ABSTRACT
Africa is the continent most affected by esophageal cancer in the world. Alcoholic beverages are controversially blamed, as esophageal cancer is a rare disease in several other countries ranked in the top 10 for consumption of alcoholic beverages. This study aims to conduct a comprehensive systematic review of published literature, statistically summarizing the strength of the association between drinking patterns and types, and the risk of esophageal cancer in Africa. A computerized search of reputable databases such as Medline/PubMed, EMBASE, Web of Science, and African Journals Online was performed to identify relevant studies published up to September 2023. The quality of the studies was evaluated using the Newcastle-Ottawa scale for case-control studies and the Agency for Healthcare Research and Quality tool for cross-sectional studies. A funnel plot and Egger test were utilized to assess potential publication bias. Meta-analyses were conducted using random-effects models with RevMan 5.3 and Stata software to estimate summary effects. The systematic review identified a total of 758,203 studies, primarily from Eastern and Southern Africa. The pooled samples across all studies comprised 29,026 individuals, including 11,237 individuals with cancer and 17,789 individuals without cancer. Meta-analysis revealed a significant association between alcohol consumption and the risk of esophageal cancer (odds ratio [OR] = 1.81; 95% confidence interval [CI], 1.50-2.19). Further analysis based on the frequency of alcoholic beverage consumption indicated a stronger association with daily (OR = 2.38; 95% CI, 1.81-3.13) and weekly (OR = 1.94; 95% CI, 1.32-2.84) drinkers in contrast to occasional drinkers (OR = 1.02; 95% CI, 0.81-1.29). Additionally, consumption of traditional alcoholic beverages was significantly associated with the risk of esophageal cancer in African populations (OR = 2.00; 95% CI, 1.42-2.82). However, no relationship has been established between the exclusive consumption of non-traditional drinks and the risk of esophageal cancer. In conclusion, the results of this study confirm the hypothesis that daily and weekly drinking patterns, significantly increase the risk of esophageal cancer in Africa, while occasional consumption does not show a significant association. Additionally, the consumption of traditional alcoholic beverages is notably linked to the risk of esophageal cancer in African populations.
ABSTRACT
Tectona grandis (T. grandis) is a medicinal plant widely used in Cameroon to treat typhoid fever and several other diseases. Despite its heavy use for medical purposes, no study has yet been conducted to assess its potentially toxic effects. This study aimed at evaluating the acute and subchronic toxicological profile of Tectona grandis leaf extract in rats. The acute toxicity study revealed neither behavioral disturbances nor death in rats. The lethal dose (DL50) of this extract is greater than 5000 mg/kg body weight. The subchronic toxicity study showed no significant change in weight gain in rats at test doses throughout the treatment period. However, there was a significant decrease in alanine transaminase activity and serum protein levels at all doses. Alkaline phosphatase activity decreased at doses of 30, 90, and 270 mg/kg and increased at the dose of 810 mg/kg body weight. Serum and urinary urea levels increased simultaneously at doses of 270 and 810 mg/kg body weight. Repeated administration of the extract also increased total cholesterol, high-density lipoprotein levels in both sexes were compared to respective controls, and the ratio of high- to low-density lipoprotein was found to be greater than 1 in all animals. However, at the dose of 810 mg/kg, necrosis was observed on the kidney sections and vascular congestion on the liver sections of animals. Aqueous extract of T. grandis did not lead to any adverse effects in rats after acute and subchronic treatment at 30 and 90 mg/kg doses. This extract can, therefore, be used for the formulation of typhoid fever phytomedicine at the therapeutic dose of 30 mg/kg, but before this, chronic and mutagenic toxicity evaluations must be carried out.
