A Review of the Literature on Childhood Burkitt Lymphoma in Nigeria

Background: Burkitt Lymphoma is common childhood tumour in sub Saharan Africa but the lack of centralized database on childhood cancer in Nigeria has made it difficult having a nationwide picture of its occurrence in the country.Objectives: This study was aimed at pooling published data from across the country with the hope of providing an overview of the profile of the disease in Nigeria.Methods: literature search was carried out on Pub Med/MEDLINE and Cochrane databases for all articles published between January 1975 and July 2015 using search strings such as children; cancer; Burkitt's; epidemiology; prevalence; treatment and Nigeria. Based on specific criteria; 39 studies were included.Results: Burkitt Lymphoma was the most common childhood malignancy in most parts of the country accounting for 18.3- 65.0% of malignant tumours but a few centers observed Retinoblas-toma as the most common. There was a decline in the frequency of Burkitt lymphoma in Ibadan from 1960-2010 and in Lagos. Peak ages of occurrence ranged from 5- 10 years; more males and children from low socio-economic classes were affected. Different centers reported predominant involvement of either the jaw or the abdomen but there were slightly more centers with predominance of the jaw. Retrospective studies yielded an estimated survival of 15-23% while the Event Free Survival probabilities at two years was 43% and 48% for the Nigerian centers that participated in an international study.Conclusion: Burkitt Lymphoma is a common tumour in Nigeria. Establishment of Cancer registries for better data capture and funding for better treatment outcomes is recommended

Service uptake and performance of the prevention of mother-to-child transmission (PMTCT) programme in Ibadan, Nigeria

The Prevention of Mother to Child Transmission (PMTCT) programme in the University College Hospital (UCH); Ibadan has been in existence for more than five years and has scaled up to other sites. The study evaluated the service uptake and performance of the programme using national key indicators. Antenatal and delivery records of women enrolled between July 2002 and June 2007 were reviewed. A total of 51952 women attended first antenatal visits and received HIV pre-test counselling. Of these; 51614 (99.5) accepted HIV test and 49134 (95.2) returned for their results. Out of the tested patients; 2152 (4.2) were identified to be HIV positive. Partners of positive patients accepting HIV testing were 361(16.7) with 87 (18.6) testing positive. There were a total of 942 deliveries out of which 39.2of the mothers and 95.2of the babies respectively received ARV prophylaxis. In all; 85.8(788/918) of the mothers opted for formula as the method of infant feeding. Out of the 303 babies eligible for ELISA testing; 68.3reported for the test and 17(8.7) tested positive. There has been progress in the programme; reflected in the increase in the number of new clients accessing the PMTCT service. However; partner testing and follow up of mother-infant pairs remain formidable challenges that deserve special attention

Mortality in Patients Treated for Tuberculous Pericarditis in Sub-Saharan Africa

Objective: To determine the mortality rate and its predictors in patients with a presumptive diagnosis of tuberculous pericarditis in sub-Saharan Africa. Design: Between 1 March 2004 and 31 October 2004; we enrolled 185 consecutive patients with presumed tuberculous pericarditis from 15 referral hospitals in Cameroon; Nigeria; and South Africa; and observed them during the 6-month course of antituberculosis treatment for the major outcome of mortality. This was an observational study; with the diagnosis and management of each patient left at the discretion of the attending physician. Using Cox regression; we have assessed the effect of clinical and therapeutic characteristics (recorded at baseline) on mortality during follow-up. Results: We obtained the vital status of 174 (94) patients (median age 33; range 14-87 years). The overall mortality rate was 26. Mortality was higher in patients who had clinical features of HIV infection than in those who did not (40versus 17; P=0.001). Independent predictors of death during follow-up were: (1) a proven non-tuberculosis final diagnosis (hazard ratio [HR] 5.35; 95confidence interval 1.76 to 16.25); (2) the presence of clinical signs of HIV infection (HR 2.28; 1.14-4.56); (3) co-existent pulmonary tuberculosis (HR 2.33; 1.20-4.54); and (4) older age (HR 1.02; 1.01-1.05). There was also a trend towards an increase in death rate in patients with haemodynamic instability (HR 1.80; 0.90-3.58) and a decrease in those who underwent pericardiocentesis (HR 0.34; 0.10-1.19). Conclusion : A presumptive diagnosis of tuberculous pericarditis is associated with a high mortality in sub-Saharan Africans. Attention to rapid aetiological diagnosis of pericardial effusion and treatment of concomitant HIV infection may reduce the high mortality associated with the disease