The estimates are based on a systematic retrospective survey of cancer cases identified in the Pathology Laboratories of Federal Medical Centre, Ido-Ekiti and University Teaching Hospital, Ado-Ekiti for the period; January 2002 to December 2009. The data recorded on each case were: source of information (histology or cytology), name, age, and sex, date of diagnosis and site of tumour. Tumour site and histology were coded according to the International Classification of Diseases, ICD-10 for presentation in tabular form. RESULTS: A total of 498 cancers were recorded. There were 177 (35.5%) males with average age of 54.5 years and 321 (64.5%) females with average age of 48.6 years. The estimated Crude Incidence (CI) rates for all cancer sites are 14.7 for males and 27.4 for females, per 100,000 population. In males, the most frequent cancer is prostate cancer (37.9%) followed by cancer of the liver (10.7%) and NonHodgkin's Lymphoma, NHL (7.9%). In females, the most common cancer is that of the breast (49.3%) followed by the cervix (8.5%) and the ovary (5.32%). A total of 28 childhood cancers were registered (17 males, 11 females). The most frequent tumours were Burkitt's lymphoma (8 cases) and soft tissue sarcomas (3 cases). CONCLUSION: This study shows that malignant neoplasms are not uncommon in Ekiti State. There is underreporting of cases as the crude incidence rates are low. This study will serve as baseline to more population-based studies in future.