Research collaboration with low resource countries: overcoming the challenges.

The gap in research capacity between low and high resource countries and the effect on the global trend of health research cannot be ignored any more. Therefore the need for research collaboration between the two groups cannot be overemphasized. The discrepancy of economies makes for differences in research capacity, psychosocial needs, ethical considerations, focus and challenges. For such collaboration to work out, every collaborator needs to be aware of these challenges and work with them. Collaborations with low resource countries will require transparency, mutual respect and respect for social norms. Collaborations should no longer be that of taker or master, but of cooperation. The dearth of adequate research manpower and well equipped laboratories in low resource countries calls for a deliberate effort by strong research centers to go a step further in collaboration and adopt a centre or laboratory.

Review of prostate cancer research in Nigeria.

UNLABELLED: Prostate cancer (CaP) disparities in the black man calls for concerted research efforts. This review explores the trend and focus of CaP research activities in Nigeria, one of the ancestral nations for black men. It seeks to locate the place of the Nigerian research environment in the global progress on CaP disparities. Literature was reviewed mainly through a Pubmed search with the terms "prostate cancer"and "Nigeria", as well as from internet and hard copies of journal pages. FINDINGS: One of the earliest publications about CaP in Nigeria was in 1973 from the nation's 1st tertiary hospital in Ibadan, reporting low incidence, followed by a lull of nearly one decade. In 1980, the incidence rate of CaP was reported as almost similar for black men in Ibadan and Washington and from then on, research work from surgeons and pathologists, from the south to the north, east to west, continued to report increasing prevalence of CaP. Apart from epidemiology, other areas of research include KAP (knowledge attitude and practice) studies (poor education of caregivers and population), histopathology (mostly adenocarcinoma), diagnosis (digital rectal examination [DRE], prostate specific antigen [PSA], ultrasound), clinical features (late presentation and high mortality), and prevention (lifestyle, education and screening). As of today there is a gaping dearth of molecular and genetic studies. CONCLUSION: The global focus on CaP disparities in black men calls for more efforts from Africa, in all areas of research, along with international collaborations for capacity building.

Prostate cancer disparities in Black men of African descent: a comparative literature review of prostate cancer burden among Black men in the United States, Caribbean, United Kingdom, and West Africa.

BACKGROUND: African American men have the highest prostate cancer morbidity and mortality rates than any other racial or ethnic group in the US. Although the overall incidence of and mortality from prostate cancer has been declining in White men since 1991, the decline in African American men lags behind White men. Of particular concern is the growing literature on the disproportionate burden of prostate cancer among other Black men of West African ancestry in the Caribbean Islands, United Kingdom and West Africa. This higher incidence of prostate cancer observed in populations of African descent may be attributed to the fact that these populations share ancestral genetic factors. To better understand the burden of prostate cancer among men of West African Ancestry, we conducted a review of the literature on prostate cancer incidence, prevalence, and mortality in the countries connected by the Transatlantic Slave Trade. RESULTS: Several published studies indicate high prostate cancer burden in Nigeria and Ghana. There was no published literature for the countries Benin, Gambia and Senegal that met our review criteria. Prostate cancer morbidity and/or mortality data from the Caribbean Islands and the United Kingdom also provided comparable or worse prostate cancer burden to that of US Blacks. CONCLUSION: The growing literature on the disproportionate burden of prostate cancer among other Black men of West African ancestry follows the path of the Transatlantic Slave Trade. To better understand and address the global prostate cancer disparities seen in Black men of West African ancestry, future studies should explore the genetic and environmental risk factors for prostate cancer among this group.

Comparing dietary and other lifestyle factors among immigrant Nigerian men living in the US and indigenous men from Nigeria: potential implications for prostate cancer risk reduction.

BACKGROUND: Although African men may share a common genetic predisposition contributing to the higher incidence of prostate cancer (CaP), the etiology of the variability in risk observed even among African men living in varying environments and cultures, highlights the strong and evolving research regarding the contribution of behavioral factors that may modify these biological risk factors. OBJECTIVE: Our aim was to recruit Nigerian men from West Africa who had migrated and currently living in the US and indigenous men living in Nigeria to evaluate and compare differences in behavioral variables that are implicated to in contribute to CaP mortality and morbidity. METHODS: Using a cross-sectional study design, we recruited participants between age 35 and 70 during a CaP screening event in Abeokuta (Nigeria) and Houston (US). Data were collected using standard questionnaires and subject interviews on factors such as smoking, dietary intake, intake of traditional and non-traditional supplements, physical activity and alcohol consumption. Descriptive analyses were used to characterize the demographic characteristics of the study participants. Sample t-test analyses were then used to compare the behavioral variables of the migrant and indigenous men from Nigeria. RESULTS: Immigrant men from Nigeria had significantly higher fruit and whole grain intake, higher number of hours of purposeful physical activity and significantly lower tobacco use and intake of trans fats in their diet compared to their indigenous counterparts which may potentially contribute to decreased CaP risk in this cohort. However, greater intake of meats, oils, alcohol and reduction in fish intake may contribute to greater risk, although the proportion of risk reduction or risk increase is difficult to estimate in this sample size. Factors associated to acculturation, the relative accessibility and the affordability may contribute to the choices made by immigrant Nigerian men compared to their indigenous counterparts. CONCLUSION: Although these results are provocative and significant, future well powered studies controlling for variability in population sampling should validate these observations.

Prostate cancer cognitive-behavioral factors in a West African population.

BACKGROUND: Similar to African American men, several published studies indicate high incidence of prostate cancer among Nigerian men. However, there is no published study on personal factors that influence prostate cancer detection in this population. We explored prostate cognitive-behavioral factors among indigenous Nigerian men and Nigerian immigrants residing in the US. METHODS: A cross-sectional survey methodology was employed to collect data from Nigerian men residing in Abeokuta (Nigeria) and Houston (US). Study participants were men between 35 and 79 years. RESULTS: The demographic characteristics of both study groups were similar. Based on two-sample comparison results, indigenous Nigerian men demonstrated significant differences from US Nigerian men on several prostate cancer personal cognitive-behavioral factors, including perceived susceptibility to prostate cancer, attitude towards prostate cancer screening and prostate cancer knowledge. CONCLUSION: Emigration of Nigerian men from Nigeria to the US has a significant impact on prostate cancer knowledge and beliefs.

Appendicitis and situs inversus viscerum in a 32-year-old female nigerian: a case report.

Situs inversus is a relatively rare congenital abnormality in which the internal organs are disposed in a mirror image of the normal. It is said to be an autosomal recessive genetic condition. Its prevalence varies with population. In the United States, Situs inversus is found in 0.01% of the population. The incidence in Nigeria is unknown. We present the case of a young lady with situs inversus discovered during management for appendicitis. As is often the case in situs situations, there was initial confusion and some significant delay in offering needed treatment due to the unusual disposition of the organs.

Reduced alcohol use in the staining of Pap smears: a satisfactory low-cost protocol for cervical cancer screening.

OBJECTIVE: To describe a low-cost Papanicolaou staining procedure that can be applied to conventional and monolayer gynecologic preparations. STUDY DESIGN: The amount of alcohol consumed in the procedure, which normally accounts for > 80% of the cost of processing, was reduced drastically by (1) using only 1 modified cytoplasmic counterstain (EA type), thereby (2) reducing the number of alcohol rinses by over half Orange-G dye is omitted. RESULTS: The resultant effect of the modified staining protocol is quite satisfactory and attractive to screening eyes: nuclear details are sharp and crisp, while the cytoplasm contains transparent differential staining with blue-green and pink. CONCLUSION: A reduction in the cost of staining should encourage cervical cancer screening, especially in developing countries, where cost is a limiting factor, thus making it possible for more women to be screened without increasing the cost of the program.