Prevalence of high-risk human papillomavirus genotypes among apparently healthy women with normal and abnormal cervical cytology in Kaduna State, Nigeria

Background: About 99.7% of cervical dysplasia and cancer cases are caused by persistent genital high-risk human papillomavirus (hrHPV) infection. Most HPV infections are subclinical and self-limiting but may persists in about 5 to 10% of infected women, resulting in pre-cancerous lesions that can progress to invasive cancer years later. This study is aimed at detecting hrHPV among apparently healthy women of reproductive age in Kaduna State, thus providing more information for effective control of HPV and cervical cancer in Nigeria. Methodology: Cervical smears were taken from 515 randomly selected apparently healthy women across selected secondary and tertiary facilities from 3 Local Government Areas (LGAs) in each Senatorial Zone of Kaduna State, Nigeria. Liquid-based cytology (LBC) technique was used to collect cervical smears and prepare smears for cytology study, while the remaining samples were stored at -80oC for molecular studies. HPV DNA were extracted from the samples and amplified by convectional PCR using specific hrHPV (HPV 16,18,31 and 45) primer sets and a broad spectrum MY09/11 and GP5+/6+ primers for a wider range of HPV genotypes. Data were analysed using the Statistical Package for Social Sciences (SPSS) version 23.0 and relationship between prevalence of hrHPV and socio-demographic factors such as age and marital status were determined using Chisquare or Fisher Exact test with p<0.05 considered statistically significant. Results: The prevalence of total HPV and hrHPV infections in the study population was 11.8% (61/515) and 9.3% (48/515) respectively. A total of 100 HPV genotypes were detected by PCR in the 61 positive smears, with 66 hrHPV types from 48 women, and 34 other HPV types from 13 women. The frequency of hrHPV genotypes detected was HPV 31 (5.8%, n=30), HPV 45 (4.1%, n=21), HPV 16 (1.7%, n=9), and HPV 18 (1.2%, n=6), with other HPV genotypes (6.6%, n=34). The frequency of cervical dysplasia was 6.4% (33/515), which was significantly associated with all HPV genotypes except HPV 16. Single HPV infection was seen in 31 (51.8%) women while multiple infections were seen in 30 (49.2%), with double infection in 21 (34.4%) and triple infections in 9 (14.7%). Conclusion: The prevalence of hrHPV infection was high among women in Kaduna State, Nigeria. DNA-based screening for hrHPV genotypes and production of new vaccine that will protect against the predominant hrHPV genotypes are thus recommended for the prevention of cervical cancer in Nigeria, Africa and beyond.

Prognostic awareness and prognostic information preferences among advanced cancer patients in Kenya

Background: Cancer is the third leading cause of death in Kenya. Yet, little is known about prognostic awareness and preferences for prognostic information. Aim: To assess the prevalence of prognostic awareness and preference for prognostic information among advanced cancer patients in Kenya. Setting: Outpatient medical oncology and palliative care clinics and inpatient medical and surgical wards of Moi Teaching and Referral Hospital (MTRH) in Eldoret, Kenya. Methods: The authors surveyed 207 adults with advanced solid cancers. The survey comprised validated measures developed for a multi-site study of end-of-life care in advanced cancer patients. Outcome variables included prognostic awareness and preference for prognostic information. Results: More than one-third of participants (36%) were unaware of their prognosis and most (67%) preferred not to receive prognostic information. Increased age (OR = 1.04, 95% CI: 1.02, 1.07) and education level (OR: 1.18, CI: 1.08, 1.30) were associated with a higher likelihood of preference to receive prognostic information, while increased symptom burden (OR= 0.94, CI: 0.90, 0.99) and higher perceived household income levels (lower-middle vs low: OR= 0.19; CI: 0.09, 0.44; and upper middle- or high vs low: OR= 0.22, CI: 0.09, 0.56) were associated with lower odds of preferring prognostic information. Conclusion: Results reveal low levels of prognostic awareness and little interest in receiving prognostic information among advanced cancer patients in Kenya. Contribution: Given the important role of prognostic awareness in providing patient-centred care, efforts to educate patients in Kenya on the value of this information should be a priority, especially among younger patients.

Histopathological profile of small bowel cancers in the City of Kinshasa, Democratic Republic of the Congo, from March 2011 to March 2023

Contexte et objectifs. Le cancer de l'intestin grêle est très peu documenté. L'objectif du présent travail était de décrire le profil épidémiologique et histopathologique des cancers de l'intestin grêle dans la ville de Kinshasa. Méthodes. C'était une étude descriptive d'une série des cas colligés dans quatre laboratoires d'Anatomie Pathologique de la ville de Kinshasa et sur une période de 12 ans. Les patients ayant comme diagnostic histologique des cancers de l'intestin grêle ont été répertoriés de manière exhaustive à partir des registres des laboratoires sélectionnés. Les pièces biopsiques archivées ont été relues. Résultats. Sur 812 cancers digestifs enregistrés durant la période d'étude, 43 avaient le cancer de l'intestin grêle soit une fréquence relative de 3,5 ℅. Le sexe masculin prépondérant (58,1 ℅). Les ¾ de nos patients avaient un âge compris entre 6 ans et 58 ans. Les patients plus âgés avaient un grade histologique plus élevé. La quasi-totalité de cancers de l'intestin grêle était déjà invasifs au moment du diagnostic et l'adenocarcinome était le cancer le plus fréquent. Le type histologique influençait significativement le grade (p= 0.007). Conclusion. Le cancer de l'intestin grêle dont le type le plus courant est l'adenocarcinome était invasif et rendant ainsi le pronostic plus défavorable. Ceci montre qu'il y a un problème de retard diagnostic. L'âge et le type histologique exerçaient une influence sur le niveau d'invasion des cancers de l'intestin grêle

Context and objective. Cancer of the small intestine is poorly documented. The aim of this study was to describe the histopathological profile of small bowel cancers in the City of Kinshasa. Methods.This was a descriptive study of a series of cases collected in four Pathological Anatomy laboratories in the city of Kinshasa over a 12-year period. Records of patients with histological diagnoses of small bowel cancers were exhaustively collected from the registries of the selected laboratories. Results Out of 812 digestive tract cancers recorded in studied period, 43 had cancers of the small intestine, with a relative frequency of 3.5 ℅. Male gender predominated (58.1 ℅). The ¾ of patients with small bowel cancers were between 6 and 58 years old. Older patients had a higher histological grade. Histological type had a significant influence on cancer grade (p= 0.0072). Conclusion. Almost all small bowel cancers were diagnosed at the invasion's stage, making the prognosis poorer. The high number of invasive cancers suggests that the delayed diagnosis of cancers could be the culprit in Kinshasa

Cout réel de la prise en charge des cancers du col de l'utérus en radiothérapie au Cameroun / The real cost of the management of cervical cancers by radiotherapy in Cameroon

Introduction. Le cancer du col utérin est le deuxième cancer de la femme au Cameroun. La radiothérapie reste une des modalités thérapeutiques phares dans la prise en charge de cette pathologie et l'État participe en y apportant une subvention. Toutefois, plusieurs patientes n'accèdent pas au traitement en raison des difficultés financières. Notre objectif était d'évaluer le coût réel de la prise en charge afin de servir de support aux politiques d'aide aux patientes. Méthodologie. Uneétude descriptive, transversale portant sur les patientes traitées en radiothérapie à l'Hôpital Général de Douala pour cancer du col de l'utérus a été réalisée d'octobre 2020 à janvier 2021.Résultats. Au total 35 dossiers de patientes ont été inclus. Lespatientes avaient de faibles revenus (<108.810 XAF /mois, 51,3%), étaient sans assurance maladie (88,6%), provenant en majorité des villes hors de Douala (54,3%), avec des cancers localement évolués. Le coût global moyen du traitement était de 511 264 XAF+/-103479 XAF (779,42 +/-157,75 euros) pour chaque patiente. La durée moyenne de traitement était de 57,34 jours, avec un nombre médian de 27 séances. Les frais supplémentaires pendant le traitement provenaient de la chimiothérapie, de la gestion des effets secondaires, notamment des transfusions sanguines, et du bilan de suivi. Plus de la moitié des patientes ont eu besoin d'une prise en charge supplémentaire par chimiothérapie ou chirurgie. Conclusion. La prise en charge du cancer du col utérin par radiothérapie est coûteuse et peu accessible à la majorité des patientes Camerounaises.

Introduction.Cervix cancer is the second cancer among women in Cameroon. Radiotherapy is often warranted in its management. Many patients do not access treatment due to financial difficulties. Our objective was to assess the real cost of care in order to support patient assistance policies. Methodology. A descriptive cross over study of women treated by radiotherapy at the Douala General Hospital from October 2020 to January 2021 was conducted. Results. A total number of 35 patient files were included in the study. Patients generally had low income (<108.810 XAF /month), without medical insurance, lived out of Douala, and were diagnosed at locally advanced stages of their disease. Average cost of treatment for radiotherapy alone was 511,264 XAF +/-103,479 XAF. Average duration of treatment was 57.34 days, with a median number of 27 sessions. Extra cost came from chemotherapy, management of side effects especially from blood transfusions, and imaging. More than half of the patients required additional expense for adjunct chemotherapy or surgery. Conclusion. The total cost of treatment for cervix cancer by radiotherapy is quite expensive, and not accessible to the average Cameroonian

Les cancers gynécologiques en pratique oncologique à Lomé / Gynecological cancer in oncology practice in Lomé

Introduction. Les cancers gynécologiques constituent un problème majeur de santé publique dans le monde. L'objectif de cette étude était de déterminer la fréquence des cancers gynécologiques en pratique oncologique à Lomé et d'en étudier les aspects épidémiologiques et histo-cliniques. Méthodes. Il s'agitd'une étude rétrospective et descriptive portant sur tous les cancers gynécologiques reçus en oncologie entre le 1erJanvier 2016 et le 31 Décembre 2021. Résultats. Au total 202 cas de cancers gynécologiques ont été enregistrés. L'âge moyen des patientes était de 54 ans avec des extrêmes de 20 et 88 ans. Les cancers les plus fréquents étaient le cancer du col utérin (n=88; 43,6%), du corps utérin (n= 57; 28,3%) et de l'ovaire (n= 35; 17,4%). Le carcinome épidermoïde était le type histologique le plus fréquent dans le cancer du col (n= 86; 97,7%) tandis que les cancers du corps de l'utérus étaient majoritairement des adénocarcinomes (n=46 ; 80,7 %). Tous les cancers de la vulve et du vagin étaient des carcinomes épidermoïdes et la majorité des cancers de l'ovaire était des tumeurs épithéliales (n=29 ; 82,9%). Les deux-tiers des patients o été diagnostiqué à un stade avancé (stade III et IV) (n=134 ; 66,3%). Conclusion. Les cancers gynécologiques sont fréquents dans notre pratique et majoritairement diagnostiqués à un stade tardif. Cette étude souligne la nécessité d'une détection précoce de ces affections afin d'améliorer le pronostic des patientes.

Introduction. Gynecological cancers are an important public health problem worldwide. The objective of this study was to describe the epidemiological, clinical, and histopathological features of gynecological cancer in clinical oncology practice in Lomé. Methods. This was a retrospective study of histopathological confirmed gynecological malignancies conducted in the department of oncology from January 2016 to December 2021. Results. A total of 202 cases were identified. The mean age of patients was 54years [range20-88years]. The most common gynecological malignancy was cervical cancer (n=88 ; 43.6%), followed by uterine corpus cancer (n= 57 ; 28.3%) and ovarian cancer (n= 35 ; 17.4%). The most common histopathological diagnosis of cervical cancer was squamous cell carcinoma (n= 86 ; 97.7%) while most corpus uterine cancers were endometrioid adenocarcinoma (n= 46 ; 80.7 %). Vulval and vagina cancers were squamous cell carcinoma and the majority of ovarian cancers were epithelial tumours (n= 29 ; 82.9%). Two-thirds of patients were diagnosed at the advanced stage (stage III et IV) (n= 134 ; 66.3%). Conclusion. Gynecologic cancers are common in our practice. This study emphasizes the necessity of early detection of these diseases to improve prognostic and patient survival

Profil évolutif de la limboconjonctivité endémique des tropiques à l'hôpital gynéco-obstétrique et pédiatrique de Yaoundé / Gynecological cancer in oncology practice in Lomé

Introduction. La limbo-conjonctivite endémique des tropiques (LCET) est une kérato-conjonctivite allergique récidivante du jeune enfant qui s'améliore après la puberté mais peut persister. Le but de cette étude était de déterminer le profil évolutif de la LCETdans notre pratique. Méthodologie. Étude longitudinale descriptive menée dans l'unité d'ophtalmologie de l'Hôpital Gynéco-Obstétrique et Pédiatrique de Yaoundé. Tous les dossiers de LCET reçus de janvier 2011 à décembre 2019 avec un recul d'aumoins deux ans de suivi ont été recensés. Les patients qui ont accepté de participer après apptéléphonique ont été inclus de janvier à mai 2021.Les variables d'étudeétaient: âge, sexe, acuité visuelle (AV), caractéristiques de la LCET selon Diallo, pronostic fonctionnel et anatomique en post puberté (plus de 15 ans). Résultats. Au total,30 patients (60 yeux) ont été étudiés. Le sex-ratio était de 2. La moyenne d'âge était de 15 ans ± 9 ans. Initialement, le prurit était le maitre symptôme (96,7%). Après un recul moyen de cinq ans, l'AV était utile chez tous les patients (100%) et la LCET stade 2 plus représentée (60%). Le nombre moyen de récidives était de trois. Les patients post pubertaires on eu une amélioration anatomique dans 56.7% des caset une aggravation dans 10%des casConclusion. Notre travail confirme l'amélioration post pubertaire globale de la LCET, nonobstant quelques formes graves depronosticpéjoratif pour la fonction visuelle.

Introduction. Tropical endemiclimbo-conjunctivitis (TELC) is a recurrent allergic kerato-conjunctivitis in young children which improves after puberty but may persist. The aim of this study was to determine the evolutionof TELCin our setting. Methodology. This was a longitudinal descriptive study conducted in the ophthalmology unit of the Yaoundé Gyneco-Obstetric and Pediatric Hospital. All TELC files received from January 2011 to December 2019 with a follow-up of at least two years of follow-up were identified. Patients who agreed to participate after a phone call were included from January to May 2021. The variables of interest were: age, sex, visual acuity (VA), TELC classification according to Diallo, functional and anatomical prognosis in post puberty (more than 15 years).A totalof30 patients (60 eyes) were recruited. The sex ratio was 2. The average age was 15 ± 9 years. Initially, pruritus was the main symptom (96.7%). After an average follow-up of five years, VA was usefulin all patients (100%) and TELCstage 2 was the most frequent stage (60%). The mean number of recurrences was three. Postpubertal patients had anatomical improvement in 56.7% of cases and worsening in 10%of cases. Conclusion. Our study confirms the overall postpubertal improvement ofTELC, except some serious forms with poor prognosis ofvisual function

Breast cancer molecular diagnostics in Rwanda: a cost-minimization study of immunohistochemistry versus a novel GeneXpert® mRNA expression assay

Objective To compare the financial and time cost of breast cancer biomarker analysis by immunohistochemistry with that by the Xpert® STRAT4 assay. Methods We estimated costs (personnel, location, consumables and indirect) and time involved in breast cancer diagnosis at the Butaro Cancer Centre of Excellence, Rwanda, using time-driven activity-based costing. We performed a cost-minimization analysis to compare the cost of biomarker analysis for estrogen receptor, progesterone receptor and human epidermal growth factor receptor-2 status with immunohistochemistry versus STRAT4. We performed sensitivity analyses by altering laboratory-specific parameters for the two methods. Findings We estimated that breast cancer diagnosis in Rwanda costs 138.29 United States dollars (US$) per patient when conducting biomarker analysis by immunohistochemistry. At a realistic immunohistochemistry antibody utilization efficiency of 70%, biomarker analysis comprises 48.7% (US$ 67.33) of diagnostic costs and takes 33 min. We determined that biomarker analysis with STRAT4 yields a reduction in diagnosis cost of US$ 7.33 (10.9%; 7.33/67.33), and in pathologist and technician time of 20 min (60.6%; 20/33), per patient. Our sensitivity analysis revealed that no cost savings would be made in laboratories with antibody utilization efficiencies over 90%, or where only estrogen and/or progesterone receptor status are assessed; however, such operational efficiencies are unlikely, and more laboratories are pursuing human epidermal growth factor receptor-2 analysis as targeted therapies become increasingly available. Conclusion Breast cancer biomarker analysis with STRAT4 has the potential to reduce the required human and capital resources in subSaharan African laboratories, leading to improved treatment selection and better clinical outcomes.

A doctor at a PHC clinic: A 'must-have' or 'nice-to-have'?

Background. Many patients have their healthcare needs met at primary healthcare (PHC) clinics in KwaZulu-Natal (KZN), without having to travel to a hospital. Doctors form part of the teams at many PHC clinics throughout KZN, offering a decentralised medical service in a PHC clinic. Objectives. To assess the benefit of having a medical doctor managing patients with more complex clinical conditions at PHC clinic level in uMgungundlovu District, KZN. Two key questions were researched: (i) were the patients whom the clinic doctors managed of sufficient clinical complexity that they warranted a doctor managing them, rather than a PHC nurse clinician? and (ii) what was the spectrum of medical conditions that the clinic doctors managed? Methods. Doctors collected data at all medical consultations in PHC clinics in uMgungundlovu during February 2020. A single-page standardised data tool was used to collect data at every consultation. Results. Thirty-five doctors were working in 45 PHC clinics in February 2020. Twenty-six of the clinic doctors were National Health Insurance (NHI)-employed. The 35 doctors conducted 7 424 patient consultations in February. Staff in the PHC clinics conducted 143 421 consultations that month, mostly by PHC nurse clinicians. The doctors concluded that 6 947 (93.6%) of the 7 424 doctor consultations were of sufficient complexity as to warrant management by a doctor. The spectrum of medical conditions was as follows: (i) consultations for maternal and child health; n=761 (10.2%); (ii) consultations involving non-communicable diseases (NCDs), n=4 372 (58.9%) ­ the six most common NCDs were, in order: hypertension, diabetes, arthritis, epilepsy, mental illness and renal disease; (iii) consultations involving communicable diseases constituted 1 745 (23.5%) of cases; and (iv) consultations involving laboratory result interpretation 1 180 (15.9%).Conclusion. This research showed that at a PHC clinic the more complex patient consultations did indeed require the skills and knowledge of a medical doctor managing these patients. These data support the benefit of a doctor working at every PHC clinic: the doctor is a 'must-have' member of the PHC clinic team, offering a regular, reliable and predictable medical service.

Aspects particuliers des myomes utérins en IRM multimodale en milieu tropical / Features of uterine myomas explored with multimodal MRI in a tropical environment

Objectif. Décrire les caractéristiques de la prise en charge des myomes utérins dans une unité d'IRM multimodale en Afrique subsaharienne. Matériels et méthodes. Étude transversale descriptive rétrospective, d'une durée de 08 mois, réalisée au service d'imagerie médicale de l'hôpital mère enfant de Bingerville. Nous avons inclus les patientes dont le motif et ou les résultats des examens faisaient mention de myomes utérins. Les paramètres étudiés étaient l'âge des patientes, le motif d'examen et les résultats de l'examen d'IRM. Résultats. Nous avons recruté 103 patientes. Leur âge moyen était de 40 ans. Dans 95,1% des cas, les indications portaient sur la cartographie et l'exploration des myomes utérins déjà connus. Les myomes étaient de découverte fortuite dans 5% des cas. Les myomes étaient uniques dans 9% et en nombre supérieur à 5 dans 61% des cas. Ils étaient majoritairement hyalins, en isosignal homogène T1 FSE (86%), en hyposignal homogène T2 PROPELLER et diffusion (97%) avec rehaussement homogène (85%). Il y avait des complications dégénératives dans 12% des cas et mécaniques dans 3% des cas. Elles étaient corrélées à un nombre de myomes supérieur à 5 (p=0,05), mais pas à la taille des myomes ni à l'âge des patientes. Les pathologies pelviennes associées (53%) étaient : lésions ovariennes non tumorales (45%), adénomyose (30%) et cancer du col utérin (25%). Conclusion. À Abidjan, les myomes utérins sont une pathologie de la femme en activité génitale, en période préménopausique. L'IRM est utilisée quasi exclusivement en seconde intention après l'échographie pour la cartographie préopératoire ou pré embolisation. La découverte de pathologies associées dont le cancer du col, devrait faire préférer l'IRM pour toute exploration diagnostique et pré thérapeutique

Objective. To describe the characteristics of the management of uterine myomas in a multimodal MRI unit of Sub-Saharan Africa. Methods. This was a cross sectional retrospective descriptive study of eight months duration that was carried out in the medical imaging department of the mother and child hospital in Bingerville. The patients whose indications and/or results of the MRI mentioned uterine myomas were included. The parameters studied were the age of the patients, the reason and the results of the MRI examination. Results. We studied 103 patients. Their average age was 40 years. In 95.1% of the cases, the indications were for mapping and exploring already known uterine myomas. Incidental myomas accounted for 5%. The myomas were unique in 9% and more than 5 in 61%. They were mostly hyaline, in homogeneous T1 FSE isosignal (86%), in homogeneous T2 PROPELLER and diffusion hyposignal (97%) with homogeneous enhancement (85%). Degenerative complications were noted in 12% and mechanical complications in 3%. They were correlated with a number of myomas greater than 5 (p=0.05) but not with size of myomas or age of patients. Associated pelvic diseases (53,4%) were mainly non tumoral ovarian lesions (45%), adenomyosis (30%) and cervical cancer (25%). Conclusion. In our setting, uterine myomas affect mainly the genitally active woman in the premenopausal period. MRI is used almost exclusively as a second line after ultrasound, for preoperative or preembolization mapping. The discovery of associated pathologies, including cervical cancer, should make MRI preferable for all diagnostic and pre-therapeutic exploration.

The synergism of hepatitis B and aflatoxicosis in hepatocellular carcinoma development: A mini-review

Hepatocellular carcinoma (HCC) is the twelfth most common cancer and the fifth leading cause of worldwide cancer related death. Chronic hepatitis B infection, caused by the hepatitis B virus (HBV) and exposure to aflatoxins is fundamental in the formation of HCC in developing countries. This review of scientific publications aims to establish the detrimental effects of aflatoxin-contaminated foods and highlights the correlation between aflatoxin and hepatitis B viral-associated hepatocellular carcinoma. Research has shown a significant increase in the occurrence of HCC in HBV-infected individuals exposed to fungal toxins. HBV demonstrates the ability to integrate and bind to p53 protein in the host DNA and propagate hepatocyte vulnerability through carcinogenic aflatoxin B1 (AFB1) damage. Although there has been clear evidence about the synergistic interaction of exposure to AFB1 and HBV infection in the induction of HCC, other literature has shown otherwise, mainly because incomplete and vague findings and hypotheses were made in regions where AFB1 and HBV pose a public health risk. Vaccination against hepatitis B and measures such as robust food safety systems to avoid hepatotoxicity and hepatocellular carcinogenesis induced by AFB1 is the most effective methods in the prevention of HCC induced by HBV and AFB1

Validation of HIV risk screening tool to identify infected adults and adolescents greater than 14 years at community level in Tanzania and Zambia

Introduction: There are several risk factors being used to identify undiagnosed HIV-infected adults. As the number of undiagnosed people gets less and less, it is important to know if existing risk factors and risk assessment tools are valid for use. Methods: Data from the Tanzania and Zambia Population-Based HIV Impact Assessment (PHIA) household surveys which were conducted during 2016 was used. We first included 12 risk factors (being divorced, separated or widowed; having an HIV+ spouse; having one of the following within 12-months of the survey: paid work, slept away from home for ≥1-month, having multiple sexual partners, clients of sex workers, sexually transmitted infection, being tuberculosis suspect, being very sick for ≥3-months; ever sold sex; diagnosed with cervical cancer; and had TB disease into a risk assessment tool and assessed its validity by comparing it against HIV test result. Sensitivity, specificity and predictive value of the tool were assessed. Receiver Operating Characteristic (ROC) curve comparison statistics was also used to determine which risk assessment tool was better. Results: HIV prevalence was 2.3% (2.0%-2.6%) (n=14,820). For the tool containing all risk factors, HIV prevalence was 1.0% when none of the risk factors were present (Score 0) compared to 3.2% when at least one factor (Score ≥1) was present and 8.0% when ≥4 risk factors were present. Sensitivity, specificity, PPV, and NPV were 82.3% (78.6%-85.9%), 41.9%(41.1%-42.7%), 3.2%(2.8%-3.6%), and 99.0%(98.8%-99.3%), respectively. The use of a tool containing conventional risk factors (all except those related with working and sleeping away) was found to have higher AUC (0.65 vs 0.61) compared to the use of all risk factors (p value <0.001). Conclusions: The use of a screening tool containing conventional risk factors improved HIV testing yield compared to doing universal testing. Prioritizing people who fulfill multiple risk factors should be explored further to improve HIV testing yield.

Epidemiological and clinicopathological profile of endometrial cancer in Gabon

Introduction: L'objectif général de notre travail était d'apporter une description épidémiologique et clinicopathologique du cancer de l'endomètre au Gabon. Patients et méthode: Cette étude descriptive et rétrospective a été réalisée à l'Institut de Cancérologie de Libreville chez les patientes atteintes du cancer de l'endomètre sur une période de 7 années (de janvier 2012 à octobre 2018). Résultats: Cette étude a inclus 32 patientes et les résultats obtenus ontmontré que ce cancer au Gabon est plus fréquent chez la femme multipare, que histologiquement le type 1 est le plus souvent rencontré et que ce cancer est de haut grade de malignité. De ce travail ressort également la difficulté du suivi des patientes. Conclusion: Le cancer de l'endomètre étant un cancer souvent d'emblée de mauvais pronostic, il est d'intérêt de mettre en place une stratégie de prévention et de management adapté.Mots clés: cancer, endomètre, étude clinicopathologique, suivi, Gabon Abstract:Introduction:The general objective of our work was to provide an epidemiological and clinicopathological description of endometrial cancer in Gabon.

Introduction: The general objective of our work was to provide an epidemiological and clinicopathological description of endometrial cancer in Gabon. Epidemiological and clinicopathological profile of... Patients and method: This descriptive and retrospective study was carried out at Cancer Institute of Libreville in patients with endometrial cancer over a period of 7 years (from January 2012 to October 2018) . Results: This study included 32 patients and the results obtained showed that this cancer in Gabon is more frequent in multiparous women, that histologically type 1 is most often encountered and that this cancer is of high grade malignancy. This work also shows the difficulty of following up patients. Conclusion: As endometrial cancer is often a cancer with a poor prognosis , it is interest to put in place an appropriate prevention and management strategy.

Les urgences urologiques dans deux hôpitaux universitaires de Douala: une étude rétrospective (2016-2020) / Urological emergencies in two university hospitals in Douala: a retrospective study (2016-2020)

Introduction: les urgences en urologie sont des situations urologiques critiques qui nécessitent une intervention rapide par un professionnel de santé qualifié en urologie. Cette étude a été menée dans le but de ressortir le profil des urgences urologiques reçues dans deux hôpitaux universitaires de la ville de Douala en appréciant leurs prises en charge en urgence. Méthodes: il s´agit d´une étude rétrospective portant sur les urgences urologiques dans deux hôpitaux de références de la ville de Douala que sont les hôpitaux Laquintinie et Général de Douala. Les dossiers ont été colligés durant une période de 5 ans (1er janvier 2016 au 31 décembre 2020). Nous avons inclus toutes les consultations effectuées en urgence et reçues par le service des urgences ainsi que toutes les données cliniques et thérapeutiques venant du registre de garde durant la période d´étude. Nous avons exclu de notre étude toutes les urgences (consultations reçues pendant la période d´étude, non relevées dans le registre des urgences) Résultats: nous avons étudié 364 patients, l´âge moyen des patients était de 43 ± 8,34 ans. Quatre vingt-douze virgule cinquante huit pourcent (92,58%) (n=337) des patients étaient des hommes. Les principales urgences urologiques reçues étaient la rétention d´urine vésicale (45,05%, n=164), la colique néphrétique (15,33%, n=56) et l´hématurie (13,18%, n=48). Les principales étiologies des rétentions d´urine vésicale étaient les tumeurs prostatiques, la colique néphrétique était principalement d´origine lithiasique (96,45%, n=159) et l´hématurie était d´origine tumorale chez 68,75%(n=33) des patients. Sur le plan thérapeutique, les gestes effectués en urgence étaient le sondage vésical (39,01%, n=142), le traitement médical était associé à une surveillance (27,47%, n=100) et la cystostomie sus pubienne (10,71%, n=39). Conclusion: les rétentions aigues d´urines vésicales sur tumeurs prostatiques constituent l´urgence urologique la plus fréquente dans les hôpitaux universitaires de la ville de Douala. Cela implique une prise en charge précoce et optimale des tumeurs prostatiques.

Profile of gynecological cancers in a tertiary hospital, Eastern Nigeria

Introduction: there is a great diversity in the profile of cancers in the world. This study set out to analyze the profile of gynecological cancer in Federal University Teaching Hospital, Owerri, [FUTHO] (former Federal Medical Centre, Owerri, Imo state, Nigeria). Methods: this was a retrospective cross sectional descriptive study of the records of women admitted in the gynecological ward in FUTHO from January 2020 to November 2022. It was analyzed using SPSS version 23.0 and reported in simple percentages for categorical variables and measures of central tendency for quantitative variables. Results: a total of 1,378 gynecological patients were admitted into the Gynaecological ward of the hospital, out of which 242 (17.6%) were cancer cases. The most common cancer over the three years in review, was ovarian, 81(33.5%), followed by cervical, 66 (27.3 %), endometrial, 65 (26.8 %), choriocarcinoma, 22 (9.1%), vulvar, 6 (2.5%) and vagina, 2(0.8%). The most common gynecological cancers in this study is very different from previous reports from Nigeria and other African countries. The pattern looks like that seen in the developed countries where endometrial and ovarian cancers top the list. Conclusion: this report shows a possible change in lifestyle and improved access to cervical cancer prevention strategies. It is also assumed that all the facilities who have recorded cervical cancer as the most common cancer can actually have a similar result as ours if a more current review is done.

Human Papilloma Virus, Risk Factors and Sequelae: How much do Female Adolescents in Port Harcourt Metropolis know?

Background: Human Papilloma virus (HPV) infection is the most common viral infection of the genital tract; is sexually transmitted with the highest rates observed in young women. This study assessed the level of knowledge of HPV and cervical cancer among adolescent girls in Port Harcourt metropolis, Nigeria. Methodology: A cross-sectional survey among 328 in-school female secondary school students aged 9 - 19 years, selected via multi-stage sampling. Information on socio-demographics, knowledge of HPV and cervical cancer and sexual history were collected using a self-administered, semi-structured questionnaire. Data was analyzed using SPSS version 23 and Chi square test was used to establish associations. Results: Only 38.2% and 30% had heard of cervical cancer and HPV respectively; the media being the most common source. Knowledge of transmission, risk factors, sequelae and prevention of infection was poor (75%). About 20.2% were aware of the causal association between HPV infection and cervical cancer. Some (3.1%) were sexually exposed and practiced unprotected sexual intercourse. Median age at sexual debut was 11 years. Older and private school students (15-19years) had better knowledge Conclusion: The level of knowledge of HPV, cervical cancer, their association and risk factors, among adolescent girls in Port Harcourt metropolis is poor. Some adolescents engage in sexual practices that put them at risk for HPV infection. Social media and upper primary and secondary school-based approach to HPV health promotion should be explored to provide detailed adolescent-friendly information to guide in prevention of HPV infection and cervical cancer.

Treatment Outcomes in COVID-19 patients with comorbidities in Kaduna state, NorthwesternNigeria

Background: Severe COVID-19 disease has been reported among people with underlying conditions such as diabetes, chronic respiratory diseases, cancer, obesity, and cardiovascular disease. This study determined the outcomes of COVID-19 among patients with comorbidities in Kaduna state, where we have the highest incidence in northern Nigeria.Methods: This study was a retrospective, descriptive cross-sectional review of the clinical records involving all age groups of 902 COVID-19 patients admitted at the four isolation centers of the Kaduna State Infectious Disease Control Centre (IDCC) between March 27th2020 to December 31st2021. Data was analyzed with SPSS version 25 and STATA SE 12 with p <0.05.Results: Out of the 902 cases, 245(27.2%) had comorbidities, hypertension 206(22.8%) was the most recorded comorbidity, others were diabetes 77(8.5%), asthma 7 (0.78%), HIV 7(0.78%), sickle cell anemia 7 (0.78%) and PTB 3 (0.33%). Patients with comorbidities had prolonged mean duration of symptoms 8.36±3.5 days, compared to 7.2±2.7 days in those without comorbidities (p=0.001).Multivariate logistic regression analysis further shows that the odds for clinical recovery from the COVID-19 disease was significantly lower for patient with hypertension (AOR=0.13, 95%CI=0.06-0.27, p = <0.01), diabetic (AOR=0.20, 95% CI=0.10-0.40, p<0.01) and HIV comorbidities (AOR=0.1, 95%CI=0.01-0.98, p=0.05) compared to those without comorbiditiesConclusion: Hypertension and diabetes were the major comorbidities in this study. Most patients with comorbidities had severe presentations and fatal poorer outcome. There is a need for sustained public health education targeted at patients with chronic diseases to be screened and treated early for COVID 19 Disease

Performance des explorations cliniques et de l'échographie mammaire dans le diagnostic des tumeurs bénignes du sein en milieu peu équipé d'Afrique subsaharienne / Performance of clinical investigations and breast ultrasound in the diagnosis of benign breast tumors in low-resource settings in sub-Saharan Africa

Contexte et objectif. Malgré leur fréquence élevée, très peu d'études ont été menées sur les tumeurs bénignes du sein (TBS) en Afrique subsaharienne. L'objectif de la présente étude a été d'évaluer la valeur diagnostique des explorations clinique et échographique mammaire des TBS en milieu peu équipé. Méthodes. Il s'agissait d'une étude documentaire, sur les TBS suivies aux Cliniques Universitaires de Kinshasa, entre janvier 2016 et décembre 2021. La valeur diagnostique des explorations clinique et échographique mammaire des TBS (sensibilité, spécificité, valeur prédictive négative VPN, VPP, coefficient Kappa) a été calculée en prenant pour référence la découverte anatomopathologique des pièces biopsiques. Résultats. Au total, 81 dossiers de TBS ont été colligés. Le Fibroadénome 58 (71,6 %), la Maladie fibrokystique (MFK) 15 (18,5 %), l'Adénome tubuleux 6(7,4 %), la Tumeur Phyllode (TP) 1(1,2 %) et le kyste 1(1,2 %) étaient les tumeurs diagnostiquées à l'anatomopathologie, après tumorectomies. A l'examen clinique, la capacité diagnostique des TBS autres que le Fibroadénome était nulle. La spécificité, la VPN et le coefficient kappa étaient respectivement, de 60,0 %, 39,1 % et 32,2 % pour le diagnostic du Fibroadénome. L'échographie mammaire était faite dans 98,6 % tandis que la mammographie seulement dans 11,1 % des cas. La majorité des tumeurs étaient classées Breast Imaging reporting and Data system (BIRADS) 2 (70,0 %). La spécificité, la VPN et le coefficient kappa étaient respectivement, de 80,6 %, 40,9 % et 39,0 % pour le Fibroadénome, et de 84,4 %, 66,7 % et 1,9 % pour la MFK. La TP était classée BIRADS3. Conclusion. L'échographie mammaire très réalisée, est très performante dans la classification BIRADS des TBS; les cliniciens exerçant en milieu peu équipé peuvent donc sans équivoque suivre les recommandations sur la prise en charge des tumeurs classées BIRADS2 et BIRADS3 à l'échographie, bien que sa performance en ce qui concerne le diagnostic différentiel de ces tumeurs soit moindre.

Déterminants du carcinome photo-induit chez les sujets de phototype albinos aux Cliniques Universitaires de Kinshasa / Determinants of photo-induced carcinoma in albino phototype people at the Kinshasa University hospital

Contexte et objectif. Les rayonnements ultra-violets constituent un facteur connu de risque de carcinome photo-induit chez l'albinos en milieu à fort ensoleillement. La présente étude a évalué l'ampleur du carcinome photo induit et a recherché les principaux déterminants chez les sujets de phototype albinos à Kinshasa. Méthodes. Dans une étude transversale, des sujets de phototype albinos recrutés de manière consécutive, ont été examinés du 1er janvier 2020 au 30 septembre 2020 au Service de dermatologie des Cliniques Universitaires de Kinshasa. La fréquence du carcinome a été estimée et ses déterminants recherchés à l'aide d'une analyse de régression logistique. Résultats. Au total 100 albinos ont été inclus. Près d'un albinos sur deux (44 %) a développé un carcinome. En analyse multivariée, l'âge >30 ans (OR : 2,68 ; IC 95% :1,65-11,10 ; p=0,017), la présence des kératoses actiniques (OR: 3.80; IC 95%: 1.43-7.23; p=0.023), un antécédent familial de cancer non cutané (OR : 2,40 ; IC95% : 1,47-12,35 ; p=0,29), un antécédent familial de carcinome (OR : 4,99 ; IC95% :3,0-9,29 ;p=0,000) et un antécédent personnel de polytransfusion (OR :2,30 ; IC 95% :1,26-6,20 ;p=0,045) ont été identifiés comme les principaux déterminants du carcinome photo-induit. Conclusion. Près d'un albinos sur deux présente un carcinome photo-induit. Ceci justifie l'intensification des mesures comportementales et préventives contre le développement des cancers cutanés ciblant particulièrement les albinos âgés de moins de 30 ans, présentant des kératoses actiniques et ceux avec antécédents familiaux de cancer (carcinome et autres).

Variétés histologiques des tumeurs bénignes du septum nasal une série documentaire de 30 cas

Contexte et objectif. Les variétés histologiques de tumeurs du septum nasal sont peu documentées dans les pays d'Afrique. La présenté étude avait pour objectif de décrire les variétés histologiques de tumeurs septales bénignes. Méthodes. C'était une analyse rétrospective de dossiers des patients admis pour tumeurs septales bénignes, entre janvier 1998 et aout 2021 ; à l'hôpital Dr Dorban en Algérie. Les variables d'intérêt englobaient les données cliniques et histopathologiques. Résultats. En 23 ans, seulement trente dossiers de tumeurs bénignes du septum nasal ont été colligés. Leur âge moyen était de 36,2 ans avec les extrêmes entre 13 et 70 ans avec une prédominance du sexe féminin (63,3 %). Les tumeurs vasculaires étaient prépondérantes (83,3 %) en particulier les hémangiomes capillaires (92 %) suivies des variétés épithéliales (13,3%) et un seul adénome pléomorphe septal. L'évolution clinique était émaillée par 3 récidives pour les hémangiomes, et absence de récidive pour l'adénome pléomorphe après 120 mois de recul. Trois autres cas étaient perdus. Conclusion: Les tumeurs bénignes du septum nasal sont rares et diversifiées sur le plan histologique. A coté des formes classiques et communes (hémangiomes, papillomes, adénomes), il existe des variétés rares et qui nécessitent une étude spécifique et une expertise dédiée.

Safe duration of silicon catheter replacement in urological patients

Objectives: This study compared the infection rates, degree of encrustation, symptoms, and complications in patients regarding the duration of urethral catheterisation (three weeks, six weeks, and eight weeks). Design: A cross-sectional study with stratified simple random sampling Setting: Urology Unit, Korle Bu Teaching Hospital Participants: One hundred and thirty-seven male patients with long-term urinary catheters Interventions: Participants were grouped into 3 weeks, 6 weeks, and 8 weeks duration of catheter replacementsPrimary outcomes measures: Symptoms due to the urinary catheters, urinalysis, urine and catheter tip cultures, sensitivity, and catheter encrustations were assessed. Results: Eighty-six patients had a primary diagnosis of benign prostatic hyperplasia (BPH), 35 had urethral strictures,13 had prostate cancer, two had BPH and urethral strictures, and one participant had bladder cancer. There was no difference in the symptoms the participants in the different groups experienced due to the urinary catheters (p > 0.05). The frequency of occurrence of complications (pyuria, p = 0.784; blocked catheter, p=0.097; urethral bleeding, p=0.148; epididymo-orchitis, p=0.769 and bladder spasms, p=1.000) showed no differences in the three groups. There was no statistical difference in the urinalysis for the three groups (p>0.05) and the degree of encrustations (3 weeks: 0.03 ± 0.06, 6 weeks: 0.11±0.27 and eight weeks: 0.12 ±0.27) with p=0.065. Conclusions: In this study, the duration of urinary catheterisation using silicone Foley's catheters did not influence the complication and symptom rates; hence silicon catheters can be placed in situ for up to 8 weeks before replacement instead of the traditional three-weekly change.