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1. Emerging cancer disease burden in a rural sub-Saharan African population: northeast Nigeria in focus

Author

Uchenna S. Ezenkwa, Aliyu Ibrahim Lawan, Musa Abubakar Garbati, Dauda E. Suleiman, Dauda A. Katagum, Abba Kabir, Adamu Isa Adamu, Abubakar Kolomi Modu, Olaniyi David Olanrewaju, Rufai Abdu Dachi, Yusuf Mohammed Abdullahi, Muhammed Alkali, Danladi Adamu Bojude, Hadiza Abdullahi Usman, Ayodele Omotoso, Matthew Schlumbrecht, Sophia H. L. George, and Bala Mohammed Audu

Subjects
cancer burden, age-specific rate, northeast Nigeria, sub-Saharan Africa, cancer care disparity, Neoplasms. Tumors. Oncology. Including cancer and carcinogens, RC254-282
Abstract

IntroductionSub-Saharan Africa (SSA) is plagued by myriads of diseases, mostly infectious; but cancer disease burden is rising among non-communicable diseases. Nigeria has a high burden of cancer, however its remote underserved culturally-conserved populations have been understudied, a gap this study sought to fill.MethodsThis was a cross-sectional multi-institutional descriptive study of histologically diagnosed cancers over a four-year period (January 2019-December 2022) archived in the Departments of Pathology and Cancer Registries of six tertiary hospitals in the northeast of Nigeria. Data obtained included age at diagnosis, gender, tumor site and available cancer care infrastructure. Population data of the study region and its demographics was obtained from the National Population Commission and used to calculate incident rates for the population studied.ResultsA total of 4,681 incident cancer cases from 2,770 females and 1,911 males were identified. The median age at diagnosis for females was 45 years (range 1–95yrs), and 56 years (range 1–99yrs) for males. Observed age-specific incidence rates (ASR) increased steadily for both genders reaching peaks in the age group 80 years and above with the highest ASR seen among males (321/100,000 persons) compared to females (215.5/100,000 persons). Breast, cervical, prostatic, colorectal and skin cancers were the five most common incident cancers. In females, breast, cervical, skin, ovarian and colorectal cancers were the top five malignancies; while prostate, haematolymphoid, skin, colorectal and urinary bladder cancers predominated in men.ConclusionRemote SSA communities are witnessing rising cancer disease burden. Proactive control programs inclusive of advocacy, vaccination, screening, and improved diagnostics are needed.

Published
2024
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2. Cervical cancer control in Gombe State, Nigeria : preparing for the future

Author

Adamu Bojude, Danladi, Campbell, Christine, and Weller, David

Subjects
cervical cancer, Nigeria, community embedded practices, community-based resources, cervical screening
Abstract

Background: Cervical cancer affects women worldwide, but sub-Saharan Africa (SSA) bears the highest burden of the disease due to multiple factors including limited knowledge, unavailability of services, cultural and religious views, and a high burden of HIV infection. Nigeria, through its National Cancer Control Plan 2018-2022, has the ambition to ensure that at least 50% of eligible women receive cervical screening through a nationwide routine screening programme, using human papillomavirus (HPV) testing or visual inspection with acetic acid (VIA), and management of precancerous lesions based on a "see and treat" model at the primary health care level, by 2022. Nigeria, however, cannot afford this goal due to a weak health system, limited resources, competing demands such as HIV and, more recently the COVID-19 pandemic. Nevertheless, communities in SSA have a noble culture of communality, kinship and interdependency. Therefore, understanding and harnessing these practices and beliefs, and the decision-making process for seeking health care, will be strategic to eliminating cervical cancer in the region. My PhD explored these opportunities for sustainable community-based cervical screening services in Gombe State, Nigeria. The objectives were to: 1. Review the literature for evidence regarding community involvement in supporting cervical cancer screening in SSA; 2. Assess the knowledge of cervical cancer and factors influencing health seeking behaviour for cervical screening services among women in Gombe State, Nigeria; and 3. Explore community readiness for community-based cervical screening services in Gombe State, Nigeria, through stakeholder interviews. Methods: My study used mixed-methods (a convergent, parallel-database variant design) research in 3 stages concurrently: 1) A systematic review (study 1a) of studies with a community focus for evidence of effectiveness and implementation of interventions by community-based resources (CBRs), such as community health workers (CHWs) and community-based civil society organisations (CBOs), in increasing uptake and/or continuing participation in cervical cancer screening in SSA (I chose to restrict coverage to SSA for findings to be of immediate applicability to my target population). A narrative framework was employed for the review's data synthesis. I also undertook a scoping review (study 1b) of recent evidence (2016-2020) describing the role of CBRs in cervical cancer screening; it focused on studies from low-and-medium-income countries (LMICs), and explored and compared findings between SSA and LMICs sub regions; 2) A community-based participant survey (study 2) of 2,158 women aged 18-70 years, attending a community health facility, which explored the understanding of cervical cancer and cervical screening seeking behaviour of women in Gombe State, Nigeria; and 3) A key informant interview (study 3) with 31 stakeholders - community and religious leaders, women leaders, health facility staff, primary care agency staff, leaders of women's organisations and NGOs supporting HIV and reproductive health services in communities in Gombe State, Nigeria. Thematic analysis was undertaken using an Ecological Model approach, to obtain insights into community factors affecting readiness for cervical screening, and a community readiness assessment scoring for overall readiness level. Results: Study 1a: 49 studies published between January 1980 and March 2019 were included. Studies were representative of 4 SSA regions: Eastern (n=20), Western (n=13), Southern (n=9), and Central (n=4); 29 cross-sectional, 6 RCTs, 6 pre-test/post-test, 1 controlled before and after study, and 5 qualitative studies were included. Most studies were of weak quality, with selection bias the most common weakness. Narrative synthesis findings: 1) Mapping of CBRs-based interventions showed that interventions provided by CBRs had multi-level impacts in three main domains: to increase demand (uptake) for cervical screening, to increase access to cervical screening, and through innovative approaches to enhance screening provision; 2) Multi-level CBRs-based interventions showed evidence of effectiveness at increasing uptake of cervical screening irrespective of study design; and 3) The facilitators and barriers affecting implementation of community-based cervical screening are reported in three major domains: factors associated with increasing demand for screening, factors associated with increasing access to screening, and factors associated with sustainability of screening services. Study 1b: From the international literature, the roles of CBRs across LMICs are broadly similar, although nuanced differences exist. Study 2: 2,158 women took part in the survey, with a mean age of 30 years (range 18-70 years). Overall, awareness of cervical cancer was low with 85% of women unaware of cervical cancer: out of the 15% that reported having awareness, less than 30% had good cervical cancer-related knowledge. The factors associated with the lowest level of awareness of cervical cancer were: being aged less than 30 years, being married, living in rural areas, lower education level (in woman and husband), no current occupation, lack of use of contraceptives, and living with HIV. The major preferences (outcomes) affecting cervical screening seeking behaviours included: 1) very low intention to screen for cervical cancer; 2) high gender preference for female health worker to perform screening; 3) high proportion of women needing permission from husband to go for screening; 4) high proportion of women preferring to be accompanied by husband to place of screening; and 5) high proportion of women preferring to get screening at general hospital rather than community clinic. The predictors associated with these behaviours included: poor cervical cancer-related knowledge, unavailability of screening services, being married, and Muslim faith. I also identified three cervical screening seeking behaviour preferences among women living with HIV compared to those without HIV: 1). 29.4% vs 70.6% for those who said they needed permission from husband to get screening; 2). 27.4% vs 72.6% for those who said they prefer to be accompanied by husband to place of screening; 3). 30.2% vs 69.8% for those who ever had cervical screening. However, no predictors were found to be associated with screening seeking behaviour preferences among women living with HIV. Therefore, women living with HIV reported a higher likelihood of accepting cervical screening services compared with those who did not have HIV, possibly due to frequent contact with health services. Study 3: Thirty one stakeholders were interviewed: 16 were female and 15 male; 16/31 were aged 40-49 years, 14/31 were health facility staff, and 7/31 were community leaders. An in-depth analysis of stakeholder perspectives identified that factors affecting readiness for community-based cervical screening services occur at multiple levels of the ecological model in the community. These factors form four broad categories of primarily negative factors affecting readiness, namely: limited knowledge, some negative attitudes and behaviours, insufficient resources and momentum, and unfavourable contextual factors, e.g. high levels of poverty and illiteracy. Interestingly, stakeholders indicated that there was a well-developed sense of community, with huge commitment from community and religious leaders, community-based organisations, women's networks and local health care workers, to overcome the identified barriers to accessing services. The overall level of readiness score for communities in Gombe State was assessed to be low, i.e. vague awareness, which is linked to the four categories of primarily negative factors listed above. Discussion: My thesis has identified strategic opportunities for future implementation of sustainable community-based cervical screening services in Gombe State, Nigeria. Among CBRs in SSA, CHWs mainly provided: educational interventions to increase demand for screening, reduction of structural barriers to increase access to screening, and innovative interventions by supporting or conducting screening. CBOs were mainly involved in providing educational interventions to increase community demand for screening, and supporting screening provision within their institutions. Women in Gombe State have limited knowledge of screening, mainly due to unavailability of services, and their characteristics, e.g. living in rural areas, having education below secondary, being married, having no occupation, and having never used contraceptives. They also indicated likely behaviour preferences, linked to their cultural and religious values and practices, which would be potential barriers to their participation in screening services. More interestingly, cervical screening seeking behaviour preferences of women who had HIV were less affected by cultural values and practices. The low level of readiness for community-based cervical screening services from stakeholders' interviews highlights the need to leverage CBRs and local health workers to raise awareness about cervical cancer and overcome barriers to accessing services. Conclusion: My thesis has highlighted the altruistic qualities in communities in SSA. Future implementation of community-based cervical screening services should draw on the skills and established roles of CBRs: to increase demand and access to screening, and to ensure sustainability of screening campaigns and programmes. It should prioritise awareness raising, integration with cultural values and practices of the community, integration with HIV services and leveraging existing HIV structures in the community, and collaboration with relevant NGOs and CBRs.

Published
2022
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3. Emerging cancer disease burden in a rural sub-Saharan African population: northeast Nigeria in focus.

Author

Ezenkwa, Uchenna S., Lawan, Aliyu Ibrahim, Garbati, Musa Abubakar, Suleiman, Dauda E., Katagum, Dauda A., Kabir, Abba, Adamu, Adamu Isa, Modu, Abubakar Kolomi, Olanrewaju, Olaniyi David, Dachi, Rufai Abdu, Abdullahi, Yusuf Mohammed, Alkali, Muhammed, Bojude, Danladi Adamu, Usman, Hadiza Abdullahi, Omotoso, Ayodele, Schlumbrecht, Matthew, George, Sophia H. L., and Audu, Bala Mohammed

Subjects
SUB-Saharan Africans, BLADDER, SKIN cancer, BURDEN of care, AGE groups, NON-communicable diseases
Abstract

Introduction: Sub-Saharan Africa (SSA) is plagued by myriads of diseases, mostly infectious; but cancer disease burden is rising among non-communicable diseases. Nigeria has a high burden of cancer, however its remote underserved culturally-conserved populations have been understudied, a gap this study sought to fill. Methods: This was a cross-sectional multi-institutional descriptive study of histologically diagnosed cancers over a four-year period (January 2019-December 2022) archived in the Departments of Pathology and Cancer Registries of six tertiary hospitals in the northeast of Nigeria. Data obtained included age at diagnosis, gender, tumor site and available cancer care infrastructure. Population data of the study region and its demographics was obtained from the National Population Commission and used to calculate incident rates for the population studied. Results: A total of 4,681 incident cancer cases from 2,770 females and 1,911 males were identified. The median age at diagnosis for females was 45 years (range 1-95yrs), and 56 years (range 1-99yrs) for males. Observed age-specific incidence rates (ASR) increased steadily for both genders reaching peaks in the age group 80 years and above with the highest ASR seen among males (321/100,000 persons) compared to females (215.5/100,000 persons). Breast, cervical, prostatic, colorectal and skin cancers were the five most common incident cancers. In females, breast, cervical, skin, ovarian and colorectal cancers were the top five malignancies; while prostate, haematolymphoid, skin, colorectal and urinary bladder cancers predominated in men. Conclusion: Remote SSA communities are witnessing rising cancer disease burden. Proactive control programs inclusive of advocacy, vaccination, screening, and improved diagnostics are needed. [ABSTRACT FROM AUTHOR]

Published
2024
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4. Clinical Features And Outcomes Of HIV-infected Women With Cervical Cancer At Federal Teaching Hospital, Gombe, Nigeria

Author

Danladi Bojude Adamu, Musa Ali-Gombe, Halima Umar Farouk, Yahaya Salisu Sadiq, Farida Bala Mashi, Mohammed Mohammed Manga, Yusuf Mohammed Abdullahi, and Idris Mohammed

Abstract

Background: Cervical cancer is an AIDS-defining malignancy and the second commonest cancer in Nigeria. The burden of cervical cancer is higher among HIV-infected women compared to HIV negative women. Objectives: The aim of the study is to describe the characteristics and outcome of treatment of HIV-infected women with cervical cancer. To our knowledge, this is the first report on their survival outcomes and associated predictors after oncology care from north-eastern Nigeria. Methodology: This was a retrospective study with a prospective follow-up of HIV-infected women with cervical cancer attended at Federal Teaching Hospital Gombe, between March 2013 to March 2017. Data extraction form was used to record data on demographic and disease characteristics, treatment received and 24-months follow-up. Analysis was done using descriptive statistics, Kaplan Meier survival and Cox regression methods. Results: Thirty-one patients were attended to during the study period, their mean age was 41.1 years (range, 31-53). The median CD4+ cells count before commencing treatment was 273 cells/mm3 (range, 100 –564 cells/mm3). Seventeen patients 17/31 (54.8%) had poor WHO performance status – grade 3-4, and 23/31 (74.2%) patients presented with advanced-stage disease 2B and above. All the patients were on Antiretroviral therapy (ART), none had surgical excision of the tumour or hysterectomy. The patients had either radiotherapy and/or chemotherapy, or no treatment. The 1-year and 2-year overall survival rates were 35.5% and 22.6% respectively. CD4 count and tumour response were associated with survival [Log-rank X2 = 9.149; p-value = 0.002] and [Log-rank X2 = 5.955; p-value = 0.015] respectively. And low CD4 counts was a determinant of survival [HR=3.8; 95%CI=1.443-10.176]. Conclusion: Most of our patients presented with advanced disease and poor performance status, as such they had poor response to treatment and survival rates. Therefore, cervical cancer screening and treatment should be integrated into HIV programmes to encourage early detection and treatment.

Published
2021

5. Research priorities to reduce the impact of COVID-19 in low- and middle-income countries

Author

Polasek, Ozren, Wazny, Kerri, Adeloye, Davies, Song, Peige, Chan, Kit Y, Bojude, Danladi A, Ali, Sajjad, Bastien, Sheri, Becerra-Posada, Francisco, Borrescio-Higa, Florencia, Cheema, Sohaila, Cipta, Darien A, Cvjetkovic, Smiljana, Castro, Lina D, Ebenso, Bassey, Femi-Ajao, Omolade, Ganesan, Balasankar, Glasnovic, Anton, He, Longtao, Heraud, Jean M, Igwesi-Chidobe, Chinonso, Iversen, Per O, Jadoon, Bismeen, Karim, Abdulkarim J, Khan, Johra, Biswas, Raaj K, Lanza, Giuseppe, Lee, Shaun WH, Li, You, Liang, Li-Lin, Lowe, Mat, Islam, Mohammad M, Marusic, Ana, Mshelia, Suleiman, Manyara, Anthony M, Htay, Mila NN, Parisi, Michelle, Peprah, Prince, Sacks, Emma, Akinyemi, Kabiru O, Shahraki-Sanavi, Fariba, Sharov, Konstantin, Rotarou, Elena S, Stankov, Srdjan, Supriyatiningsih, Wenang, Chan, Benjamin TY, Tremblay, Mark, Tsimpida, Dialechti, Vento, Sandro, Glasnovic, Josipa V, Wang, Liang, Wang, Xin, Ng, Zhi X, Zhang, Jianrong, Zhang, Yanfeng, Campbell, Harry, Chopra, Mickey, Cousens, Simon, Krstic, Goran, Macdonald, Calum, Mansoori, Parisa, Patel, Smruti, Sheikh, Aziz, Tomlinson, Mark, Tsai, Alexander C, Yoshida, Sachiyo, Rudan, Igor, ISoGH, Int Soc Global Hlth, University of Split, Algebra University College [Zagreb], Children’s Investment Fund Foundation [London] (CIFF), University of Edinburgh, Zhejiang University, Gombe State University [Nigeria] (GUS), Ziauddin University [Karachi, Pakistan], Norwegian University of Life Sciences (NMBU), Public Health Development Organization [El Paso, Texas, USA], Universidad Adolfo Ibáñez [Santiago], Weill Cornell Medicine [Qatar], Universitas Pelita Harapan [Jakarta, Indonesia], University of Belgrade [Belgrade], Institut Pasteur de Dakar, Réseau International des Instituts Pasteur (RIIP), Stellenbosch University, Massachusetts General Hospital [Boston], Organisation Mondiale de la Santé / World Health Organization Office (OMS / WHO), and This study was supported by the International Society of Global Health (ISoGH).

Subjects
MESH: Pandemics, Pandemics / prevention & control, COVID-19 Vaccines, COVID-19 / epidemiology, covid, LMIC, priorities, [SDV.MHEP.MI]Life Sciences [q-bio]/Human health and pathology/Infectious diseases, MESH: Child, Humans, MESH: COVID-19, Pandemics/prevention & control, Child, Pandemics, Developing Countries, MESH: Developing Countries, COVID-19/epidemiology, [SDV.MHEP.ME]Life Sciences [q-bio]/Human health and pathology/Emerging diseases, MESH: Humans, Health Policy, MESH: Research Design, Public Health, Environmental and Occupational Health, COVID-19 / prevention & control, COVID-19, [SDV.BBM.BM]Life Sciences [q-bio]/Biochemistry, Molecular Biology/Molecular biology, Research Design, MESH: COVID-19 Vaccines, [SDV.MP.VIR]Life Sciences [q-bio]/Microbiology and Parasitology/Virology, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie
Abstract

Background: \ud The COVID-19 pandemic has caused disruptions to the functioning of societies and their health systems. Prior to the pandemic, health systems in low- and middle-income countries (LMIC) were particularly stretched and vulnerable. The International Society of Global Health (ISoGH) sought to systematically identify priorities for health research that would have the potential to reduce the impact of the COVID-19 pandemic in LMICs.\ud \ud Methods: \ud The Child Health and Nutrition Research Initiative (CHNRI) method was used to identify COVID-19-related research priorities. All ISoGH members were invited to participate. Seventy-nine experts in clinical, translational, and population research contributed 192 research questions for consideration. Fifty-two experts then scored those questions based on five pre-defined criteria that were selected for this exercise: 1) feasibility and answerability; 2) potential for burden reduction; 3) potential for a paradigm shift; 4) potential for translation and implementation; and 5) impact on equity.\ud \ud Results: \ud Among the top 10 research priorities, research questions related to vaccination were prominent: health care system access barriers to equitable uptake of COVID-19 vaccination (ranked 1st), determinants of vaccine hesitancy (4th), development and evaluation of effective interventions to decrease vaccine hesitancy (5th), and vaccination impacts on vulnerable population/s (6th). Health care delivery questions also ranked highly, including: effective strategies to manage COVID-19 globally and in LMICs (2nd) and integrating health care for COVID-19 with other essential health services in LMICs (3rd). Additionally, the assessment of COVID-19 patients’ needs in rural areas of LMICs was ranked 7th, and studying the leading socioeconomic determinants and consequences of the COVID-19 pandemic in LMICs using multi-faceted approaches was ranked 8th. The remaining questions in the top 10 were: clarifying paediatric case-fatality rates (CFR) in LMICs and identifying effective strategies for community engagement against COVID-19 in different LMIC contexts.\ud \ud Interpretation: \ud Health policy and systems research to inform COVID-19 vaccine uptake and equitable access to care are urgently needed, especially for rural, vulnerable, and/or marginalised populations. This research should occur in parallel with studies that will identify approaches to minimise vaccine hesitancy and effectively integrate care for COVID-19 with other essential health services in LMICs. ISoGH calls on the funders of health research in LMICs to consider the urgency and priority of this research during the COVID-19 pandemic and support studies that could make a positive difference for the populations of LMICs.

Published
2022

6. Research priorities to reduce the impact of COVID-19 in low- and middle-income countries

Author

Polasek, O, Wazny, K, Adeloye, D, Song, P, Chan, KY, Bojude, DA, Ali, S, Bastien, S, Becerra-Posada, F, Borrescio-Higa, F, Cheema, S, Cipta, DA, Cvjetkovic, S, Castro, LD, Ebenso, B, Femi-Ajao, O, Ganesan, B, Glasnovic, A, He, L, Heraud, JM, Igwesi-Chidobe, C, Iversen, PO, Jadoon, B, Karim, AJ, Khan, J, Biswas, RK, Lanza, G, Lee, SWH, Li, Y, Liang, L-L, Lowe, M, Islam, MM, Marusic, A, Mshelia, S, Manyara, AM, Htay, MNN, Parisi, M, Peprah, P, Sacks, E, Akinyemi, KO, Shahraki-Sanavi, F, Sharov, K, Rotarou, ES, Stankov, S, Supriyatiningsih, W, Chan, BTY, Tremblay, M, Tsimpida, D, Vento, S, Glasnovic, J, Wang, L, Wang, X, Ng, ZX, Zhang, J, Zhang, Y, Campbell, H, Chopra, M, Cousens, S, Krstic, G, Macdonald, C, Mansoori, P, Patel, S, Sheikh, A, Tomlinson, M, Tsai, AC, Yoshida, S, Rudan, I, Polasek, O, Wazny, K, Adeloye, D, Song, P, Chan, KY, Bojude, DA, Ali, S, Bastien, S, Becerra-Posada, F, Borrescio-Higa, F, Cheema, S, Cipta, DA, Cvjetkovic, S, Castro, LD, Ebenso, B, Femi-Ajao, O, Ganesan, B, Glasnovic, A, He, L, Heraud, JM, Igwesi-Chidobe, C, Iversen, PO, Jadoon, B, Karim, AJ, Khan, J, Biswas, RK, Lanza, G, Lee, SWH, Li, Y, Liang, L-L, Lowe, M, Islam, MM, Marusic, A, Mshelia, S, Manyara, AM, Htay, MNN, Parisi, M, Peprah, P, Sacks, E, Akinyemi, KO, Shahraki-Sanavi, F, Sharov, K, Rotarou, ES, Stankov, S, Supriyatiningsih, W, Chan, BTY, Tremblay, M, Tsimpida, D, Vento, S, Glasnovic, J, Wang, L, Wang, X, Ng, ZX, Zhang, J, Zhang, Y, Campbell, H, Chopra, M, Cousens, S, Krstic, G, Macdonald, C, Mansoori, P, Patel, S, Sheikh, A, Tomlinson, M, Tsai, AC, Yoshida, S, and Rudan, I

Abstract

BACKGROUND: The COVID-19 pandemic has caused disruptions to the functioning of societies and their health systems. Prior to the pandemic, health systems in low- and middle-income countries (LMIC) were particularly stretched and vulnerable. The International Society of Global Health (ISoGH) sought to systematically identify priorities for health research that would have the potential to reduce the impact of the COVID-19 pandemic in LMICs. METHODS: The Child Health and Nutrition Research Initiative (CHNRI) method was used to identify COVID-19-related research priorities. All ISoGH members were invited to participate. Seventy-nine experts in clinical, translational, and population research contributed 192 research questions for consideration. Fifty-two experts then scored those questions based on five pre-defined criteria that were selected for this exercise: 1) feasibility and answerability; 2) potential for burden reduction; 3) potential for a paradigm shift; 4) potential for translation and implementation; and 5) impact on equity. RESULTS: Among the top 10 research priorities, research questions related to vaccination were prominent: health care system access barriers to equitable uptake of COVID-19 vaccination (ranked 1st), determinants of vaccine hesitancy (4th), development and evaluation of effective interventions to decrease vaccine hesitancy (5th), and vaccination impacts on vulnerable population/s (6th). Health care delivery questions also ranked highly, including: effective strategies to manage COVID-19 globally and in LMICs (2nd) and integrating health care for COVID-19 with other essential health services in LMICs (3rd). Additionally, the assessment of COVID-19 patients' needs in rural areas of LMICs was ranked 7th, and studying the leading socioeconomic determinants and consequences of the COVID-19 pandemic in LMICs using multi-faceted approaches was ranked 8th. The remaining questions in the top 10 were: clarifying paediatric case-fatality rates (CFR) in

Published
2022

9. Magnetic resonance imaging in radiotherapy treatment target volumes definition for brain tumours: a systematic review and meta-analysis

Author

Abasiama D. Obotiba, Adamu D. Bojude, Aminu U. Usman, AM Abubakar, Idris Garba, Mutiat N. Miftaudeen, Umar Abubakar, and Mustapha Barde

Subjects
medicine.diagnostic_test, business.industry, medicine.medical_treatment, Planning target volume, Computed tomography, Magnetic resonance imaging, Radiotherapy treatment planning, Confidence interval, 030218 nuclear medicine & medical imaging, Radiation therapy, 03 medical and health sciences, 0302 clinical medicine, Oncology, 030220 oncology & carcinogenesis, Meta-analysis, Statistical significance, medicine, Radiology, Nuclear Medicine and imaging, Nuclear medicine, business
Abstract

PurposeThe aim of this study is to establish clinical evidence regarding the use of magnetic resonance imaging (MRI) in target volume definition for radiotherapy treatment planning of brain tumours.MethodsPrimary studies were systematically retrieved from six electronic databases and other sources. Studies included were only those that quantitatively compared computed tomography (CT) and MRI in target volume definition for radiotherapy of brain tumours. Study characteristics and quality were assessed and the data were extracted from eligible studies. Effect estimates for each study was computed as mean percentage difference based on individual patient data where available. The included studies were then combined in meta-analysis using Review Manager (RevMan) software version 5.0.ResultFive studies with a total number of 72 patients were included in this review. The quality of the studies was rated strong. The percentages mean differences of the studies were 7·47, 11·36, 30·70, 41·69 and −24·6% using CT as the baseline. The result of statistical analysis showed small-to-moderate heterogeneity; τ2=36·8; χ2=6·23; df=4 (p=0·18); I2=36%. The overall effect estimate was −1·85 [95% confidence interval (CI); −7·24, 10·94], Z=0·40 (p=0·069>0·5).ConclusionBrain tumour volumes measured using MRI-based method for radiotherapy treatment planning were larger compared with CT defined volumes but the difference lacks statistical significance.

Published
2017

11. Potential Role of the Quality Assurance Review Center Platform in Global Radiation Oncology

Author

Adewumi Alabi, Adamu Danladi Bojude, Atara Ntekim, Thomas J. Fitzgerald, Paul Nguyen, Wilfred Ngwa, Twalib Ngoma, Uchechukwu N. Shagaya, Emmanuel Ikhile, Jonathan D. Schoenfeld, Erno Sajo, Nwamaka Lasebikan, Omoruyi Credit Irabor, Fatiregun Omolara, Madar Bhagwat, Janaki Moni, Musa Ali-Gombe, Fran Laurie, and Mamsau Ngoma

Subjects
Cancer Research, medicine.medical_specialty, Radiation, Quality Assurance, Health Care, business.industry, International Cooperation, 03 medical and health sciences, 0302 clinical medicine, Oncology, Neoplasms, 030220 oncology & carcinogenesis, Radiation oncology, Radiation Oncology, medicine, Humans, Radiology, Nuclear Medicine and imaging, Medical physics, Center (algebra and category theory), 030212 general & internal medicine, business, Developing Countries, Quality assurance
Published
2017

12. Comparative Analysis of Cervical Human Papillomavirus DNA Testing and Cytological Findings among Women Presenting for 'Pap' Smear in a Tertiary Health Centre in Northern Nigeria

Author

Rasheed Bakare, A Osoba, Adeola Fowotade, Mohammed Mohammed Manga, A. U. El-Nafaty, Y Abdullahi, A Bojude, S Adamu, and H Pindiga

Subjects
03 medical and health sciences, medicine.medical_specialty, 0302 clinical medicine, Obstetrics, business.industry, 030220 oncology & carcinogenesis, medicine, Human papillomavirus DNA, 030212 general & internal medicine, General Medicine, Northern nigeria, business, Health centre
Published
2016

14. Potential Role of the Quality Assurance Review Center Platform in Global Radiation Oncology

Author

Ngwa, Wilfred, primary, Ikhile, Emmanuel, additional, Ntekim, Atara, additional, Lasebikan, Nwamaka, additional, Alabi, Adewumi, additional, Shagaya, Uchechukwu N., additional, Omolara, Fatiregun, additional, Ali-Gombe, Musa, additional, Bojude, Adamu Danladi, additional, Ngoma, Mamsau, additional, Ngoma, Twalib, additional, Bhagwat, Madar, additional, Irabor, Omoruyi Credit, additional, Schoenfeld, Jonathan, additional, Nguyen, Paul, additional, Sajo, Erno, additional, Laurie, Fran, additional, Moni, Janaki, additional, and Fitzgerald, Thomas J., additional

Published
2017
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16. Magnetic resonance imaging in radiotherapy treatment target volumes definition for brain tumours: a systematic review and meta-analysis.

Author

Abubakar, Auwal, Bojude, Adamu D., Usman, Aminu U., Garba, Idris, Obotiba, Abasiama D., Barde, Mustapha, Miftaudeen, Mutiat N., and Abubakar, Umar

Subjects
BRAIN tumor diagnosis, BRAIN tumors, CHI-squared test, COMPUTED tomography, CONFIDENCE intervals, MAGNETIC resonance imaging, META-analysis, QUALITY assurance, SYSTEMATIC reviews, DATA analysis software
Abstract

Purpose: The aim of this study is to establish clinical evidence regarding the use of magnetic resonance imaging (MRI) in target volume definition for radiotherapy treatment planning of brain tumours. Methods: Primary studies were systematically retrieved from six electronic databases and other sources. Studies included were only those that quantitatively compared computed tomography (CT) and MRI in target volume definition for radiotherapy of brain tumours. Study characteristics and quality were assessed and the data were extracted from eligible studies. Effect estimates for each study was computed as mean percentage difference based on individual patient data where available. The included studies were then combined in meta-analysis using Review Manager (RevMan) software version 5.0. Result: Five studies with a total number of 72 patients were included in this review. The quality of the studies was rated strong. The percentages mean differences of the studies were 7·47, 11·36, 30·70, 41·69 and −24·6% using CT as the baseline. The result of statistical analysis showed small-to-moderate heterogeneity; τ 2=36·8; χ 2=6·23; df=4 (p =0·18); I 2=36%. The overall effect estimate was −1·85 [95% confidence interval (CI); −7·24, 10·94], Z=0·40 (p =0·069>0·5). Conclusion: Brain tumour volumes measured using MRI-based method for radiotherapy treatment planning were larger compared with CT defined volumes but the difference lacks statistical significance. [ABSTRACT FROM AUTHOR]

Published
2018
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19. Post burn digital contracture our way: The pains, The gains

Author

Zainab Yunusa Kaltungo, Olabisi Shakiru Olajide, and Adamu Danladi Bojude

Subjects
medicine.medical_specialty, business.industry, medicine.medical_treatment, medicine.disease, Surgery, Z-plasty, Anesthesia, Ankylosis, medicine, Etiology, Outpatient clinic, Disease characteristics, Elective surgery, Contracture, medicine.symptom, business, Muscle contracture
Abstract

Background: Post burn digital contractures account for 30% of new outpatient clinic visits but 25% of elective surgery load in our practice. There is a lot of backlog and pressure to operate particularly in the pediatric age group. We were able to demonstrate in this series that irrespective of the duration, uncomplicated post burn contractures are usually not complicated by ankylosis and a single stage complete release is possible. Aims and Objectives: 1. To determine if multiplicity of joint involvement and duration between burn and corrective surgery affect outcome. 2. To determine the range of complications after post burn digital contracture release. 3. To determine if preoperative plain radiographs are necessary in uncomplicated post burn digital contractures. Materials and Methods: Retrospective analysis of the records of 33 patients. Data collected included socio demographic and disease characteristics, etiology of burns, duration of burns before corrective surgery, complications after corrective surgery. Data was analyzed using SPSS version 16.0. All patients with contractures in other joint other than digits and from other causes other than burns, or burns associated with mechanical trauma were excluded. Results: Mean age 8 yrs, nearly equal sex distribution. Scald 48.5%, flame 21.2%, contact burn 9.1%, others 21.2%. Mean duration between burn and contracture release 40months. Overall, 172 joints were involved in 33 patients, 69.7% had incision ,+ FTSG, 3% had incision+ STSG, 6.1% had Z plasty only and 21.2% had Z plasty + FTSG. In 32 patients (97%) complete intra op contracture release was achieved. Twenty patients (60.6%) healed without complications, recorded complications post op were wound infection (30%), graft shift and digital tip gangrence. Conclusion: Prolonged duration between burn and eventual contracture release does not affect achieving complete contracture release, neither does multiplicity of joint involvement.

Published
2015

21. Impact of burn unit routine on outcome: A 5-year experience

Author

Adamu Danladi Bojude, Zainab Yunusa Kaltungo, and Olabisi Shakir Olajide

Subjects
Delayed wound healing, medicine.medical_specialty, Case files, business.industry, Incidence (epidemiology), After discharge, medicine.disease, Surgery, Teaching hospital, medicine, Scalding, Hypertrophic scars, business, Cause of death
Abstract

Background: The burn unit, like any high dependency, unit is awash with multi-antibiotic resistant microbes, and the clinician is in a constant battle to prevent such infections from becoming established. After the elimination of hypovolemic shock as a cause of death, infections constitute the leading cause of morbidity and mortality in burn patients. Aims and Objectives: This study aimed to determine the incidence of infection in our burn unit and to demonstrate how our burn unit routine leads to a low incidence of infection in our setting. Materials and Methods: This is a retrospective review of the records of patients attended to between 2009 and 2013 in the burn unit of Federal Teaching Hospital, Gombe, Nigeria. Details of the treatment and follow-up data were obtained from patients' case files using a predesigned pro forma. All patients were within 24 h of burn and had wounds cleaned under general anesthesia before admission to the unit. In addition, all patients with major burns received infusion of glucose, potassium, and insulin (GKI). Antibiotics use was strictly regulated and was guided by known antimicrobial and sensitivity patterns. Results: Thirty-three patients were admitted within the study period, of whom 27 patients had complete information and were analyzed. The mean age of the burn patients was 11 ± 16.7 (SD) years. There were 16 (59.3%) males and 11 (40.7%) females. Scalding and flame burns accounted for 20 (74.1%) and seven (25.9%) patients, respectively. Only four (14.8%) patients developed wound infection on admission (three were in the age range of 11 years and below, while one was 57 years old) and one patient had gastrointestinal tract (GIT) infection. One patient died from suspected thromboembolism within 24 h of burn, and 14 (51.8%) and 12 (44.4%) patients were discharged with and without residual burn wounds, respectively. The average burn surface area was 18.9%. The average length of stay (LOS) was 18.65 days and the average LOS per patient per percentage burn surface was 0.98 days. On follow-up at 2 weeks after discharge, four (14.8%) patients had delayed wound healing and seven (25.9%) patients developed hypertrophic scars. Conclusion: Our findings indicate a low incidence of infection related complications and it appears that our burn unit routine may play a significant role.

Published
2014

22. Epidemiological patterns of cervical human papillomavirus infection among women presenting for cervical cancer screening in North-Eastern Nigeria

Author

Aliyu Usman El-nafaty, Adeola Fowotade, Yusuf Mohammed Abdullahi, Mohammed Mohammed Manga, Hamidu Umar Pindiga, Abimbola Olu Osoba, Rasheed Bakare, and Danladi Bojude Adamu

Subjects
Cancer Research, medicine.medical_specialty, Cross-sectional study, Epidemiology, Genotypes, Nigeria, HPV vaccines, Cervix, Genotype, medicine, Women, Gynecology, Cervical cancer, business.industry, HPV infection, Human Papillomavirus, medicine.disease, medicine.anatomical_structure, Infectious Diseases, Oncology, Tropical medicine, business, Demography, Research Article
Abstract

Background Sub-Saharan countries including Nigeria have the highest burden of Human Papillomavirus (HPV) infection in the world. Most studies on HPV surveillance in Nigeria were done in the southern part of the country. Geographical and socio-cultural diversity of Nigeria makes these data unlikely to be universally representative for the entire country. Northern Nigeria especially the North-East carries a higher prevalence of cervical cancer and many of its risk factors. The region may be harbouring a higher prevalence of HPV infection with a possibility of different genotypic distribution. This study was carried out to determine the burden and confirm the predominant HPV genotypes among women presenting for cervical cancer screening at the Federal Teaching Hospital Gombe (FTHG), North-eastern, Nigeria. Methods The study was an observational hospital based cross sectional study among women who presented for cervical cancer screening in FTHG. A total of 209 consenting women were tested for cervical HPV infection using PCR. DNA sequencing was carried out on positive samples to determine the prevalent HPV genotypes. Results The prevalence of cervical HPV infection among the participants with mean age of 39.6 ± 10.4 years was 48.1 %. The five most predominant genotypes were 18, 16, 33, 31 and 35, with prevalence of 44.7 %, 13.2 %, 7.9 %, 5.3 % and 5.3 % respectively. Other genotypes observed were 38, 45, 56, 58, 82 and KC5. Multiple HPV infections were detected among 7.9 % of participants. Risk factors such as level of education (X2 = 15.897; p = 0.007), age at sexual debut (X2 = 6.916; p = 0.009), parity (X2 = 23.767; p = 0.000), number of life time sexual partners (X2 = 7.805; p = 0.005), age at first pregnancy (X2 = 10.554; p = 0.005) and history of other malignancies (X2 = 7.325; p = 0.007) were found to have a statistically significant association with HPV infection. Conclusion This study identified a high burden of HPV infection in Northern Nigeria while also confirming HPV 18 and 16 as the most predominant genotypes. It further justifies the potential benefit of the currently available HPV vaccines in the area. A larger and community based study is however recommended for better representation of the area. Electronic supplementary material The online version of this article (doi:10.1186/s13027-015-0035-8) contains supplementary material, which is available to authorized users.

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