Coronavirus Disease (COVID-19) Current Status in Ogun State, Nigeria

Coronavirus (COVID-19) is an illness caused by a virus that can be transmitted by human contact. After the first infections in China at the end of 2019, COVID-19 has continued to spread across the world. No continent has been able to escape this virus. In Nigeria, the first case of COVID-19 was detected on 27th February 2020 in Lagos State; an Italian visitor on a business trip to Ewekoro cement plant, Ogun State, this did not lead to an immediate outbreak in the state, however, series of immediate interventions were put in place by the government of Ogun state and the Federal Republic of Nigeria in response to COVID-19.At the time of preparing this manuscript the Nigeria Centre for Disease Control (NCDC) reported a total infected cases of 25,133 people, with 9,402 recoveries and total death of 573 cases. In this article, the daily number of confirmed cases of COVID-19 were obtained from publicly available outbreak situation report of the Nigeria Centre for Disease Control (NCDC) and the Ogun State Ministry of Health a preliminary epidemiological analysis of COVID-19 outbreak in Ogun state between 27th February and 28th June, 2020 and a breakdown of the disease in the local governments of the state is provided. A total of 774 confirmed cases and 18 COVID-19 deaths were recorded in nineteen local government areas out of twenty local government areas in Ogun state, Nigeria. 342 (43.7%) of the infected cases seen were detected in the Ado Odo Ota local government area, and the Sagamu local government area with about 206 (26.3%) infected cases which are border towns to Lagos state the most infected state in Nigeria. 78.6% of the infected cases were in the middle age group, specifically the 25-34, 35-44 and 45-54 age categories. The number of men infected with COVID-19 in Ogun state is 3 times that of women infected implying that Men are more at risk for worse outcomes and death, irrespective of age, with COVID-19. This study thus provides an insight into the COVID-19 current situation in Ogun state and serve as a reminder to policymakers, health officers, disease control agencies and the general public, that although the number of confirmed cases may be relatively low in Ogun state, the risk is still very high and potentially, there could be many asymptomatic cases in the state, Ogun State

Cases of neuro-ferritinopathy from Sudan

Neuro-ferritnopathy (NBIA) is a bag of diseases due to abnormal iron metabolism. It has different underlying genetic and enzymatic abnormalities. On the other hand, they share some radiological features. Patients present with a wide range of cerebral symptoms and signs. Diagnosis depends on the semiology, genetic testing and MRI imaging. No specific treatment is available for these cases and they represent a challenge to the treating neurologist. Here we illustrate two interesting cases with their clinical and imaging findings to raise the awareness of such rare diseases and help diagnosing them in a low- resource setting

Burkitt Lymphoma: A Potentially Curable Childhood Tumour: Experience in Ile-Ife, Nigeria (1986-2014)

Background: Burkitt lymphoma (BL) is the commonest tumour among Nigerian children. It is reported to be highly responsive to readily available cytotoxic drugs; yet, the outcome of therapy remains abysmal.Objectives: To review the epidemiology of BL in terms of risk factors, age incidence, regional distribution, disease sub-types, examine the available treatment regimens locally and internationally and report on the outcome of treatment in Nigeria under different conditions.Methods: A comprehensive literature review on the epidemiology of BL was undertaken and results of publications and clinical trials of BL were evaluated.Results: Three major sub-types of Burkitt lymphoma are recognised in the world literature; the classic endemic BL (eBL) in sub-Saharan Africa, EBV-independent sporadic BL (sBL) found in population outside the endemic areas and the HIV-related BL (HIV-BL), which is found in regions with high incidence of HIV infection. All the sub-types have common cytogenetic abnormalities: t (8, 14), t (8, 22), and t (2, 8). The COM regimen incorporating cyclophosphamide, oncovin and methotrexate (with the intrathecal cytarabine and methotrexate), was found to be very effective for eBL. Treatment outcome was dismal for the self-financed patients treated with COM regimen between 1986 and 2000 (Group A) compared to the internationally sponsored patients treated between 2000 and 2014 (Group B). While 16.8% of Group A patients had no chemotherapy, 9.8% were lost to toxic deaths and 88% defaulted; most of the patients in group B had full chemotherapy; the Event-Free Survival (EFS) rates at 12 and 24 months were 58.3% and 53.4%, respectively

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

Burkitt's lymphoma in Cameroon: a review of 300 cases in two referral health facilities in Yaounde

In this descriptive retrospective study; we reviewed 300 cases of Burkitt's lymphoma (BL) diagnosed within 10 years from January 1; 2000 to December 31; 2010. The study took place in the pathology laboratories of the Central Hospital and the General Hospital in Yaounde; Cameroon. The aim was to review the anatomo-clinical and epidemiological aspects of the disease; especially with respect to its localization. We found that BL affected mostly children aged 5-14 years with peaks at 4 and 12 years. A slight male predominance was observed. The abdomino-pelvic site was more frequent (57.7%). Diagnosis of the tumor was mainly by fine-needle aspiration cytology (FNAC). About 6% of our patients tested positive for the human immunodeficiency virus (HIV). We recommend further in-depth studies to find out if there are any emerging factors that influence the localization of the disease in endemic areas or if our finding is incidental

Patient compliance in the treatment of burkitt's lymphoma in rural Zambia: a retrospective study on 80 burkitt's lymphoma patients in Katete, Zambia

Background : In African settings the treatment results of Burkitt's lymphoma (BL) seem to be less favourable compared with Western settings. The aim of this retrospective study was to analyse some factors that affect the treatment of BL. Patients and Methods : Over a 16 year period; data were extracted of 80 patients. Results : Complete remission 5; very good partial response 35; partial response 16; no response 10; data missing 34. Of all patients; 56did have a positive response to treatment. However; 51of this subgroup of patients did not finish treatment. There was no difference in completion of treatment between patients living in Katete district finishing treatment vs. living outside Katete district (respectively 25vs. 32; P = 0.7148). Conclusion: There is potential for higher cure rates for BL in tropical settings if full effort is put into compliance since a majority of patients; even while having a good prognosis; abandon treatment. Large distance to hospital makes no difference in completing the chemotherapy course

Paediatric solid tumours in Nigerian children: a changing pattern?

Background: Childhood cancer is fast becoming an important paediatric problem in Nigeria and several parts of Africa; with the progressive decline of infectious and nutritional diseases. The following study was a 5-year retrospective review of paediatric solid tumours as seen at the Jos University Teaching Hospital; Nigeria. Objective: To determine the relative frequencies of childhood solid malignant tumours in Jos; Central Nigeria and compare with reports of previous studies both locally and abroad. Materials and Methods: Cancer registers and medical records of patients were used to extract demographic data; specimen number and/or codes. Archival materials were retrieved from the histopathology laboratory and sections were made from paraffin embedded blocks of these specimens. Slides of these histological sections were reviewed and reclassified where necessary. The relative frequencies were then determined. Results: One hundred and eighty one solid tumours of children were diagnosed within the study period. Ninety-four (51) were benign and 87 (49) malignant. Male: Female ratio was 1.3:1. The commonest malignant tumour diagnosed was rhabdomyosarcoma which accounted for 27 (31); comprising of 15 (55.6); 11 (40.7) and 1 (3.7) embryonal; alveolar and pleomorphic rhabdomyosarcomas; respectively. Non Hodgkin lymphoma and Burkitt lymphoma accounted for 17 (19.5) and 12 (13.8); respectively. Conclusion: Based on the result of our study; we conclude that the commonest solid malignancy of childhood in Jos; Nigeria is rhabdomyosarcoma. This has implications for diagnosis; management and prognosis of theses soft tissue sarcomas in our paediatric population

Malignant tumours of childhood in Zaria

Background: The increased prevalence of hitherto uncommon tumours in children in our geographic setting formed the basis for this study. This study aimed to determine the current histopathologic distribution pattern of paediatric malignancies in Zaria. Materials and Methods : An eight year (2000-2007) consecutive analysis of malignant tumours in children ages 0 to 15 years in a referral University laboratory. All tissue biopsies were fixed in 10formalin and processed in wax. Tumours were characterised histologically into tissues of origin and categorised into three age groups; 1 year; 1-5 years and 6-15 years. Result : 189 children with malignant tumours were analysed. They showed a male preponderance (M: F; 1.2: 1.0) and their ages ranged from 5 days to 15 years. Tumours of mesenchymal origin were the commonest (115: 60.8) while epithelial tumours including germ cell tumours accounted for 74 (39.2) cases. The age group 1-5 years had the highest epithelial tumours while age group 6-15 years had the most tumours with 102 (54) cases overall. The five commonest tumours over-all were rhabdomyosarcoma; Burkitt lymphoma; retinoblastoma; non-Hodgkin's lymphoma and nephroblastoma. Germ cell tumours affected the ovary predominantly and two of the endodermal sinus tumour cases were seen in the testis of an eighteen month child and sacrococcygeum of a 5 year old girl; respectively. Of the six immature teratoma cases; four were cutaneous in distribution. The vascular tumours included epithelioid haemangioendothelioma; haemangioblastoma and Dabska tumour and they accounted for (5.8) of all tumours seen. The commonest sites of occurrence of these tumours were the oculo-orbital; jaw; head and neck regions with 82 cases (43.4) while lymph nodes were involved in 31 (16.4) cases. Conclusion : The distribution and occurrence of malignant tumours in children is age related. Lymphomas were the commonest tumours overall while retinoblastoma and Burkitt lymphoma were the commonest tumours affecting children below 5 years and 6-10 years old; respectively; in our centre. The head region and lymph nodes were the sites of predilection for majority of these tumours

Le Lymphome de Burkitt a localisation maxillo-faciale en milieu pediatrique au CHU Gabriel Toure; Bamako; Mali : a propos de 24 cas

Le lymphome de Burkitt; initialement decrit en Afrique; y demeure l'une des tumeurs malignes les plus frequentes de l'enfant. Au Mali; aucune etude importante n'a ete faite sur les lymphomes de Burkitt de l'enfant et encore moins sur les formes maxillo-faciales. L'objectif de cette etude retrospective; unicentrique est d'etudier les aspects epidemio- logiques; cliniques; paracliniques et therapeutiques des enfants traites pour lymphome de Burkitt maxillo-facial. Entre janvier et decembre 2006; les enfants d'age inferieur ou egal a 15 ans; non anterieurement traites; chez qui le diagnostic de lymphome de Burkitt maxillo-facial a ete cytologiquement porte ont ete inclus dans l'etude. Tous nos malades ont ete traites selon le protocole de traitement des lymphomes de Burkitt GFA 2005. Ont ete inclus dans l'etude 24 enfants. Le sex ratio (M/F) etait de 2;4. Tous nos patients ont ete diagnostiques a un stade tardif de la maladie (87;5de stade III et 12;5de stade IV). 37;5d'entre eux ont eu une remission complete apres trois cures d'Endoxan associees a trois injections intrathecales demethotrexate et d'hydrocortisone ; 16; 6ont ete perdus de vue. La toxicite des drogues etait hematologique dans 71;5des cas. L'alopecie etait presente dans tous les cas apres 6 cures. Dans 70;8des cas aucun episode infectieux n'a ete note.Apres un recul de plus d'un an; 29;2des sujets restent en remission complete.Malgre nos capacites limitees en soins et en moyens de surveillance; nous avons pu obtenir environ 30de survie pour nos malades atteints de lymphome de Burkitt a des stades avances. Il est possible que des strategies basees sur l'information; la sensibilisation et l'education des parents; la formation du personnelmedical et paramedical et l'amelioration du plateau technique puissent aider a reduire le taux de mortalite du lymphome de Burkitt chez l'enfant au Mali

Lymphome de Burkitt pediatrique a revelation ORL: quelle prise en charge en milieu sub sahelien ? Reflexion sur trois cas

Le lymphome de Burkitt dans sa forme Africaine peut se manifester sous des signes d'emprunt ORL a type de tumefaction orbito-maxillo-faciale. Le diagnostic peut etre fait par les ORL a travers un faisceau de signes cliniques et une cytoponction. La prise en charge se fait dans des unites d'oncologie medicale ou le bilan d'extension et le lancement de la chimiotherapie sont des imperatifs incontournables. Actuellement cette tumeur a potentiel tres agressif repond a une poly chimiotherapie bien conduite

Burkitt's Lymphoma in Africa; a Review of the Epidemiology and Etiology

Burkitt's lymphoma (BL) was first described in Eastern Africa; initially thought to be a sarcoma of the jaw. Shortly it became well known that this was a distinct form of Non Hodgkin's lymphoma.The disease has given insight in all aspects of cancer research and care. Its peculiar epidemiology has led to the discovery of Epstein Barr virus (EBV) and its importance in the cause of several viral illnesses and malignancies.The highest incidence and mortality rates of BL are seen in Eastern Africa. BL affects mainly children; and boys are more susceptible than girls. Evidence for a causal relationship between EBV and BL in the endemic form is fairly strong. Frequency of association between EBV and BL varies between different patient groups and different parts of the world. EBV may play a role in the pathogenesis of BL by deregulation of the oncogene c-MYC by chromosomal translocation.Although several studies suggest an association between malaria and BL; there has never been a conclusive population study in support of a direct role of malaria in causation of BL.The emergence of HIV and a distinct subtype of BL in HIV infected have brought a new dimension to the disease particularly in areas where both HIV and BL are endemic. BL has been reported as a common neoplasmin HIV infected patients; but not in other forms of immuno-depression; and the occurrence of BL seems to be higher amongst HIV positive adults; while the evidence of an association amongst children is still disputed.The role of other possible risk factors such as low socio-economical status; exposure to a plant species common in Africa called Euphorbiaceae; exposure to pesticies and to other infections such as schistosomiasis and arbovirus (an RNA virus trans- mitted by insect vectors) remain to be elucidated

Paediatric malignancies

This study aims to describe the pattern of paediatric malignancies in a tertiary hospital in North Eastern Nigeria. This was a retrospective study of all paediatric malignancies diagnosed between June 2000 and May 2006 at the Federal Medical Centre; Gombe; Nigeria. Data were collected from the histopathology and haematology registers; as well as patients' case files and were analyzed. A total of 3;313 children were admitted within the study period. Out of this; 68(2.05) children aged less than 15 years (M:F=1:1) had histologically confirmed malignancies. Malignant lymphomas were the most common (42.65) of all the childhood malignancies; with Burkitt's lymphoma ranking highest (68.97). Burkitt's lymphoma also accounted for 29.41of all the malignancies. Other common malignancies included sarcomas 10(14.71); neurofibromatosis 9(13.24); nephroblastoma 8(11.77); acute lymphoblastic leukaemia 5(7.35) and retinoblastoma 4(5.88). The less common paediatric malignancies were melanoma; invasive lobular breast carcinoma and squamous cell carcinoma of the breast; which together accounted for 4.41. Burkitt's lymphoma is the most frequently diagnosed malignant neoplasm in children at the Federal Medical Centre; Gombe

Profil du bilan biologique initial de l'enfant atteint du lymphome de Burkitt à Abidjan: cas du service de péediatrie du CHU de Treichville

L'OBJECTIF : de ce travail etait de repertorier les differentes perturbations du bilan biologique initial de l'enfant atteint du lymphome de Burkitt dans le but d'ameliorer la prise en charge; METHODOLOGIE: II s'agit d'une etude retrospective effectuee dans l'unite d' oncologie du service de pediatrie du CHU de Treichville portant sur 115 patients de 0 a 18 ans atteints du lymphome de Burkitt sur une periode de Sans 5mois (janvier 2000-juin 2005) et ayant un bilan biologique.RESULTATS :-Au Plan epidemiologique :*une moyenne de 21 cas/an enregistres portant sur des enfants d'age moyen de 7;64 ans avec une predominance masculine nette (sex-ratio = 2;19);*une predominance des cas dans les regions des lagunes (28;6pour cent); Sud-Bandama (10;7pour cent); igneby (9;8) et moyen Cavally (9;8pour cent);*un niveau social bas dans 71pour cent des cas ;*48;7pour cent des localisations tumorales etaient abdominales avec un delai de consultation long 1 a 3 mois dans 65;6pour cent.-Au Plan Clinique*66pour cent de patients etaient au stade III de Murphy avec;*dans 52;7pour cent des cas un poids inferieur a la normale pour leur age.-Au plan biologique; nous avons mis en evidence*Une anemie de type hypochrome microcytaire a ete retrouvee dans 81;4pour cent des cas avec 78pour cent de deces*Une elevation des transaminases et de la bilirubinemie*les taux eleves d'uree et de creatinine realisant un tableau d'insuffisance renale ont ete mortels dans 100pour cent des cas.*le syndrome de lyse tumorale realise par un taux d'acide urique eleve dans 36;4pour cent des cas; une hyperkaliemie (7;5pour cent des cas); une hypocalcemie (38;5pour centdes cas).*un taux de LDH eleve dans 72;4pour cent des cas.Ces elements sus cites pourraient etre consideres comme des facteurs de mauvais pronostic.- Au plan Therapeutique et Evolutif;70pour cent des patients ont ete traites avec pour resultats: 44;3pour cent de deces; 40pour cent de perdus de vue; 9;6pour cent de guerisons et 2;6pour cent de rechutes.CONCLUSION: L'anemie hypochrome microcytaire; la leucocytose; l'hyperuricemie; l'hyperlacticodeshydrogenase et perturbations du bilan ionique; renal et hepatique sont les principales anomalies biologiques rencontrees au cours de cette etude

Le lymphome de Burkitt en milieu hospitalier du Burkina Faso: Aspects thérapeutiques et évolutifs

Une étude rétrospective portant sur 41 dossiers d'enfants hospitalisés et traités pourlymphome de Burkitt, sur une période de 10 ans, a été effectuée dans les services de pédiatrie et de chirurgie maxillo-faciale de l'hôpital de Bobo-Dioulasso aux fins d'étudier les aspects thérapeutiques et évolutifs de la maladie. Les moyens thérapeutiques ont été la chirurgie d'ablation des volumineuses tumeurs (19,5%) et la monochimiothérapie au cyclophosphamide (83%) selon les procédés de Burkitt(64,7%) et de N'gu (35,3%). La létalité sous chimiothérapie était de 8,8%. L'évolution immédiate a montré 58,8% de rémission complète, 26,5% de rémission partielle, 11,8% de résistance au traitement

Resultats du suivi au long cours des patients atteints de lymphome de Burkitt et traites par le protocole CMA

L'etude portant sur le suivi au long court des patients atteints de lymphome BURKITT et traites par le protocole CMA; realisee sur pres de dix (10) ans; a ete menee sur 75 patients dans le service d'hematologie du CHU de Yopougon. Au terme de cette etude; il ressort les conclusions suivantes: SUR LE PLAN EPIDEMIO-CLINIQUE; on note que : -L'age moyen des patients est de 11;94 ans; le sex-ratio est egal a 1.14 en faveur du sexe masculin; le niveau socio-economique est predominant ; -Le stade III de ZIEGLER est predominant (58;6 pour cent) ; -Les localisations tumorales sont dominees par les formes abdomino-pelviennes initiales (6 1;33pour cent) ; -Les masses importantes predominent (56pour cent) ; -Le delai moyen de diagnostic est de 110 jours (extreme 14 jours - 1;45 ans). SUR LE PLAN THERAPEUTIQUE: -La remission complete est estimee a 73pour cent des cas ; -18 cas de guerison ont ete obtenus; 15pour cent de rechutes ont ete observes et 33pour cent de deces ; -La survie de nos patients est de 4;5 ans avec des extremes allant de 82 jours a 9 ans. SUR LE PLAN PRONOSTIC: Les facteurs de bon pronostic sont : -Le sexe masculin ; -L'age superieur a 11 ans ; -Le niveau socio-economique eleve ; -La bonne compliance ; -Le stade III de ZIEGLER ; -Les localisations abdomino-pelviennes ; -Les masses moderees ; -La precocite du diagnostic ; -L'obtention de la remission complete ; -La precocite de la reponse therapeutique

Valeurs pronostiques de la Beta 2 microglobuline et de la L.D.H. dans le lymphome de Burkitt

65 patients ayant presente un lymphome de BURKITT; et colliges sur une periode de 15 ans dans le service d'hematologie clinique du CHU de Yopougon; nous ont permis de realiser la presente etude qui avait pour but d'evaluer la valeur pronostique de la beta microglobuline et de la LDH dans le lymphome de BURKITT. Au terme de cette etude; il ressort les conclusions suivantes : SUR LE PLAN EPIDEMIOLOGIQUE : -Age moyen des patients est estime a 09;54pour cent ; -Sex-ratio est egal a 1;24 en faveur du sexe masculin ; -Une predominance des sujets de bas niveau socioeconomique. SUR LE PLAN CLINIQUE : -Les localisations; l'atteinte abdomino-pelvienne est frequente avec 57pour cent des cas ; -Le stade III de ZIEGLER est predominant avec 66;10pour cent ; -La taille de la masse tumorale est dominee par les masses importantes 61;50pour cent. SUR LE PLAN BIOLOGIQUE : -33 patients soit 50;76pour cent avaient un taux de (32 microglobuline normal contre 32 patients soit 49;24pour cent ayant un taux de (32 microglobuline eleve ; -25 patients soit 38;46pour cent avaient un taux de LDH normal. 40 patients soit 61;54pour cent avaient un taux de LDH eleve. SUR LE PLAN THERAPEUTIQUE : -Le choix therapeutique a porte sur le protocole CMA 70pour cent ; -La remission complete est estimee a 63pour cent ; -Les vivants sont estimes a 57pour cent ; -Nous avons enregistrer 12pour cent de perdu de vue ; -Nous avons obtenu 31pour cent de deces. CONCERNANT LA SURVIE GLOBALE : -nous avons note une probalite de survie de 60;2pour cent a 6 mois; de 57;6pour cent a 12 mois et 47;5pour cent a 24 mois. VALEURS PRONOSTIQUES : *Pour les valeurs elevees de (32 microglobuline; nous remarquons: -43;75pour cent de remission complete avec une influence statistiquement significative de la (32 microglobuline sur la reponse therapeutique (P 0;005) ; -60pour cent de deces avec une influence statistiquement significative de la (32 microglobuline sur le devenir de nos patients (P = 0;003) ; -Une survie de trois ans avec une influence statistiquement significative de la beta microglobuline sur la survie de nos patients (P = 0;004). *Pour les valeurs elevees de LDH; nous remarquons: -47;50pour cent de remission complete avec une influence statistiquement significative de la LDH sur la reponse therapeutique (P = 0;0043) ; -42;5pour cent de deces avec une influence statistiquement significative de la LDH sur le devenir de nos patients (P = 0;01) ; -Une survie de moins de trois ans avec une influence statistiquement significative de la LDH sur la survie de nos patients (P = 0;0003)