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1. Breast Cancer and Tamoxifen: A Nigerian Perspective to Effective Personalised Therapy

Author: Adehin A, Kennedy MA, Soyinka JO, Alatise OI, Olasehinde O, and Bolaji OO
Subjects: breast cancer, estrogen receptor, tamoxifen, nigeria, epigenetics, genomics, Neoplasms. Tumors. Oncology. Including cancer and carcinogens, RC254-282
Abstract: Ayorinde Adehin,1,2 Martin Alexander Kennedy,3 Julius Olugbenga Soyinka,1 Olusegun Isaac Alatise,4 Olalekan Olasehinde,4 Oluseye Oladotun Bolaji1 1Department of Pharmaceutical Chemistry, Faculty of Pharmacy, Obafemi Awolowo University, Ile-Ife, Nigeria; 2Institute of Biomedical and Pharmaceutical Sciences, Guangdong University of Technology, Guangzhou, People’s Republic of China; 3Department of Pathology and Biomedical Science; Carney Centre of Pharmacogenomics, University of Otago, Christchurch, New Zealand; 4Department of Surgery, Faculty of Clinical Sciences, College of Health Sciences, Obafemi Awolowo University, Ile-Ife, NigeriaCorrespondence: Ayorinde Adehin Department of Pharmaceutical Chemistry, Faculty of PharmacyObafemi Awolowo University, Ile-Ife, NigeriaTel +234 8022013470Email aadehin@oauife.edu.ngAbstract: Estrogen-receptor positivity in tumour, often requiring long-term tamoxifen therapy, is thought to characterise between 43% and 65% of breast cancer cases in Nigeria. The patient population is further marked by late-stage diagnosis which significantly heightens the tendency for tumour relapse in the course of tamoxifen therapy. Despite tamoxifen being considered a reliable chemopreventive in high-risk individuals and an effective adjuvant therapy for hormone-sensitive tumours, mortality has remained high among breast cancer patients in the West African region where Nigeria belongs. The Nigerian breast cancer population, like other similar patient-populations in the West African region, provides a mix of intrinsic genome-diversity and perhaps unique tumour biology and evolution. These peculiarities suggest the need for a rational approach to tumour management and a personalised delivery of therapy in Nigeria’s dominant estrogen-receptor-positive patient population. Herein, critical indices of tamoxifen-therapy success are discussed in the context of the Nigerian breast cancer population with emphasis on salient aspects of tamoxifen-biotransformation, host- and tumour-genomics, and epigenetics.Keywords: breast cancer, estrogen receptor, tamoxifen, Nigeria, epigenetics, genomics
Published: 2020

2. Maternal and neonatal outcomes after caesarean delivery in the African Surgical Outcomes Study: a 7-day prospective observational cohort study

Author: Abadagan, Hippolyte, Abbas, N, Abdelatif, A Ibrahim, Abdoulaye, Traoré, Abd-rouf, A, Abduljalil, A, Abdulrahman, A, Abdurazig, S, Abokris, A, Abozaid, W, Abugassa, SOA, Abuhdema, F, Abujanah, SA, Abusamra, R, Abushnaf, A, Abusnina, SA, Abuzalout, TS, Ackermann, HM, Adamu, YB, Addanfour, A, Adeleke, DM, Adigun, TA, Adisa, AO, Adjignon, Sèhivè Valéry, Adu-Aryee, NA, Afolabi, BB, Agaba, AFX, Agaba, PKA, Aghadi, K, Agilla, H, Ahmed, B, Ahmed, El-Z, Ahmed, Al-J, Ahmed, M, Ahossi, Rene, Aji, SA, Akanyun, S, Akhideno, I, Akhter, M, Akinyemi, OA, Akkari, M, Akodjenou, Joseph, AL Samateh, AL, al Shams, ES, Alagbe-Briggs, OT, Alakkari, EA, Alalem, RB, Alashhab, M, Alatise, OI, Alatresh, A, Alayeb Alayeb, MSI, Albakosh, BA, Albert, F, Alberts, ANJD, Aldarrat, AD, Alfari, A, Alfetore, A, Algbali, M, Algddar, A, Algedar, HA, Alghafoud, IA, Alghazali, A, Alhajj, M, Alhendery Alhendery, A, Alhoty, FFH, Ali, A, Ali, YA, Alioune, Beye Seïdina, Alkassem, MA, Alkchr, MA, Alkesa, TS, Alkilani, A, Alkobty Alkobty, F, Allaye, Thomas, Alleesaib, SBM, Alli, A, Allopi, K, Allorto, NL, Almajbery, A, Almesmary, R, Almisslati, SHA, Almoraid, F, Alobeidi, H, Alomami, MA, Alphonsus, Christella S, Alqawi, OA, Alraheem, AA, Alsabri, SA, Alsayed, A, Alsellabi, B, Al-Serksi, M, Alshareef, MSA, Altagazi, AA, Aluvale, JS, Alwahedi, HW, Alzahra, EA, Alzarouk, MA, Al-Zubaidy, K, Amadou, M, Amadou, Maiga, Amanor-Boadu, Simbo D, Amer, Al-A, Amisi, BT, Amuthenu, MA, Anabah, TWA, Anani, Felix, Anderson, PGR, Andriamampionona, AGB, Andrianina, L, Anele, A, Angelin, R, Anjar, N, Antùnez, O, Antwi-Kusi, Akwasi, Anyanwu, LJC, Aribi, AA, Arowolo, OA, Arrey, O, Ashebir, Daniel Zemenfes, Assefa, SB, Assoum, Guy, Athanse, V, Athombo, JS, Atiku, M, Atito-Narh, E, Atomabe, Anatole, Attia, A, Aungraheeta, M, Aurélia, DMA, Ayandipo, OO, Ayebale, AET, Azzaidey, HMZ, Babajee, NB, Badi, HB, Badianga, EK, Baghni, RB, Bahta, MT, Bai, M, Baitchu, Y, Baloyi, AM, Bamuza, KA, Bamuza, MI, Bangure, L, Bankole, OB, Barongo, ML, Barow, MM, Basenero, Apollo, Bashiya, L, Basson, CH, Bechan, Sudha, Belhaj, S, Ben Mansour, MM, Benali, D, Benamour, ASB, Berhe, A, Bertie, JD, Bester, JJA, Bester, M, Bezuidenhout, JD, Bhagwan, K, Bhagwandass, DR, Bhat, KAP, Bhuiyan, MMZU, Biccard, Bruce M, Bigirimana, F, Bikuelo, CJ, Bilby, BE, Bingidimi, SS, Bischof, KE, Bishop, David G, Bitta, C, Bittaye, M, Biyase, Thuli, Blake, CA, Blignaut, E, Blignaut, F, BN Tanjong, BN, Bogoslovskiy, A, Boloko, PM, Boodhun, SKB, Bori, I, Boufas, F, Brand, M, Brouckaert, Nicholas T, Bruwer, JD, Buccimazza, I, Bula Bula, IM, Bulamba, Fred, Businge, BC, Bwambale, YB, Cacala, SRC, Cadersa, MA, Cairns, Chris, Carlos, F, Casey, ME, Castro, AC, Chabayanzara, ND, Chaibou, MS, Chaibva, TNO, Chakafa, NK, Chalo, C, Changfoot, C, Chari, MC, Chelbi, L, Chibanda, JT, Chifamba, HN, Chikh, N, Chikumba, E, Chimberengwa, P, Chirengwa, J, Chitungo, FM, Chiwanga, MC, Chokoe, MM, Chokwe, TM, Chrirangi, B, Christian, M, Church, B, Cisekedi, JC, Clegg-Lamptey, JN, Cloete, Estie, Coltman, Megan, Conradie, W, Constance, N, Coulibaly, Youssouf, Cronje, L, Da Silva, MA, Daddy, H, Dahim, L, Daliri, D, Dambaki, MS, Dasrath, A, Davids, JG, Davies, Gareth L, De Lange, JT, de Wet, JB, Dedekind, B, Degaulle, MA, Dehal, V, Deka, PD, Delinikaytis, S, Desalu, IS, Dewanou, Hubert, Deye, MB Moussa, Dhege, C, Diale, BSG, Dibwe, DF, Diedericks, BJS, Dippenaar, JM, Dippenaar, L, Diyoyo, MP, Djessouho, Edith, Dlamini, SN, Dodiyi-Manuel, A, Dokolwana, BA, Domoyyeri, DP, Drummond, Leanne W, du Plessis, DE, du Plessis, WM, du Preez, LJ, Dube, K, Dube, NZ, Dullab, KD, Duvenhage, R, Echem, RC, Edaigbini, SA, Egote, AK, Ehouni, A, Ekwen, G, Ekwunife, NC, El Hensheri, M, Elfaghi, IE, Elfagieh, MA, Elfallah, S, Elfiky, Mahmoud, Elgelany, S, Elghallal, AM, Elghandouri, MG, Elghazal, ZS, Elghobashy, AM, Elharati, FT, Elkhogia, Abdulaziz M, Elkhwildi, RM, Ellis, S, Elmadani, L, Elmadany, HB, Elmehdawi, H, Elmgadmi, A, Eloi, H, Elrafifi, D, Elsaadi, G, Elsaity, RB, Elshikhy, A, Eltaguri, M, Elwerfelli, A, Elyasir, IE, Elzoway, AZ, Elzufri, AM, Enendu, EO, Enicker, BC, Enwerem, EO, Esayas, R, Eshtiwi, M, Eshwehdi, AA, Esterhuizen, JL, Esterhuizen, Tonya M, Etuk, EB, Eurayet, O, Eyelade, OR, Fanjandrainy, RF, Fanou, Lionelle, Farina, Z, Fawzy, Maher, Feituri, A, Fernandes, NL, Ford, LM, Forget, Patrice, François, T, Freeman, T, Freeman, YBM, Gacii, VM, Gadi, B, Gagara, M, Gakenia, A, Gallou, PD, Gama, GGN, Gamal, MG, Gandy, YG, Ganesh, A, Gangaly, Diallo, Garcia, M, Gatheru, AP, Gaya, SSD, Gbéhadé, Oswald, Gerbel, G, Ghnain, A, Gigabhoy, R, Giles, DG, Girmaye, GT, Gitau, S, Githae, B, Gitta, Said, Gobin, Veekash, Goga, Riaz, Gomati, AAG, Gonzalez, ME, Gopall, J, Gordon, Christina Salmina, Gorelyk, O, Gova, M, Govender, K, Govender, P, Govender, S, Govindasamy, V, Green-Harris, JTK, Greenwood, MB, Grey-Johnson, SV, Grobbelaar, Mariette, Groenewald, MA, Grünewald, KK, Guegni, Ambroise, Guenane, M, Gueye, S, Guezo, Marius, Gunguwo, T, Gweder, MG, Gwila, M, Habimana, L, Hadecon, Rodrigue, Hadia, E, Hamadi, L, Hammouda, M, Hampton, MI, Hanta, R, Hardcastle, Tim C, Hariniaina, JA, Hariparsad, S, Harissou, AH, Harrichandparsad, R, Hasan, SHA, Hashmi, HB, Hayes, MP, Hdud, A, Hebli, SH, Heerah, HMSN, Hersi, S, Hery, AH, Hewitt-Smith, Adam, Hlako, TC, Hodges, SCH, Hodgson, Richard Eric, Hokoma, M, Holder, H, Holford, EB, Horugavye, E, Houston, C, Hove, M, Hugo, D, Human, CM, Hurri, H, Huwidi, O, Ibrahim, AI, Ibrahim, Traoré, Idowu, OK, Igaga, IE, Igenge, John, Ihezie, O, Ikandi, K, Ike, IAR, Ikuku, JJN, Ilbarasi, MN, Ilunga, IBB, Ilunga, JPM, Imbangu, NAV, Imessaoudene, Z, Imposo, DH, Iraya, AM, Isaacs, M, Isiguzo, M, Issoufou, A, Izquirdo, P, Jaber, A, Jaganath, UV, Jallow, CS, Jamabo, S, Jamal, ZS, Janneh, L, Jannetjies, MJ, Jasim, I, Jaworska, Megan AJ, Jay Narain, S, Jermi, K, Jimoh, R, Jithoo, S, Johnson, M, Joomye, S, Judicael, RM, Judicaël, M, Juwid, A, Jwambi, LP, Kabango, R, Kabangu, JK, Kabatoro, DK, Kabongo, AN, Kabongo, K, Kabongo, LT, Kabongo, MD, Kady, N, Kafu, S, Kaggya, M, Kaholongo, BNK, Kairuki, PCK, Kakololo, SI, Kakudji, K, Kalisa, Amina, Kalisa, R, Kalufwelu, MR, Kalume, S, Kamanda, RJ, Kangili, MK, Kanoun, H, Kapesa, Kapp, P, Karanja, JK, Karar, M, Kariuki, K, Kaseke, K, Kashuupulwa, PNK, Kasongo, KJP, Kassa, SK, Kateregga, GK, Kathrada, MIS, Katompwa, PM, Katsukunya, L, Kavuma, KAM, Khalfallah, Khamajeet, A, Khetrish, SB, Kibandwa, Kibochi, W, Kilembe, AM, Kintu, AK, Kipng'etich, B, Kiprop, B, Kissoon, VMK, Kisten, Theroshnie K, Kiwanuka, JK, Kluyts, Hyla-Louise, Knox, MEK, Koledale, AK, Koller, VL, Kolotsi, MA, Kongolo, M, Konwuoh, ND, Koperski, WJ, Koraz, MYK, Kornilov, AA, Koto, M Zach, Kransingh, Samantha, Krick, D, Kruger, S, Kruse, C, Kuhn, W, Kuhn, WP, Kukembila, AM, Kule, KL, Kumar, M, Kusel, Belinda S, Kusweje, VK, Kuteesa, KJ, Kutor, YY, Labib, MA, Laksari, M, Lanos, F, Lawal, TA, Le Manach, Yannick, Lee, C, Lekoloane, RM, Lelo, SN, Lerutla, B, Lerutla, MT, Levin, AI, Likongo, TB, Limbajee, ML, Linyama, DM, Lionnet, C, Liwani, MM, Loots, E, Lopez, A Garrido, Lubamba, CLC, Lumbala, KF, Lumbamba, AJM, Lumona, John, Lushima, RF, Luthuli, L, Luweesi, HL, Lyimo, TSK, Maakamedi, HM, Mabaso, BM, Mabina, M, Maboya, ME, Macharia, I, Macheka, AM, Machowski, AZ, Madiba, Thandinkosi E, Madsen, ASM, Madzimbamuto, Farai, Madzivhe, LJ, Mafafo, SC, Maghrabi, M, Mahamane, Diango Djibo, Maharaj, A, Maharaj, AD, Mahmud, MR, Mahoko, M, Mahomedy, NA, Mahomva, O, Mahureva, TM, Maila, RK, Maimane, DM, Maimbo, M, Maina, SN, Maiwald, Dela A, Maiyalagan, MD, Majola, N, Makgofa, N, Makhanya, V, Makhaye, WP, Makhlouf, NM, Makhoba, S, Makopa, EK, Makori, O, Makupe, Alex M, Makwela, MA, Malefo, ME, Malongwe, SM, Maluleke, DM, Maluleke, MR, Mamadou, K Touré, Mamaleka, MP, Mampangula, Y, Mamy, RM, Mananjara, MNR, Mandarry, MTM, Mangoo, DM, Manirimbere, C, Manneh, A, Mansour, A, Mansour, I, Manvinder, M, Manyere, DV, Manzini, VT, Manzombi, JK, Mapanda, PM, Marais, LC, Maranga, O, Maritz, JPB, Mariwa, FK, Masela, RS, Mashamba, MM, Mashava, Doreen M, Mashile, MV, Mashoko, E, Masia, OR, Masipa, JN, Masiyambiri, ATM, Matenchi, MW, Mathangani, W, Mathe, RC, Matola, Christopher Y, Matondo, PM, Matos-Puig, R, Matoug, FFH, Matubatuba, JT, Mavesere, HP, Mavhungu, R, Maweni, S, Mawire, CJM, Mawisa, T, Mayeza, S, Mbadi, R, Mbayabu, M, Mbewe, N, Mbombo, WD, Mbuyi, T, Mbuyi, WMS, Mbuyisa, MW, Mbwele, Bernard, Mehyaoui, RM, Menkiti, ID, Mesarieki, LVM, Metali, A, Mewanou, Serge, Mgonja, L, Mgoqo, N, Mhatu, S, Mhlari, TM, Miima, S, Milod, IM, Minani, P, Mitema, F, Mlotshwa, A, Mmasi, JE, Mniki, T, Mofikoya, BO, Mogale, JO, Mohamed, A, Mohamed, S, Mohamed, TS, Mohamed, AM, Mohamed, P, Mohammed, I, Mohammed, FAM, Mohammed, M, Mohammed, NM, Mohlala, MP, Mokretar, R, Molokoane, FM, Mongwe, KN, Montenegro, L, Montwedi, OD, Moodie, QK, Moopanar, M, Morapedi, M, Morulana, TG, Moses, VL, Mossy, P, Mostafa, H, Motilall, SR, Motloutsi, SP, Moussa, Kanté, Moutari, M, Moyo, OM, Mphephu, PE, Mrara, Busi, Msadabwe, C, Mtongwe, VM, Mubeya, FK, Muchiri, K, Mugambi, J, Muguti, GIM, Muhammad, AB, Mukama, IF, Mukenga, MM, Mukinda, FK, Mukuna, PM, Mungherera, ARW, Munlemvo, Dolly M, Munyaradzi, TW, Munyika, AA, Muriithi, JM, Muroonga, MP, Murray, R, Mushangwe, VK, Mushaninga, M, Musiba, VEM, Musowoya, JM, Mutahi, S, Mutasiigwa, MGH, Mutizira, G, Muturi, A, Muzenda, T, Mvwala, KR, Mvwama, NM, Mwale, A, Mwaluka, CN, Mwamba, JD, Mwanga, HAM, Mwangi, CM, Mwansa, S, Mwenda, V, Mwepu, IM, Mwiti, TM, Mzezewa, SZ, Nabela, L, Nabukenya, MTN, Nabulindo, SM, Naicker, K, Naidoo, D, Naidoo, L, Naidoo, LC, Naidoo, N, Naidoo, R, Naidoo, RD, Naidoo, S, Naidoo, TD, Naidu, TK, Najat, NZ, Najm, Y, Nakandungile, F, Nakangombe, P, Namata, CN, Namegabe, ES, Nansook, A, Nansubuga, NP, Nantulu, C, Nascimento, Rodrigue, Naude, GT, Nchimunya, H, Ndaie, MA, Ndarukwa, PN, Ndasi, Henry, Ndayisaba, Gabriel, Ndegwa, D, Ndikumana, R, Ndonga, Andrew KN, Ndung'u, C, Neil, MC, Nel, MS, Neluheni, EV, Nesengani, DS, Nesengani, NT, Netshimboni, LE, Ngalala, AM, Ngari, BM, Ngari, NBM, Ngatia, E, Ngcobo, GK, Ngcobo, TS, Ngorora, D, Ngouane, D, Ngugi, K, Ngumi, Zipporah WW, Nibe, Z, Ninise, E, Niyondiko, JC, Njenga, PW, Njenga, MN, Njoroge, M, Njoroge, S, Njuguna, W, Njuki, PN, Nkesha, T, Nkuebe, TN, Nkuliyingoma, NP, Nkunjana, M, Nkwabi, Ernest, Nkwine, RN, Nnaji, C, Notoane, I, Nsalamba, Shaaban, Ntlhe, LM, Ntoto, C, Ntueba, B, Nyassi, MT, Nyatela-Akinrinmade, Z, Nyawanda, HO, Nyokabi, NN, Nziene, VN, Obadiah, S, Ochieng, OJP, Odia, PK, Oduor, OEO, Ogboli-Nwasor, EO, Ogendo, SWO, Ogunbode, O, Ogundiran, TO, Ogutu, O, Ojewola, RW, Ojujo, M, Ojuka, DO, Okelo, OS, Okiya, S, Okonu, N, Olang, PR, Omigbodun, Akinyinka O, Omoding, S, Omoshoro-Jones, J, Onyango, R, Onyegbule, A, Orjiako, O, Osazuwa, MO, Oscar, Kpatinvo, Osinaike, BB, Osinowo, AO, Othin, OM, Otman, FFH, Otokwala, J, Ouanes, F, Oumar, Ongoïba, Ousseini, AO, Padayachee, S, Pahlana, SM, Pansegrouw, J, Paruk, FP, Patel, MB, Patel-Mujajati, Ushmaben, Patience, AP, Pearse, Rupert M, Pembe, JD, Pengemale, GN, Perez, N, Perez, MF Aguilera, Peter, A Mallier, Phaff, M, Pheeha, RM, Pienaar, BH, Pillay, V, Pilusa, KA, Pochana, MP, Polishchuk, O, Porrill, Owen S, Post, EF, Prosper, A, Pupyshev, M, Rabemazava, A, Rabiou, MS, Rademan, L, Rademeyer, M, Raherison, RAR, Rajah, FR, Rajcoomar, MSR, Rakhda, Z, Rakotoarijaona, AHR, Rakotoarisoa, AHN, Rakotoarison, Sylvia R, Rakotoarison, RR, Rakotoniaina, François, Ramadan, L, Ramananasoa, MLR, Rambau, M, Ramchurn, TPR, Ramilson, HE, Ramjee, Rajesh J, Ramnarain, H, Ramos, R, Rampai, TJ, Ramphal, SR, Ramsamy, T, Ramuntshi, R, Randolph, R, Randriambololona, DMA, Ras, WAP, Rasolondraibe, RAF, Rasolonjatovo, JDLC, Rautenbach, RM, Ray, S, Rayne, Sarah R, Razanakoto, FAR, Reddy, SR, Reed, Anthony R, Rian, JR, Rija, FR, Rink, B, Robelie, AT, Roberts, CA, Rocher, AGL, Rocher, S, Rodseth, Reitze N, Rois, I, Rois, W, Rokhsi, S, Roos, J, Rorke, Nicolette F, Roura, H, Rousseau, FJ, Rousseau, N, Royas, L, Roytowski, D, Rungan, Devan, Rwehumbiza, SSR, Ryabchiy, BB, Ryndine, V, Saaiman, CR, Sabwa, HK, Sadat, S, Saed, SS, Salaheddin, E, Salaou, H, Saleh, M, Salisu-Kabara, HM, Sama, Hamza Doles, Samateh, Ahmadou L, Sam-Awortwi (Jnr), W, Samuel, N, Sanduku, DK, Sani, Chaibou M, Sanyang, LN, Sarah, HN, Sarkin-Pawa, A, Sathiram, R, Saurombe, T, Schutte, H, Sebei, MP, Sedekounou, MD, Segooa, MP, Semenya, EM, Semo, BO, Sendagire, CS, Senoga, SA, Senusi, FS, Serdyn, T, Seshibe, MD, Shah, GB, Shamamba, R, Shambare, CS, Shangase, TN, Shanin, SH, Shefren, IE, Sheshe, AA, Shittu, OB, Shkirban, AS, Sholadoye, T, Shubba, A, Sigcu, N, Sihope, SE, Sikazwe, DS, Sikombe, BS, Simaga Abdoul, K, Simo, WAG, Singata, K, Singh, AS, Singh, S, Singh, Usha, Sinoamadi, V, Sipuka, N, Sithole, NLM, Sitima, S, Skinner, David Lee, Skinner, GC, Smith, OI, Smits, CAG, Sofia, MSI, Sogoba, Gaoussou, Sohoub, A, Sookun, SS, Sosinska, O, Souhe, Rosalie, Souley, G, Souleymane, Thiam, Spicer, JM, Spijkerman, Sandra, Steinhaus, H, Steyn, A, Steyn, G, Steyn, HC, Stoltenkamp, Heidi L, Stroyer, S, Swaleh, A, Swayeb, E, Szpytko, AJ, Taiwo, NA, Tarhuni, A, Tarloff, D, Tchaou, Blaise, Tchegnonsi, Charles, Tchoupa, M, Teeka, MO, Thakoor, B, Theunissen, MM, Thomas, BP, Thomas, MB, Thotharam, A, Tobiko, O, Torborg, AM, Tshisekedi, SM, Tshisola, SK, Tshitangano, R, Tshivhula, F, Tshuma, HT, Tumukunde, Janat, Tun, M, Udo, IA, Uhuebor, DI, Umeh, KU, Usenbo, AO, Uwiteyimbabazi, JdD, Van der Merwe, DJ, van der Merwe, FH, van der Walt, JE, van Dyk, Dominique, Van Dyk, JG, van Niekerk, JJS, van Wyk, S, van Zyl, HA, Veerasamy, B, Venter, PJ, Vermeulen, AJ, Villarreal, R, Visser, J, Visser, L, Voigt, M, von Rahden, Richard P, Wafa, A, Wafula, A, Wambugu, PK, Waryoba, P, Waweru, EN, Weideman, M, Wise, Robert D, Wynne, EE, Yahya, AI, Yahya, AA, Yahya, R, Yakubu, Y, Yanga, JJ, Yangazov, YM, Yousef, O, Yousef, G, Youssouf, Coulibaly, Yunus, AA, Yusuf, AS, Zeiton, AZ, Zentuti, HZ, Zepharine, Henry, Zerihun, AB, Zhou, S, Zidan, A, Zié, Sanogo Zimogo, Zinyemba, CZ, Zo, A, Zomahoun, Lidwine, Zoobei, NZ, Zoumenou, Eugene, Zubia, NZ, Bishop, David, Dyer, Robert A, Maswime, Salome, Tumukunde, Janat T, Madzimbamuto, Farai D, Ndonga, Andrew K N, Ngumi, Zipporah W W, and Mehyaoui, Ryad
Published: 2019
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3. Cancer research across Africa: a comparative bibliometric analysis.

Author: Mutebi, M, Lewison, G, Aggarwal, A, Alatise, OI, Booth, C, Cira, M, Grover, S, Ginsburg, O, Gralow, J, Gueye, S, Kithaka, B, Kingham, TP, Kochbati, L, Moodley, J, Mohammed, SI, Mutombo, A, Ndlovu, N, Ntizimira, C, Parham, GP, Walter, F, Parkes, J, Shamely, D, Hammad, N, Seeley, J, Torode, J, Sullivan, R, Vanderpuye, V, Mutebi, M, Lewison, G, Aggarwal, A, Alatise, OI, Booth, C, Cira, M, Grover, S, Ginsburg, O, Gralow, J, Gueye, S, Kithaka, B, Kingham, TP, Kochbati, L, Moodley, J, Mohammed, SI, Mutombo, A, Ndlovu, N, Ntizimira, C, Parham, GP, Walter, F, Parkes, J, Shamely, D, Hammad, N, Seeley, J, Torode, J, Sullivan, R, and Vanderpuye, V
Abstract: INTRODUCTION: Research is a critical pillar in national cancer control planning. However, there is a dearth of evidence for countries to implement affordable strategies. The WHO and various Commissions have recommended developing stakeholder-based needs assessments based on objective data to generate evidence to inform national and regional prioritisation of cancer research needs and goals. METHODOLOGY: Bibliometric algorithms (macros) were developed and validated to assess cancer research outputs of all 54 African countries over a 12-year period (2009-2020). Subanalysis included collaboration patterns, site and domain-specific focus of research and understanding authorship dynamics by both position and sex. Detailed subanalysis was performed to understand multiple impact metrics and context relative outputs in comparison with the disease burden as well as the application of a funding thesaurus to determine funding resources. RESULTS: African countries in total published 23 679 cancer research papers over the 12-year period (2009-2020) with the fractional African contribution totalling 16 201 papers and the remaining 7478 from authors from out with the continent. The total number of papers increased rapidly with time, with an annual growth rate of 15%. The 49 sub-Saharan African (SSA) countries together published just 5281 papers, of which South Africa's contribution was 2206 (42% of the SSA total, 14% of all Africa) and Nigeria's contribution was 997 (19% of the SSA total, 4% of all Africa). Cancer research accounted for 7.9% of all African biomedical research outputs (African research in infectious diseases was 5.1 times than that of cancer research). Research outputs that are proportionally low relative to their burden across Africa are paediatric, cervical, oesophageal and prostate cancer. African research mirrored that of Western countries in terms of its focus on discovery science and pharmaceutical research. The percentages of female researchers in Africa wer
Published: 2022

4. Unveiling research training gaps in oncology: Evaluating a research capacity-building effort among Nigerian physicians

Author: Owoade, IA, primary, Wuraola, F, additional, Olasehinde, O, additional, Akinyemi, PA, additional, Randolph, K, additional, Dare, AJ, additional, Kingham, TP, additional, and Alatise, OI, additional
Published: 2022
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5. A huge low-grade fibromyxoid sarcoma of small bowel mesentery simulating hyper immune splenomegaly syndrome: a case report and review of literature

Author: Alatise, OI, Oke, OA, Olaofe, OO, Omoniyi-Esan, GO, and Adesunkanmi, ARK
Published: 2013
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6. Breast fine needle aspiration cytology in a Nigerian tertiary hospital

Author: Alatise, OI, Lawal, OO, Olasode, OO, and Adesunkanmi, ARK
Abstract: Objectives: Breast disease remains a major public health issue worldwide. It is the most common cancer among Nigerian women. Fine needle aspiration cytology (FNAC) is an important preoperative assessment tool along with clinical and mammography examination in both screen detected and symptomatic breast disease. This study provide opportunity to determining the accuracy of FNAC and factors affecting false negative rate in Obafemi Awolowo University Teaching Hospital complex, Ile-Ife, Osun state Nigeria Method: All patients seen in the breast clinic with lump were sent to the pathology department for FNAC from January 1997 to December 2004.The sociodemographic data; cytology result, final histology result and the clinical staging for breast cancer were analyzed. Results: Eight hundred and sixty-four patients had FNAC during the studied period, however only 632 cases had available final histological report. Of these, 20 (3.2%) were male while 612 (96.8%) were female, the age ranged from 15 years to 99 years, median of 36.50. We found that absolute sensitivity for malignancy to be 70.8%. The false negative rate was 14.9%, while the false positive rate was 1.8%. The suspicious rate was 9.8% while the inadequate rate was 5.4%. Conclusion: FNAC remains the least invasive, the most rapid and the most cost effective method to confirm clinical and radiological suspicion of malignancy, however, the test has high false negative rate. We recommend that consultation between pathologists and the clinicians should be facilitated and encouraged to reduce the high false negative. Also, multi-disciplinary audits of difficult case should be part of the work routine.
Published: 2016

7. Emergency non–obstetric abdominal surgery in pregnancy

Author: Alatise, OI, Lawal, OO, Agbakwuru, EA, Adesunkanmi, ARK, Faponle, AF, Dare, FO, Ogunniyi, SO, and Akinola, DO
Abstract: Background: Despite recent advances in anaesthetic, perinatal and preoperative care, surgical intervention during pregnancy may still result in fetal loss from either spontaneous abortion (especially in the first trimester) or premature labor (especially in the third trimester). This study was aimed at determining the factors that affect fetal and maternal outcome following emergency non-obstetric abdominal surgery in pregnancy.Methods: We reviewed all cases of emergency non-obstetric abdominal surgery performed on pregnant women at Obafemi Awolowo University Teaching Hospital complex from January 1991 and December 2006. The socio-demographic characteristics, obstetric history, diagnosis and outcome of management were documented and analyzed.Results: A total of 46 pregnant patients presented with various conditions necessitating emergency non-obstetric abdominal surgery during the study period. Their ages ranged from 23 to 39 years with a mean age of 29.33 +/-4.904. Six (13%) of the patients presented during the first trimester, 32 (69.6%) patients during the second trimester and 8 (17.4%) were seen in the third trimester. Thirty-two (69.6%) patients presented with features of acute appendicitis out of 12 had ruptured appendicitis and 8 had appendicular abscess. Eight (17.4%) had intestinal obstruction, 5 (10.8%) had haemoperitonueum from abdominal injury and 1 (6.7%) had an ectopic foetus in bladder. Four (8.8%) mothers and 20(43.5%) babies died. Factors affecting maternal outcome included parity (P=0.010), duration of symptoms (P
Published: 2016

8. Challenges of Pancreatic Cancer Management in a Resource Scarce Setting

Author: Alatise, OI, Lawal, OO, and Ojo, OT
Abstract: Backgrounds: Of all forms of gastrointestinal malignancy, adenocarcinoma of the pancreas is associated with the worst survival. Management of pancreatic cancer is associated with some challenges. This study is aimed at determining the hospital incidence, sociodemographic characteristics, managements and management's outcome of carcinoma of pancreas at our hospital. We also discuss the management challenges encountered with these patients.Material and methods: We reviewed 96 pancreatic cancer patients seen at Awolowo University Teaching Hospital Complex, Ile –Ife, Nigeria, from July 1989 to July 2007.Results: There were ninety six patients diagnosed with cancer of the pancreas but only 80 patients had histological proof of pancreatic cancer. This account for 2.1% of all malignancies seen and 238/100000 total admissions during the study period. The median age is 55.0. There were 62 (64.6%) male and 34 (35.4%) female with male to female ratio been 2:1. Duration of symptoms in the patients ranges from 4 weeks to 109 weeks. Only three (3.1%) patients has tumor located in a particular anatomical sub site: two head of pancreas and one tail of the pancreas. Other patients had extensive tumor involving the head and body of the pancreas. Two patients had pancreaticoduodenectomy, one had resection of the tumor at the tail of pancreas and 45 patients had triple bypass. Patients with low serum albumin and serum sodium and elevated transaminases at presentation, had poorer prognosis than other patients.Conclusion: Pancreatic cancer is not uncommon in our center with male preponderance. Most patients present with advanced condition only amenable to palliative measures. There are significant challenges in the area of diagnosis, screening, treatment and research.
Published: 2016

9. Characteristics of Inflammatory Bowel Disease in Three Tertiary Health Centers in Southern Nigeria

Author: Alatise, OI, Otegbayo, JA, Nwosu, MN, Lawal, OO, Ola, SO, Anyanwu, SNC, Ndububa, DA, Akere, A, Odike, MAC, Agbakwuru, EA, Soyemi, OM, and Okonkwo, UC
Subjects: Inflammatory bowel disease, colonoscopy, Nigeria, treatments, Sulphasalazine
Abstract: BACKGROUND: Inflammatory bowel disease (IBD) refers to two chronic inflammatory disorders of the gastrointestinal tract which is generally believed to be rare in most African countries. The objectives of the current study were to present the experience of three tertiary gastroenterology centers in southern part of Nigeria on IBD, highlighting the age distribution of the patients seen, management and the impact on the quality of their life in university-based community-type practices in Nigeria.METHODS: This was a retrospective review of charts of inflammatory bowel disease seen between January 2007 and June 2010 at three teaching hospitals in Southern Nigeria. Diagnosis of IBD was made from clinical manifestations, colonoscopic and histopathological findings.RESULTS: During the study period, 12 patients presented with clinical features consistent with inflammatory bowel disease. There were 8 (66.7%) males and 4 (33.3%) females and had ages ranged from 18 years to 80 years with a median of 26.5 years. Eight (66.7%) patients had ulcerative colitis while 4(33.3%) had Crohn’s disease. Ten {83.3%) patients hadsevere disease with main clinical features being recurrent diarrhoea and passage of mucoid bloody stools. All the patients had treatments with sulphasalazine or mesalazine, steroids and antibiotics with good responses. One patient died following the occurrence of toxic megacolon.CONCLUSION: Although IBD is uncommon in Nigeria, high index of suspicion is necessary by attending physicians managing patients with recurrent passage of mucoid bloody stools. Prompt gastroenterological referral and judicious use of colonoscopy and biopsy will assist in making the diagnosis. WAJM 2012; 31(1): 28–33.Key words: Inflammatory bowel disease, colonoscopy, Nigeria, treatments, Sulphasalazine.
Published: 2014

10. Management challenges of pancreatic cancer in a resource scarce setting

Author: Alatise, OI, Lawal, OO, and Tope, OO
Subjects: Pancreatic cancer, Managements, Challenges, Outcome
Abstract: Background: Of all forms of gastrointestinal malignancy, adenocarcinoma of the pancreas is associated with the worst survival. Management of pancreatic cancer is associated with some challenges. This study is aimed at determining the hospital incidence, sociodemographic characteristics, managements and management’s outcome of carcinoma of pancreas at our hospital. We also discuss the management challenges encountered with these patients.Patients and Methods: We review 96 pancreatic cancer patients seen at Awolowo University Teaching Hospital Complex, Ile –Ife, Nigeria, from July 1989 to July 2007.Results: There were ninety six patients diagnosed with cancer of the pancreas but only 80 patients had histological proof of pancreatic cancer. This account for 2.1% of all malignancies seen and 238/100000 total admissions during the study period. The median age is 55.0. There were 62 (64.6%) male and 34 (35.4%) female with male to female ratio been 2:1. Duration of symptoms in the patients ranges from 4 weeks to 109 weeks. Only three (3.1%) patients has tumor located in a particular anatomical sub site: two head of pancreas and one tail of the pancreas. Other patients had extensive tumor involving the head and body of the pancreas. Two patients had pancreaticoduodenectomy, one had resection of the tumor at the tail of pancreas and 45 patients had triple bypass. Patients with low serum albumin and serum sodium and elevated transaminases at presentation, had poorer prognosis than other patients.Conclusion: We found that pancreatic cancer is not uncommon in our center with male preponderance. Most patients present with advanced condition only amenable to palliative measures. There are significant challenges in the area of diagnosis, screening, treatment and research.Key words: Pancreatic cancer, Managements, Challenges, Outcome
Published: 2014

11. Open hemorrhoidectomy under local anesthesia for symptomatic hemorrhoids; our experience in Ile –Ife, Nigeria

Author: Alatise, OI, Agbakwurul, AE, Takure, AO, Adisa, AO, and Akinkuolie, AA
Subjects: Open hemorrhoidectomy, local anesthesia, Nigeria
Abstract: Background: Ligation-excision hemorrhoidectomy is considered the gold-standard treatment for prolapsed hemorrhoids. The procedure is commonly done under general or regional anesthesia. This study is aimed to assess the feasibility and tolerability of open – hemorrhoidectomy under local anaesthesia in our setting.Methods: This is a prospective study carried out in Obafemi Awolowo University Teaching Hospital Complex, Ile Ife, Nigeria, over a 5-year period. All consenting adult patients with prolapsing hemorrhoids were offered Milligan – Morgan hemorrhoidectomy under local anesthesia. They were assessed for tolerance and complications.Results: More than 95% of patients tolerated the procedure with manageable complications.Conclusions: Open excisional hemorrhoidectomy under local anesthesia is feasible, safe and well tolerated in our environment and may encourage early presentation of patients with piles to hospital.Keyword: Open hemorrhoidectomy, local anesthesia, Nigeria.
Published: 2014

12. Pancreatic cancer in Nigeria: Past, present and future

Author: Alatise, OI, Ndububa, DA, Ojo, OS, Agbakwuru, EA, Adekanle, O, and Arowolo, OA
Abstract: Pancreatic cancer remains a lethal disease worldwide despite an improved understanding of the disease. The main risk factors are age, smoking and genetic factors, however, the primary causal factors for pancreatic cancers are poorly understood. Advances in molecular biology have, however, greatly improved understanding of the pathogenesis of pancreatic cancer. Many patients have mutations of the K-ras oncogene, and various tumor-suppressor genes are also inactivated. Growth factors also play an important part. Obviously, little is known about the cancer in Nigeria. Patients usually present late hence, surgical bypass is the main procedure performed in majority of the patients. Managements of pancreatic cancer in Nigeria is quite challenging due to lack of awareness of the disease, which lead to late presentations, lack of appropriate investigating modality, unavailability of super specialist skill in complex pancreatic surgery, absence of proper palliative measures, and lack of clinical and basic research in pancreatic cancer. On top of all this is the issue of poverty which made it difficult for most patients to access the available facility. This review is aimed at reviewing the current knowledge about pancreatic cancer, highlighting the current practice and limitation in Nigeria.Material and method: We performed a literature search for all English-language articles dealing with pancreatic cancers by combining the keywords “pancreatic cancer” with the following topics: Nigeria, sub Saharan Africa, carcinogenesis, angiogenesis, progression, metastasis, pathology, pathobiology, pathophysiology, molecular genetics, and genetics, published from 1980 to 2010. Databases searched included MEDLINE, PreMEDLINE, African Journal Online (AJOL), and the Cochrane Database of Systematic Reviews, the google search, the Database of Abstracts of Reviews of Effectiveness, and the Cochrane Central Registry of Controlled Trials. Additional references were obtained from the bibliographies of selected articles. We selected pertinent studies emphasizing randomized controlled trials to formulate this technical review.
Published: 2012

13. Pattern of death in a Nigerian teaching hospital; 3-decade analysis

Author: Adeolu, AA, Arowolo, OA, Alatise, OI, Osasan, SA, Bisiriyu, LA, Omoniyi, EO, and Odesanmi, WO
Subjects: Adult, Aged, 80 and over, Male, Adolescent, Incidence, Infant, Newborn, Infant, Nigeria, Middle Aged, Young Adult, Age Distribution, Cause of Death, Child, Preschool, Outcome Assessment, Health Care, Humans, Original Article, Female, Hospital Mortality, Sex Distribution, Child, Hospitals, Teaching, Aged, Retrospective Studies
Abstract: In developing countries such as Nigeria, limited resources require that health priorities be selected wisely and death-related research is clearly warranted. The aim of this study is to provide a comprehensive report on the various causes of death in our center from 1978 to 2006.This was a descriptive, retrospective study of all deaths recorded at the Obafemi Awolowo University Teaching Hospitals Complex (OAUTHC), Ile - Ife, Osun State in Southwest Nigeria from 1978 to 2006.A total number of 9,947 deaths were recorded during the study period and there were 6,277 male deaths (63.1%) and 3,670 female deaths (36.9%) with a female to male ratio of 1:1.5. The age ranged from birth to 100 years with a median of 25 years. Infection (2,594 patients; 26.1%) was the most common cause of death and this was followed closely by trauma death (2,028 patients; 20.4%) and neonatal death (1,074 patients; 10.8%). Death from infectious disease and trauma reduced from 1,048 and 1,441 in the first decade (1977 - 1986) to 478 and 133 in the last decade respectively. While death from neoplasia increased from 112 in the first decade to 354 in the last decade of the study period.Our study shows that death from infectious disease in the present decade has reduced to almost half that was recorded in first decade. Similarly death from trauma has also reduced compared to the first decade of the study. Death from neoplasia is however higher in the last decade.
Published: 2010

14. Pattern and outcome of traumatic gastro- intestinal injuries in Ile-Ife

Author: Olasehinde, O, primary, Adisa, AO, additional, Aderibigbe, AS, additional, Alatise, OI, additional, Etonyeaku, AC, additional, Adesunkanmi, ARK, additional, and Agbakwuru, EA, additional
Published: 2015
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15. Spectrum of diseases and diagnostic values of ultrasound in adult patients with nontraumatic acute abdomen in a Nigerian tertiary health facility

Author: Asaleye, CM, primary, Adetiloye, VA, additional, Alatise, OI, additional, and Ashaolu, BO, additional
Published: 2015
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16. Early experience with stapled gastrointestinal anastomoses in a Nigerian hospital

Author: Adisa, AO, primary, Arowolo, OA, additional, Alatise, OI, additional, Agbakwuru, EA, additional, and Olasehinde, O, additional
Published: 2015
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17. Single versus two layer suturing for wound closure after inguinal hernia repair

Author: Agbakwuru, EA, Olabanji, JK, Alatise, OI, Katung, IA, and Unakpoya, UU
Abstract: No Abstract.
Published: 2009

18. Acute Appendicitis: Incidence and Management in Nigeria

Author: Alatise, OI and Ogunweide, T
Abstract: Appendicitis is the leading cause of surgical emergency admission in most hospital in Nigeria. It accounts for about 15-40% of all emergency surgery done in most centers in the country. All age groups can develop the disease including the fetus in utero, but the incidence is higher in the second and third decade of life. Majority of patients in Nigeria present late with complicated disease. Surgery is the treatment of choice for appendicitis. However patients must be adequately resuscitated before the procedure. Prognosis is excellent. High morbidities and occasional mortalities seen are usually due to late presentation and delay in treatments. Fear of surgery and cost of treatment are the main reason for late presentation. Mass education should be done to enlighten the populace on the evil of late presentation. The government should be implored to make widely available social support facilities that patients can make use of, at least in emergency situations. IFEMED Journal Vol. 14 (1) 2008: pp. 66-70
Published: 2008

19. Pattern and validity of clinical diagnosis of upper gastrointestinal diseases in South-west Nigeria

Author: Agbakwuru, EA, Fatusi, AO, Ndububa, DA, Alatise, OI, Arigbabu, OA, and Akinola, DO
Subjects: Adult, Male, Adolescent, Gastrointestinal Diseases, Nigeria, Risk Assessment, Sensitivity and Specificity, Severity of Illness Index, Endoscopy, Gastrointestinal, Cohort Studies, Young Adult, Age Distribution, Humans, Sex Distribution, Child, Developing Countries, Physical Examination, Aged, Retrospective Studies, Analysis of Variance, Chi-Square Distribution, Incidence, Reproducibility of Results, Original Articles, Middle Aged, Survival Analysis, Child, Preschool, Female
Abstract: Background: Diagnosis of upper gastrointestinal (UGI) diseases is often made on clinical grounds alone in Nigeria due to lack of endoscopic facilities. The validity of using such diagnosis is presently unknown. Objective: The study aimed to determine: age and sex distribution of patients presenting for UGI endoscopy; pattern of clinical and endoscopic diagnoses in patients with UGI diseases; and, the validity of clinic-based diagnosis. Methods: Medical records of patients presenting at Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Nigeria for UGI endoscopy between September 1999 and August 2003 were reviewed. Data was analysed for sensitivity, specificity, positive predictive value, and negative predictive value of clinical diagnosis using endoscopic diagnosis as “gold” standard. Results: Males constituted 53.4% of subjects and mean age was 45 years (+ 1.69 SD). Peptic ulcer disease (PUD) constituted 67.6% of referral diagnosis but 33.9% of endoscopic diagnosis. PUD had the highest sensitivity value (0.72) while gastritis had the least (0.04). Specificity ranged from 0.40 for PUD to 1.00 for corrosive oesophagitis. Positive predictive value ranged from 0.29 (oesophageal cancer) to 0.67 (corrosive oesophagitis) and negative predictive value ranged from 0.66 for gastritis to 0.99 for corrosive oesophagitis. Conclusion: The validity of clinical diagnosis in UGI conditions varied widely, and in general, there is poor agreement between clinical and endoscopic diagnoses. African Health Sciences Vol. 6(2) 2006: 98- 103
Published: 2006

20. Polyp prevalence at colonoscopy among Nigerians: A prospective observational study

Author: Alatise, OI, primary, Arigbabu, AO, additional, Lawal, OO, additional, Sowande, OA, additional, Odujoko, OO, additional, Ojo, O, additional, Agbakwuru, AE, additional, and Adegoke, O, additional
Published: 2014
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21. Perioperative patient outcomes in the African Surgical Outcomes Study: a 7-day prospective observational cohort study

Author: Biccard, Bruce M, Madiba, Thandinkosi E, Kluyts, Hyla-Louise, Munlemvo, Dolly M, Madzimbamuto, Farai D, Basenero, Apollo, Gordon, Christina S, Youssouf, Coulibaly, Rakotoarison, Sylvia R, Gobin, Veekash, Samateh, Ahmadou L, Sani, Chaibou M, Omigbodun, Akinyinka O, Amanor-Boadu, Simbo D, Tumukunde, Janat T, Esterhuizen, Tonya M, Manach, Yannick Le, Forget, Patrice, Elkhogia, Abdulaziz M, Mehyaoui, Ryad M, Zoumeno, Eugene, Ndayisaba, Gabriel, Ndasi, Henry, Ndonga, Andrew K N, Ngumi, Zipporah W W, Patel, Ushmah P, Ashebir, Daniel Zemenfes, Antwi-Kusi, Akwasi A K, Mbwele, Bernard, Sama, Hamza Doles, Elfiky, Mahmoud, Fawzy, Maher A, Pearse, Rupert M, Abadagan, Hippolyte, Abbas, N, Abdelatif, A Ibrahim, Abdoulaye, Traoré, Abd-rouf, A, Abduljalil, A, Abdulrahman, A, Abdurazig, S, Abokris, A, Abozaid, W, Abugassa, SOA, Abuhdema, F, Abujanah, SA, Abusamra, R, Abushnaf, A, Abusnina, SA, Abuzalout, TS, Ackermann, HM, Adamu, YB, Addanfour, A, Adeleke, DM, Adigun, TA, Adisa, AO, Adjignon, Sèhivè Valéry, Adu-Aryee, NA, Afolabi, BB, Agaba, AFX, Agaba, PKA, Aghadi, K, Agilla, H, Ahmed, B, Ahmed, El-Z, Ahmed, Al-J, Ahmed, M, Ahossi, Rene, Aji, SA, Akanyun, S, Akhideno, I, Akhter, M, Akinyemi, OA, Akkari, M, Akodjenou, Joseph, AL Samateh, AL, al Shams, ES, Alagbe-Briggs, OT, Alakkari, EA, Alalem, RB, Alashhab, M, Alatise, OI, Alatresh, A, Alayeb Alayeb, MSI, Albakosh, BA, Albert, F, Alberts, ANJD, Aldarrat, AD, Alfari, A, Alfetore, A, Algbali, M, Algddar, A, Algedar, HA, Alghafoud, IA, Alghazali, A, Alhajj, M, Alhendery Alhendery, A, Alhoty, FFH, Ali, A, Ali, YA, Ali, A, Alioune, Beye Seïdina, Alkassem, MA, Alkchr, MA, Alkesa, TS, Alkilani, A, Alkobty Alkobty, F, Allaye, Thomas, Alleesaib, SBM, Alli, A, Allopi, K, Allorto, NL, Almajbery, A, Almesmary, R, Almisslati, SHA, Almoraid, F, Alobeidi, H, Alomami, MA, Alphonsus, Christella S, Alqawi, OA, Alraheem, AA, Alsabri, SA, Alsayed, A, Alsellabi, B, Al-Serksi, M, Alshareef, MSA, Altagazi, AA, Aluvale, JS, Alwahedi, HW, Alzahra, EA, Alzarouk, MA, Al-Zubaidy, K, Amadou, M, Amadou, Maiga, Amanor-Boadu, Simbo D, Amer, Al-A, Amisi, BT, Amuthenu, MA, Anabah, TWA, Anani, Felix, Anderson, PGR, Andriamampionona, AGB, Andrianina, L, Anele, A, Angelin, R, Anjar, N, Antùnez, O, Antwi-Kusi, Akwasi, Anyanwu, LJC, Aribi, AA, Arowolo, OA, Arrey, O, Ashebir, Daniel Zemenfes, Assefa, SB, Assoum, Guy, Athanse, V, Athombo, JS, Atiku, M, Atito-Narh, E, Atomabe, Anatole, Attia, A, Aungraheeta, M, Aurélia, DMA, Ayandipo, OO, Ayebale, AET, Azzaidey, HMZ, Babajee, NB, Badi, HB, Badianga, EK, Baghni, RB, Bahta, MT, Bai, M, Baitchu, Y, Baloyi, AM, Bamuza, KA, Bamuza, MI, Bangure, L, Bankole, OB, Barongo, ML, Barow, MM, Basenero, Apollo, Bashiya, L, Basson, CH, Bechan, Sudha, Belhaj, S, Ben Mansour, MM, Benali, D, Benamour, ASB, Berhe, A, Bertie, JD, Bester, JJA, Bester, M, Bezuidenhout, JD, Bhagwan, K, Bhagwandass, DR, Bhat, KAP, Bhuiyan, MMZU, Biccard, Bruce M, Bigirimana, F, Bikuelo, CJ, Bilby, BE, Bingidimi, SS, Bischof, KE, Bishop, David G, Bitta, C, Bittaye, M, Biyase, Thuli, Blake, CA, Blignaut, E, Blignaut, F, BN Tanjong, BN, Bogoslovskiy, A, Boloko, PM, Boodhun, SKB, Bori, I, Boufas, F, Brand, M, Brouckaert, Nicholas T, Bruwer, JD, Buccimazza, I, Bula Bula, IM, Bulamba, Fred, Businge, BC, Bwambale, YB, Cacala, SRC, Cadersa, MA, Cairns, Chris, Carlos, F, Casey, ME, Castro, AC, Chabayanzara, ND, Chaibou, MS, Chaibva, TNO, Chakafa, NK, Chalo, C, Changfoot, C, Chari, MC, Chelbi, L, Chibanda, JT, Chifamba, HN, Chikh, N, Chikumba, E, Chimberengwa, P, Chirengwa, J, Chitungo, FM, Chiwanga, MC, Chokoe, MM, Chokwe, TM, Chrirangi, B, Christian, M, Church, B, Cisekedi, JC, Clegg-Lamptey, JN, Cloete, Estie, Coltman, Megan, Conradie, W, Constance, N, Coulibaly, Youssouf, Cronje, L, Da Silva, MA, Daddy, H, Dahim, L, Daliri, D, Dambaki, MS, Dasrath, A, Davids, JG, Davies, Gareth L, De Lange, JT, de Wet, JB, Dedekind, B, Degaulle, MA, Dehal, V, Deka, PD, Delinikaytis, S, Desalu, IS, Dewanou, Hubert, Deye, MB Moussa, Dhege, C, Diale, BSG, Dibwe, DF, Diedericks, BJS, Dippenaar, JM, Dippenaar, L, Diyoyo, MP, Djessouho, Edith, Dlamini, SN, Dodiyi-Manuel, A, Dokolwana, BA, Domoyyeri, DP, Drummond, Leanne W, du Plessis, DE, du Plessis, WM, du Preez, LJ, Dube, K, Dube, NZ, Dullab, KD, Duvenhage, R, Echem, RC, Edaigbini, SA, Egote, AK, Ehouni, A, Ekwen, G, Ekwunife, NC, El Hensheri, M, Elfaghi, IE, Elfagieh, MA, Elfallah, S, Elfiky, Mahmoud, Elgelany, S, Elghallal, AM, Elghandouri, MG, Elghazal, ZS, Elghobashy, AM, Elharati, FT, Elkhogia, Abdulaziz M, Elkhwildi, RM, Ellis, S, Elmadani, L, Elmadany, HB, Elmehdawi, H, Elmgadmi, A, Eloi, H, Elrafifi, D, Elsaadi, G, Elsaity, RB, Elshikhy, A, Eltaguri, M, Elwerfelli, A, Elyasir, IE, Elzoway, AZ, Elzufri, AM, Enendu, EO, Enicker, BC, Enwerem, EO, Esayas, R, Eshtiwi, M, Eshwehdi, AA, Esterhuizen, JL, Esterhuizen, Tonya M, Etuk, EB, Eurayet, O, Eyelade, OR, Fanjandrainy, RF, Fanou, Lionelle, Farina, Z, Fawzy, Maher, Feituri, A, Fernandes, NL, Ford, LM, Forget, Patrice, François, T, Freeman, T, Freeman, YBM, Gacii, VM, Gadi, B, Gagara, M, Gakenia, A, Gallou, PD, Gama, GGN, Gamal, MG, Gandy, YG, Ganesh, A, Gangaly, Diallo, Garcia, M, Gatheru, AP, Gaya, SSD, Gbéhadé, Oswald, Gerbel, G, Ghnain, A, Gigabhoy, R, Giles, DG, Girmaye, GT, Gitau, S, Githae, B, Gitta, Said, Gobin, Veekash, Goga, Riaz, Gomati, AAG, Gonzalez, ME, Gopall, J, Gordon, Christina Salmina, Gorelyk, O, Gova, M, Govender, K, Govender, P, Govender, S, Govindasamy, V, Green-Harris, JTK, Greenwood, MB, Grey-Johnson, SV, Grobbelaar, Mariette, Groenewald, MA, Grünewald, KK, Guegni, Ambroise, Guenane, M, Gueye, S, Guezo, Marius, Gunguwo, T, Gweder, MG, Gwila, M, Habimana, L, Hadecon, Rodrigue, Hadia, E, Hamadi, L, Hammouda, M, Hampton, MI, Hanta, R, Hardcastle, Tim C, Hariniaina, JA, Hariparsad, S, Harissou, AH, Harrichandparsad, R, Hasan, SHA, Hashmi, HB, Hayes, MP, Hdud, A, Hebli, SH, Heerah, HMSN, Hersi, S, Hery, AH, Hewitt-Smith, Adam, Hlako, TC, Hodges, SCH, Hodgson, Richard Eric, Hokoma, M, Holder, H, Holford, EB, Horugavye, E, Houston, C, Hove, M, Hugo, D, Human, CM, Hurri, H, Huwidi, O, Ibrahim, AI, Ibrahim, Traoré, Idowu, OK, Igaga, IE, Igenge, John, Ihezie, O, Ikandi, K, Ike, IAR, Ikuku, JJN, Ilbarasi, MN, Ilunga, IBB, Ilunga, JPM, Imbangu, NAV, Imessaoudene, Z, Imposo, DH, Iraya, AM, Isaacs, M, Isiguzo, M, Issoufou, A, Izquirdo, P, Jaber, A, Jaganath, UV, Jallow, CS, Jamabo, S, Jamal, ZS, Janneh, L, Jannetjies, MJ, Jasim, I, Jaworska, Megan AJ, Jay Narain, S, Jermi, K, Jimoh, R, Jithoo, S, Johnson, M, Joomye, S, Judicael, RM, Judicaël, M, Juwid, A, Jwambi, LP, Kabango, R, Kabangu, JK, Kabatoro, DK, Kabongo, AN, Kabongo, K, Kabongo, LT, Kabongo, MD, Kady, N, Kafu, S, Kaggya, M, Kaholongo, BNK, Kairuki, PCK, Kakololo, SI, Kakudji, K, Kalisa, Amina, Kalisa, R, Kalufwelu, MR, Kalume, S, Kamanda, RJ, Kangili, MK, Kanoun, H, Kapesa, Kapp, P, Karanja, JK, Karar, M, Kariuki, K, Kaseke, K, Kashuupulwa, PNK, Kasongo, KJP, Kassa, SK, Kateregga, GK, 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T, Mayeza, S, Mbadi, R, Mbayabu, M, Mbewe, N, Mbombo, WD, Mbuyi, T, Mbuyi, WMS, Mbuyisa, MW, Mbwele, Bernard, Mehyaoui, RM, Menkiti, ID, Mesarieki, LVM, Metali, A, Mewanou, Serge, Mgonja, L, Mgoqo, N, Mhatu, S, Mhlari, TM, Miima, S, Milod, IM, Minani, P, Mitema, F, Mlotshwa, A, Mmasi, JE, Mniki, T, Mofikoya, BO, Mogale, JO, Mohamed, A, Mohamed, A, Mohamed, A, Mohamed, S, Mohamed, S, Mohamed, TS, Mohamed, A, Mohamed, A, Mohamed, AM, Mohamed, P, Mohammed, I, Mohammed, FAM, Mohammed, M, Mohammed, NM, Mohlala, MP, Mokretar, R, Molokoane, FM, Mongwe, KN, Montenegro, L, Montwedi, OD, Moodie, QK, Moopanar, M, Morapedi, M, Morulana, TG, Moses, VL, Mossy, P, Mostafa, H, Motilall, SR, Motloutsi, SP, Moussa, Kanté, Moutari, M, Moyo, OM, Mphephu, PE, Mrara, Busi, Msadabwe, C, Mtongwe, VM, Mubeya, FK, Muchiri, K, Mugambi, J, Muguti, GIM, Muhammad, AB, Mukama, IF, Mukenga, MM, Mukinda, FK, Mukuna, PM, Mungherera, ARW, Munlemvo, Dolly M, Munyaradzi, TW, Munyika, AA, Muriithi, JM, Muroonga, MP, Murray, R, Mushangwe, VK, Mushaninga, M, Musiba, VEM, Musowoya, JM, Mutahi, S, Mutasiigwa, MGH, Mutizira, G, Muturi, A, Muzenda, T, Mvwala, KR, Mvwama, NM, Mwale, A, Mwaluka, CN, Mwamba, JD, Mwanga, HAM, Mwangi, CM, Mwansa, S, Mwenda, V, Mwepu, IM, Mwiti, TM, Mzezewa, SZ, Nabela, L, Nabukenya, MTN, Nabulindo, SM, Naicker, K, Naidoo, D, Naidoo, L, Naidoo, LC, Naidoo, N, Naidoo, R, Naidoo, RD, Naidoo, S, Naidoo, TD, Naidu, TK, Najat, NZ, Najm, Y, Nakandungile, F, Nakangombe, P, Namata, CN, Namegabe, ES, Nansook, A, Nansubuga, NP, Nantulu, C, Nascimento, Rodrigue, Naude, GT, Nchimunya, H, Ndaie, MA, Ndarukwa, PN, Ndasi, Henry, Ndayisaba, Gabriel, Ndegwa, D, Ndikumana, R, Ndonga, Andrew KN, Ndung'u, C, Neil, MC, Nel, MS, Neluheni, EV, Nesengani, DS, Nesengani, NT, Netshimboni, LE, Ngalala, AM, Ngari, BM, Ngari, NBM, Ngatia, E, Ngcobo, GK, Ngcobo, TS, Ngorora, D, Ngouane, D, Ngugi, K, Ngumi, Zipporah WW, Nibe, Z, Ninise, E, Niyondiko, JC, Njenga, PW, Njenga, MN, Njoroge, M, Njoroge, S, Njuguna, W, Njuki, PN, Nkesha, T, Nkuebe, TN, Nkuliyingoma, NP, Nkunjana, M, Nkwabi, Ernest, Nkwine, RN, Nnaji, C, Notoane, I, Nsalamba, Shaaban, Ntlhe, LM, Ntoto, C, Ntueba, B, Nyassi, MT, Nyatela-Akinrinmade, Z, Nyawanda, HO, Nyokabi, NN, Nziene, VN, Obadiah, S, Ochieng, OJP, Odia, PK, Oduor, OEO, Ogboli-Nwasor, EO, Ogendo, SWO, Ogunbode, O, Ogundiran, TO, Ogutu, O, Ojewola, RW, Ojujo, M, Ojuka, DO, Okelo, OS, Okiya, S, Okonu, N, Olang, PR, Omigbodun, Akinyinka O, Omoding, S, Omoshoro-Jones, J, Onyango, R, Onyegbule, A, Orjiako, O, Osazuwa, MO, Oscar, Kpatinvo, Osinaike, BB, Osinowo, AO, Othin, OM, Otman, FFH, Otokwala, J, Ouanes, F, Oumar, Ongoïba, Ousseini, AO, Padayachee, S, Pahlana, SM, Pansegrouw, J, Paruk, FP, Patel, MB, Patel, Ushmaben, Patience, AP, Pearse, Rupert M, Pembe, JD, Pengemale, GN, Perez, N, Perez, MF Aguilera, Peter, A Mallier, Phaff, M, Pheeha, RM, Pienaar, BH, Pillay, V, Pilusa, KA, Pochana, MP, Polishchuk, O, Porrill, Owen S, Post, EF, Prosper, A, Pupyshev, M, Rabemazava, A, Rabiou, MS, Rademan, L, Rademeyer, M, Raherison, RAR, Rajah, FR, Rajcoomar, MSR, Rakhda, Z, Rakotoarijaona, AHR, Rakotoarisoa, AHN, Rakotoarison, Sylvia R, Rakotoarison, RR, Ramadan, L, Ramananasoa, MLR, Rambau, M, Ramchurn, TPR, Ramilson, HE, Ramjee, Rajesh J, Ramnarain, H, Ramos, R, Rampai, TJ, Ramphal, SR, Ramsamy, T, Ramuntshi, R, Randolph, R, Randriambololona, DMA, Ras, WAP, Rasolondraibe, RAF, Rasolonjatovo, JDLC, Rautenbach, RM, Ray, S, Rayne, Sarah R, Razanakoto, FAR, Reddy, SR, Reed, Anthony R, Rian, JR, Rija, FR, Rink, B, Robelie, AT, Roberts, CA, Rocher, AGL, Rocher, S, Rodseth, Reitze N, Rois, I, Rois, W, Rokhsi, S, Roos, J, Rorke, Nicolette F, Roura, H, Rousseau, FJ, Rousseau, N, Royas, L, Roytowski, D, Rungan, Devan, Rwehumbiza, SSR, Ryabchiy, BB, Ryndine, V, Saaiman, CR, Sabwa, HK, Sadat, S, Saed, SS, Salaheddin, E, Salaou, H, Saleh, M, Salisu-Kabara, HM, Sama, Hamza Doles, Samateh, Ahmadou L, Sam-Awortwi (Jnr), W, Samuel, N, Sanduku, DK, Sani, Chaibou M, Sanyang, LN, Sarah, HN, Sarkin-Pawa, A, Sathiram, R, Saurombe, T, Schutte, H, Sebei, MP, Sedekounou, MD, Segooa, MP, Semenya, EM, Semo, BO, Sendagire, CS, Senoga, SA, Senusi, FS, Serdyn, T, Seshibe, MD, Shah, GB, Shamamba, R, Shambare, CS, Shangase, TN, Shanin, SH, Shefren, IE, Sheshe, AA, Shittu, OB, Shkirban, AS, Sholadoye, T, Shubba, A, Sigcu, N, Sihope, SE, Sikazwe, DS, Sikombe, BS, Simaga Abdoul, K, Simo, WAG, Singata, K, Singh, AS, Singh, S, Singh, Usha, Sinoamadi, V, Sipuka, N, Sithole, NLM, Sitima, S, Skinner, David Lee, Skinner, GC, Smith, OI, Smits, CAG, Sofia, MSI, Sogoba, Gaoussou, Sohoub, A, Sookun, SS, Sosinska, O, Souhe, Rosalie, Souley, G, Souleymane, Thiam, Spicer, JM, Spijkerman, Sandra, Steinhaus, H, Steyn, A, Steyn, G, Steyn, HC, Stoltenkamp, Heidi L, Stroyer, S, Swaleh, A, Swayeb, E, Szpytko, AJ, Taiwo, NA, Tarhuni, A, Tarloff, D, Tchaou, Blaise, Tchegnonsi, Charles, Tchoupa, M, Teeka, MO, Thakoor, B, Theunissen, MM, Thomas, BP, Thomas, MB, Thotharam, A, Tobiko, O, Torborg, AM, Tshisekedi, SM, Tshisola, SK, Tshitangano, R, Tshivhula, F, Tshuma, HT, Tumukunde, Janat, Tun, M, Udo, IA, Uhuebor, DI, Umeh, KU, Usenbo, AO, Uwiteyimbabazi, JdD, Van der Merwe, DJ, van der Merwe, FH, van der Walt, JE, van Dyk, Dominique, Van Dyk, JG, van Niekerk, JJS, van Wyk, S, van Zyl, HA, Veerasamy, B, Venter, PJ, Vermeulen, AJ, Villarreal, R, Visser, J, Visser, L, Voigt, M, von Rahden, Richard P, Wafa, A, Wafula, A, Wambugu, PK, Waryoba, P, Waweru, EN, Weideman, M, Wise, Robert D, Wynne, EE, Yahya, AI, Yahya, AA, Yahya, R, Yakubu, Y, Yanga, JJ, Yangazov, YM, Yousef, O, Yousef, G, Youssouf, Coulibaly, Yunus, AA, Yusuf, AS, Zeiton, AZ, Zentuti, HZ, Zepharine, Henry, Zerihun, AB, Zhou, S, Zidan, A, Zié, Sanogo Zimogo, Zinyemba, CZ, Zo, A, Zomahoun, Lidwine, Zoobei, NZ, Zoumenou, Eugene, and Zubia, NZ
Abstract: There is a need to increase access to surgical treatments in African countries, but perioperative complications represent a major global health-care burden. There are few studies describing surgical outcomes in Africa.
Published: 2018
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22. Selenium levels in neoplastic breast lesions

Author: Alatise, OI, primary, Babalola, OO, additional, Omoniyi-Esan, GO, additional, Lawal, OO, additional, Adesunkanmi, ARK, additional, and Agbakwuru, EA, additional
Published: 2013
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23. Presentation, distribution pattern, and management of diverticular disease in a Nigerian tertiary hospital

Author: Alatise, OI, primary, Arigbabu, AO, additional, Lawal, OO, additional, Adetiloye, VA, additional, Agbakwuru, EA, additional, and Ndububa, DA, additional
Published: 2013
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24. Spectrum of colonoscopy findings in Ile-Ife Nigeria

Author: Alatise, OI, primary, Arigbabu, AO, additional, Agbakwuru, EA, additional, Lawal, OO, additional, Ndububa, DA, additional, and Ojo, OS, additional
Published: 2012
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25. Bowel preparation for colonoscopy: Enema versus Sodium Phosphate

Author: Alatise, OI, primary, Arigbabu, AO, additional, Lawal, OO, additional, Ndububa, DA, additional, Agbakwuru, EA, additional, Ojo, OS, additional, and Adekanle, O, additional
Published: 2011
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26. Incisional Hernia in Women: Predisposing Factors and Management Where Mesh is Not Readily Available

Author: Agbakwuru, EA, primary, Olabanji, JK, additional, Alatise, OI, additional, Okwerekwu, RO, additional, and Esimai, OA, additional
Published: 2008
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27. Clinical Pattern Of Male Breast Cancer In Ile-Ife, Nigeria

Author: Adisa, AO, primary, Arowolo, OA, additional, Alatise, OI, additional, Lawal, OO, additional, and Adesunkanmi, ARK, additional
Published: 2008
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28. Intimate partner violence in Ile-Ife, Nigeria: Women's experiences and men's perspectives

Author: Fatusi, AO, primary and Alatise, OI, additional
Published: 2007
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29. Early results of the posterior saggital anorectoplasty in the treatment of anorectal malformations in Nigerian children

Author: Sowande, OA, primary, Adejuyigbe, O, additional, Alatise, OI, additional, and Usang, UE, additional
Published: 2006
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30. Management outcome and associated factors in burn injuries with and without facial involvement in a Nigerian population.

Author: Fatusi OA, Fatusi AO, Olabanji JK, Alatise OI, Fatusi, Olawunmi A, Fatusi, Adesegun O, Olabanji, J Kayode, and Alatise, Olusegun I
Published: 2006
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31. Gastric Cancer at a Nigerian Tertiary Referral Center: Experiences With Establishing an Institutional Cancer Registry.

Author: Yibrehu B, Mohammed TO, Murthy S, Aderibigbe AS, Daramola OB, Arije O, Owoade I, Wuraola FO, Olasehinde O, Betiku O, Folorunso SA, Omoyiola O, Aderounmu A, Adisa AO, Kingham PT, and Alatise OI
Abstract: Background: In Nigeria, gastric cancer is the 10th most common and 9th most deadly malignancy. The limited availability of robust data makes further characterizing it challenging. The objective of this study was to assess the presentation, and management of gastric cancer in Nigeria using an institutional cancer registry., Methods: We reviewed a prospective database of patients diagnosed with any gastric cancer at a single tertiary referral center over 15 years (2007-2022). Patients with suspected gastric cancer were surveyed for sociodemographics and then added to the institutional gastric cancer registry. Thereafter, periodic chart review and phone call was used to obtain investigation results, and survival data, respectively. Only patients with complete histopathology were included in analysis., Results: 138 patients met inclusion criteria (mean age 55.3 years, 68.8% male). Patients typically presented with weight loss (119, 86.2%) and anorexia (92, 66.7%). Blood work (132, 95.7%) and ultrasound (80, 57.9%) were the most common investigations. Most fully staged patients presented with metastatic disease (39, 90.2%). Patients underwent at least one treatment modality (109, 79.0%), and most 54 (49.5%) underwent both chemotherapy and surgery. Patients undergoing surgery usually had resection of their tumor (58, 67.4%). The median time of follow-up was 45.6 months, and 51.4% (71) of patients were dead at that time point., Conclusion: Our gastric cancer database identified that most patients present with advanced disease and are undergoing at least one treatment modality. The next steps include initiatives to strengthen the quality of registry data, identify high-risk patients, and provide timely treatment., (© 2024 Wiley Periodicals LLC.)
Published: 2024
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32. The out-of-pocket cost of breast cancer care in Nigeria: A prospective analysis.

Author: Wuraola FO, Blackman C, Olasehinde O, Aderounmu AA, Adeleye A, Omoyiola OZ, Kingham TP, Fodero RF, Adisa AO, Lumati J, Dare A, Alatise OI, and Knapp G
Abstract: Background: Most patients pay out-of-pocket for cancer care in Nigeria, which can result in a catastrophic health care expenditure (CHE). There is a paucity of economic data on the cost of care and the impact this may have on the household. This study provides a prospective analysis of direct and indirect out-of-pocket costs for breast cancer care at a single tertiary care institution in South West Nigeria., Methods: Consecutive patients undergoing curative intent treatment for a new diagnosis of breast cancer between August 2019 and September 2022 were approached for enrollment. A novel questionnaire was delivered to patients during hospital admission and again during six-month follow-up. Patients self-reported annual household income, capacity-to-pay, and all direct and indirect expenditures associated with access care. A CHE was defined using three commonly used definitions, including total healthcare expenditure that exceeds 40 % of a household's capacity-to-pay, or exceeds the proportion of annual income set at thresholds of 10 % and 25 %., Results: Data were collected from 71 eligible patients with a mean age of 49.5 years (SD 11.26). Sixty-six percent (47/71, 66.2 %) of patients had ≥ Stage III disease at presentation, and 95.8 % received systemic chemotherapy. Only 23.9 % received adjuvant radiotherapy. The mean annual capacity-to-pay for the cohort was $2866.93 (SD $2749.74). The mean cost of care was $5192.77 (SD $4567.71). Out of the 71 patients enrolled in the study, between 56 (78.9 %) and 71 (100 %) experienced a CHE, depending on the included costs (direct +/- indirect) and threshold used. Sixty-six percent of patients had no form of health insurance., Conclusions: Over 70 % of breast cancer patients at a tertiary care facility in Nigeria experience a CHE because of out-of-pocket costs associated with accessing care., Policy Summary: A more effective and accessible health insurance mechanism is required in Nigeria to protect women with breast cancer from the cost of cancer care., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024. Published by Elsevier Ltd.)
Published: 2024
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33. Endoscopic management of postcholecystectomy complications at a Nigerian tertiary health facility.

Author: Alatise OI, Akinyemi PA, Owojuyigbe AO, Ojumu TA, Omisore AD, Aderounmu A, Ekinadese A, and Asombang AW
Subjects: Humans, Male, Female, Middle Aged, Nigeria, Adult, Aged, Cholecystectomy adverse effects, Cholangitis etiology, Cholangitis surgery, Biliary Fistula etiology, Biliary Fistula surgery, Young Adult, Aged, 80 and over, Cholangiopancreatography, Endoscopic Retrograde adverse effects, Postoperative Complications etiology, Postoperative Complications surgery, Tertiary Care Centers
Abstract: Background: Cholecystectomy and common bile duct exploration for biliary stone disease are common hepatobiliary surgeries performed by general surgeons in Nigeria. These procedures can be complicated by injury to the biliary tree or retained stones, requiring repeat surgical intervention. This study presents the experience of using endoscopic retrograde cholangiopancreatography (ERCP) in the management of hepatobiliary surgery complications at the academic referral center of Obafemi Awolowo University Teaching Hospital (OAUTHC) Ile-Ife, Nigeria., Methods: All patients with postcholecystectomy complications referred to the endoscopy unit at OAUTHC from March 2018 to April 2023 were enrolled. Preoperative imaging included a combination of abdominal ultrasound, CT, MRI, magnetic resonance cholangiopancreatography (MRCP), and T-tube cholangiogram. All ERCP procedures were performed under general anesthesia., Results: Seventy-two ERCP procedures were performed on 45 patients referred for postcholecystectomy complications. The most common mode of presentation was ascending cholangitis [16 (35.6%)], followed by persistent biliary fistula [12 (26.7%)]. The overall median duration of symptoms after cholecystectomy was 20 weeks, with a range of 1-162 weeks. The most common postcholecystectomy complication observed was retained stone [16 (35.6%)]. Other postcholecystectomy complications included bile leakage, bile stricture, bile leakage with stricture, and persistent bile leakage from the T-tube in 12 (26.7%), 11 (24.4%), 4 (8.9%), and 2 (4.4%) patients, respectively. Ampullary cannulation during ERCP was successful in all patients (45, 100%). Patients with complete biliary stricture (10/12) required hepaticojejunostomy., Conclusion: Endoscopic management of postcholecystectomy complications was found to be safe and reduce the number of needless surgeries to which such patients are exposed. We recommended prompt referral of such patients for ERCP., (© 2024. The Author(s).)
Published: 2024
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34. Delays in Presentation, Diagnosis, and Treatment Among Patients With GI Cancer in Southwest Nigeria.

Author: Onwuka JU, Wuraola FO, Owoade IA, Ogunyemi YF, Di Bernardo M, Dare AJ, Mohammed TO, Sheikh M, Olasehinde O, Kingham TP, Robbins HA, and Alatise OI
Subjects: Humans, Nigeria epidemiology, Male, Female, Middle Aged, Aged, Adult, Gastrointestinal Neoplasms diagnosis, Gastrointestinal Neoplasms therapy, Gastrointestinal Neoplasms epidemiology, Delayed Diagnosis statistics & numerical data, Time-to-Treatment statistics & numerical data
Abstract: Purpose: The incidence of GI cancers is increasing in sub-Saharan African countries. We described the oncological care pathway and assessed presentation, diagnosis, and treatment intervals and delays among patients with GI cancer who presented to the Obafemi Awolowo University Teaching Hospitals Complex in Ile-Ife, Nigeria., Methods: We analyzed data from 545 patients with GI cancer in the African Research Group for Oncology (ARGO) database. We defined presentation interval as the interval between symptom onset and presentation to tertiary hospital, diagnostic interval as between presentation and diagnosis, and treatment interval as between diagnosis and initiation of treatment. We considered >3 months, >1 month, and >1 month to be presentation, diagnosis, and treatment delays, respectively. We compared lengths of intervals using Mann-Whitney U tests and logistic regression., Results: The most frequent cancer types were pancreatic (32%) and colorectal (28%). Most patients presented at stages III (38%) and IV (30%). The median presentation interval was 84 days (IQR, 56-191), and 49% presented after 3 months or longer. The median diagnosis and treatment intervals were 0 (IQR, 0-8) and 7 (IQR, 0-23) days, respectively. There was no relationship between age, sex, education, or distance to tertiary hospital and presentation delay, but patients with stage III to IV versus I to II had higher odds of presentation delay (odds ratio [OR], 1.68 [95% CI, 1.13 to 2.50]). Among patients with pancreatic cancer, older patients were less likely to have a diagnosis delay (OR, 0.50 [95% CI, 0.25 to 0.98])., Conclusion: About half of patients with GI cancer in Ile-Ife, Nigeria, did not present to tertiary hospitals until more than 90 days after noticing symptoms. Efforts are warranted to improve public knowledge of GI cancer symptoms and to strengthen health systems for prompt diagnosis and referral to specialty care.
Published: 2024
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35. Hepato-pancreato-biliary surgery in West Africa: a timely capacity assessment.

Author: Alatise OI, Yibrehu B, Jackman J, Arije O, Olasehinde O, Keli E, Offei A, Jaiteh L, Aderounmu A, and Kingham PT
Subjects: Humans, Cross-Sectional Studies, Africa, Western, Health Services Accessibility, Biliary Tract Surgical Procedures, Digestive System Surgical Procedures, Health Care Surveys
Abstract: Background: West Africa has among the highest rates of hepato-pancreato-biliary (HPB) malignancies in the world. Although surgery is critical for treatment, the availability of HPB surgery in Africa is unknown. This cross-sectional study investigated the current HPB surgical capacity of West African hospitals., Method: The Surgeons OverSeas Personnel, Infrastructure, Procedure, Equipment, and Supplies (PIPES) survey was modified to include HPB-specific parameters and quantify capacity. The survey was completed by consultant surgeons from West Africa. A PIPES index was calculated, and a higher score corresponded to greater HPB surgical capacity., Results: The HPB PIPES survey was completed by 35 institutions from The Gambia, Ghana, Ivory Coast, and Nigeria. Most institutions (94.2%) were tertiary referral centres; five had an HPB-trained surgeon. The most commonly available procedure was an open cholecystectomy (91.4%), followed by gastric bypass (88.6%). Major hepatic resections (14.3%) and the Whipple procedure (17.1%) were rare. ICU capabilities were present at 88.6% of facilities while interventional radiology was present in 25.7%., Conclusions: This is the first HPB capacity assessment in Africa. This study showed the limited availability of HPB surgery in West Africa. These results can be used for regional quality improvement initiatives and as a baseline for future capacity assessments., (Copyright © 2024 The Author(s). Published by Elsevier Ltd.. All rights reserved.)
Published: 2024
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36. Feasibility, acceptability, and initial efficacy of empathic communication skills training to reduce lung cancer stigma in Nigeria: a pilot study.

Author: Banerjee SC, Asuzu C, Mapayi B, Olunloyo B, Odiaka E, Daramola OB, Gilliland J, Owoade IA, Kingham P, Alatise OI, Fitzgerald G, Kahn R, Olcese C, and Ostroff JS
Subjects: Humans, Nigeria, Pilot Projects, Female, Male, Middle Aged, Adult, Health Personnel education, Health Personnel psychology, Quality of Life, Physician-Patient Relations, Lung Neoplasms psychology, Lung Neoplasms therapy, Empathy, Communication, Feasibility Studies, Social Stigma
Abstract: Effective communication about cancer diagnosis and prognosis in sub-Saharan African oncology settings is often challenged by the cancer-related shame and stigma patients and families experience. Enhancing empathic communication between health care providers, including physicians and nurses, and oncology patients and their families can not only reduce cancer stigma but also improve patient engagement, treatment satisfaction, and quality of life. To reduce lung cancer stigma, we adapted an evidence-based empathic communication skills training intervention to reduce patients' experience of stigma in Nigeria and conducted a pilot study examining the feasibility and acceptability of the empathic communication skills training. Thirty health care providers, recruited from University College Hospital, Ibadan, and Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, participated in a 2.25-hour didactic and experiential training session. Participant surveys were completed before and after the training. Overall, participants reported highly favorable training evaluations, with at least 85% of health care providers agreeing or strongly agreeing to survey items assessing training relevance, novelty, clarity, and facilitator effectiveness. Self-efficacy to communicate empathically with patients increased significantly from before-training (Mean [SD] = 3.93 [0.28]) to after-training (Mean [SD] = 4.55 [0.15]; t29 = 3.51, P < .05). Significant improvements were observed in health care provider reports of empathy toward lung cancer survivors and attitude toward lung cancer care as well as significant reductions in lung cancer blame were noted. The empathic communication skills training was feasible, well received by oncology clinicians in Nigeria, and demonstrated improvements in health care provider-reported outcomes from before- to after-training., (© The Author(s) 2024. Published by Oxford University Press. All rights reserved. For permissions, please email: journals.permissions@oup.com.)
Published: 2024
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37. Assessing safe chemotherapy needs and practices in Ile-Ife, Nigeria: a multi-disciplinary quality improvement project.

Author: Koranteng L, Wuraola FO, Thom B, Lynch K, Adesuji A, Bifarin M, Randolph K, Olatunde O, Olatunji F, Okunola S, Makut P, Olumide O, Johnson L, Ogundipe T, Adeyemo A, Kingham TP, Barton-Burke M, and Alatise OI
Subjects: Humans, Nigeria, Surveys and Questionnaires, Health Personnel education, Neoplasms drug therapy, Quality Improvement, Antineoplastic Agents therapeutic use, Needs Assessment
Abstract: Objective: To explore the gaps in the safe handling, administration, preparation and disposal of chemotherapy agents in low and middle-income countries., Design: Two surveys comprising a needs assessment survey and an American Cancer Society (ACS) ChemoSafe Facility Assessment., Setting: 2019 African Research Group for Oncology Symposium in South-West Nigeria (needs assessment) and the 2021 virtual engagement (ChemoSafe Assessment)., Participants: Health professionals (n=50 of 98) from multiple institutions across Nigeria (needs assessment survey) and a designated task force of health professionals (n=10) from one teaching hospital in Southwest Nigeria(ChemoSafe Facility Assessment)., Results: In 2019, 75% of survey respondents (n=50) reported a lack of training resources for safe handling of chemotherapy. Additionally, 61% felt dissatisfaction with assessment practices for preparing and administering chemotherapy. ChemoSafe is a programme developed by the ACS to assess the ability of a facility to handle hazardous drugs. The 2021 ACS ChemoSafe survey administered at one teaching hospital indicated several areas for improvement to promote concordance with international standards for safe handling. Thirty-three (19.5%) items received a 'Yes' response (ie, met compliance with international standards)., Conclusion: There is a need for the implementation of training resources for handling, administering and disposing of chemotherapy at sites across Nigeria. Strategies to identify and prioritise areas of need must be implemented in the context of available resources., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)
Published: 2024
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38. Updates in global oncology: Advancements and future directions.

Author: Jackman JM, Yibrehu B, Doyle A, Alatise OI, Wuraola FO, Olasehinde O, and Peter Kingham T
Subjects: Humans, Developing Countries, Global Health, Medical Oncology trends, Neoplasms therapy
Abstract: Globally, cancer is the second leading cause of death, and low- and middle-income countries bear most of the disease burden. While cancer is increasingly recognized as a major global health issue, more work remains. Understanding the status of global cancer care will shape the next steps in ensuring equitable global access to cancer care. This article highlights ongoing initiatives in global oncology and the next steps in advancing the field., (© 2024 Wiley Periodicals LLC.)
Published: 2024
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39. Gastroenterology training in Africa: an assessment of curriculum and perception.

Author: Tazinkeng N, Monteiro JFG, Thomson SR, David Y, Madkour A, Katsidzira L, Ogutu E, Afihene M, Desalegn H, Chukwudike ES, Adekunle AD, Alatise OI, Oyeleke G, and Asombang AW
Subjects: Humans, Curriculum, Education, Medical, Graduate, Gastrointestinal Tract, Perception, Gastroenterology education
Abstract: Competing Interests: We declare no competing interests. Editorial note: The Lancet Group takes a neutral position with respect to territorial claims in published maps.
Published: 2024
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40. Knowledge, Attitudes, and Practice of chemotherapy management among nurses at Obafemi Awolowo University Teaching Hospital, Ile-Ife, Nigeria.

Author: Winn A, Afolabi EK, Bifarin M, Avwioro T, Alatise OI, Kingham PT, and Barton-Burke M
Abstract: Objective: Cancer is a leading global health challenge with increasing morbidity and mortality. In Nigeria, cancer leads to over 100,000 new cases and 70,000 deaths annually. In resource-constrained countries such as Nigeria, registered nurses (RNs) that provide oncology care lack specialty education in oncology nursing care. Nigerian nurses are the largest portion of the healthcare workforce and can play a key role in improving oncology care. This study aimed to assess RNs' knowledge, willingness, and ability to perform tasks related to chemotherapy administration and symptom management, assess current practices, identify available resources, and identify gaps in RNs' knowledge of oncology care., Methods: A descriptive, correlational, Institutional Review Board (IRB)-approved study was conducted using a modified Knowledge, Attitudes, and Practice questionnaire and a questionnaire adapted from the Organizational Readiness to Change Assessment. The principle investigator (PI) adopted the role as an observer to witness an accurate picture of nursing practice at Obafemi Awolowo University Teaching Hospital (OAUTH) and identify gaps in education and knowledge around oncology nursing care. A Research Electronic Data Capture database was developed using paper-formatted questionnaires that were exported to Excel for statistical analysis., Results: This study supports findings from literature highlighting that nurses working in oncology units lack specialized oncology training, which leads to gaps in knowledge and practice. Questionnaire responses and clinical observations at OAUTH support RNs' willingness to learn skills related to oncology nursing care. Nurses are self-aware that they have more to learn about how to prepare and administer chemotherapy, and 90% of nurses reported that an ongoing chemotherapy training program would be helpful at OAUTH., Conclusions: By identifying gaps in education and knowledge about oncology care and by identifying available resources, an oncology training program could be developed for nurses working in oncology units at OAUTH and other Nigerian hospitals, leading to improved oncology patient care and outcomes., (© 2024 The Authors.)
Published: 2023
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41. Insulinoma Presenting as Seizures: Challenges of Managing a Rare Disease in a Resource-challenged Setting.

Author: Soyoye DO, Atolani SA, Adetunji TA, and Alatise OI
Abstract: Insulinomas are functioning pancreatic neuroendocrine tumors (NETs). They secrete insulin, and hence, present with hypoglycemia. We report a case of insulinoma in a 16-year-old girl presenting as seizures. She was initially managed at a private clinic and later commenced on carbamazepine when convulsion persisted. Convulsions were generalized, associated with dizziness and altered sensorium, often preceded by hunger and physical exertion, but relieved by the intake of carbonated drinks and fruit juice. She was referred to the neurology clinic when seizures persisted, despite the use of anticonvulsant. She was later referred to the endocrine clinic on suspicion of insulinoma when her random blood glucose (BG) was found to be low during an episode of convulsion. She was moderately obese but other examination findings were normal. She had a 72-hour prolonged fast, which was terminated when hypoglycemia (BG = 2.2 mmol/L) ensued after 12 hours, with elevated serum insulin and C-peptide. Abdominal magnetic resonance imaging scan showed a pancreatic tumor suggestive of insulinoma. She subsequently had distal pancreatectomy performed with complete resolution of symptoms. Unusual presentation of insulinoma may delay diagnosis, resulting in wastage of resources with increased morbidities and mortality., (© The Author(s) 2023. Published by Oxford University Press on behalf of the Endocrine Society.)
Published: 2023
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42. The African Research Group for Oncology: A decade fostering colorectal cancer research in Nigeria.

Author: Dare AJ, Olatoke SA, Okereke CE, Abdulkareem FB, Adeyeye A, Badejo O, Du M, Fayenuwo OJ, Gali BM, Kahn R, Knapp G, Ntiamoah P, Olcese C, Oludara MA, Omisore A, Omoyiola OZ, Owoade IA, Brennan MF, Kingham TP, and Alatise OI
Subjects: Humans, Nigeria epidemiology, Health Personnel, Colorectal Neoplasms therapy
Abstract: The African Research Group for Oncology (ARGO) was formed in 2013 to undertake methodologically rigorous cancer research in Nigeria, and to strengthen cancer research capacity in the country through training and mentorship of physicians, scientists, and other healthcare workers. Here, we describe how ARGO's work in colorectal cancer (CRC) has evolved over the past decade. This includes the consortium's scientific contributions to the understanding of CRC in Nigeria and globally and its research capacity-building program., (© 2023 Wiley Periodicals LLC.)
Published: 2023
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43. Immediate lymph node extraction improves retrieval rate following axillary lymph node dissection: an effective approach to improving guideline-concordant breast cancer care in Nigeria.

Author: Olasehinde O, Bernardo MD, Komolafe AO, Omoyiola OZ, Wuraola FO, Betiku O, Ogunrinde O, Aderounmu A, Olaofe OO, Adefidipe A, Ewoye E, Mohammed TO, Oyeneye F, Adisa AO, Alatise OI, and Omoniyi-Esan G
Abstract: Background: Axillary lymph node staging is essential for making therapeutic decisions and for prognostication. A minimum of ten lymph nodes is recommended for accurate staging. This study describes the process and outcomes of an audit cycle that resulted in a novel intervention instituted to improve concordance with guidelines., Methods: The study began with a retrospective audit of lymph node retrieval following axillary lymph node dissection (ALND). Subsequent phases evaluated the efficacy of immediate lymph node extraction before fixation by comparing the mean number of lymph nodes and the proportion of guideline-concordant cases to retrospective data and concurrent cases without the intervention., Results: The mean number of lymph nodes retrieved in the retrospective phase was 5.2, which is less than the recommended threshold. The intervention resulted in a significant increase in lymph node retrieval over the baseline rate (13.7 versus 5.2, p = 0.026). There was also a significantly higher number of lymph nodes following the intervention compared to concurrent cases managed during the same period without the intervention (13.7 versus 7.9, p = 0.004). The concordance rate was 89% in the intervention group compared to 47% in the non-intervention group ( p = 0.019). There was no significant difference when the intervention was administered by either surgeons or pathologists (13.5 versus 12, p = 0.25)., Conclusion: Immediate extraction of lymph nodes resulted in significant improvement of concordant lymph node retrieval in all phases of the study. We recommend that this practice be validated in larger cohorts for possible recommendation as an effective way of improving lymph node retrieval following ALND., Competing Interests: The authors have no conflict of interest to declare., (© the authors; licensee ecancermedicalscience.)
Published: 2023
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44. Population-Level Access to Breast Cancer Early Detection and Diagnosis in Nigeria.

Author: Omisore AD, Sutton EJ, Akinola RA, Towoju AG, Akhigbe A, Ebubedike UR, Tansley G, Olasehinde O, Goyal A, Akinde AO, Alatise OI, Mango VL, Kingham TP, and Knapp GC
Subjects: Humans, Female, Early Detection of Cancer, Nigeria epidemiology, Health Services Accessibility, Mammography, Breast Neoplasms diagnostic imaging, Breast Neoplasms epidemiology
Abstract: Purpose: Mammography, breast ultrasound (US), and US-guided breast biopsy are essential services for breast cancer early detection and diagnosis. This study undertook a comprehensive evaluation to determine population-level access to these services for breast cancer early detection and diagnosis in Nigeria using a previously validated geographic information system (GIS) model., Methods: A comprehensive list of public and private facilities offering mammography, breast US, and US-guided breast biopsy was compiled using publicly available facility data and a survey administered nationally to Nigerian radiologists. All facilities were geolocated. A cost-distance model using open-source population density (GeoData Institute) and road network data (OpenStreetMap) was used to estimate population-level travel time to the nearest facility for mammography, breast US, and US-guided biopsy using GIS software (ArcMAP)., Results: In total, 1,336 facilities in Nigeria provide breast US, of which 47.8% (639 of 1,336) are public facilities, and 218 provide mammography, of which 45.4% (99 of 218) are public facilities. Of the facilities that provide breast US, only 2.5% (33 of 1,336) also provide US-guided breast biopsy. At the national level, 83.1% have access to either US or mammography and 61.7% have access to US-guided breast biopsy within 120 minutes of a continuous one-way travel. There are differences in access to mammography (64.8% v 80.6% with access at 120 minutes) and US-guided breast biopsy (49.0% v 77.1% with access at 120 minutes) between the northern and southern Nigeria and between geopolitical zones., Conclusion: To our knowledge, this is the first comprehensive evaluation of breast cancer detection and diagnostic services in Nigeria, which demonstrates geospatial inequalities in access to mammography and US-guided biopsy. Targeted investment is needed to improve access to these essential cancer care services in the northern region and the North East geopolitical zone.
Published: 2023
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45. Clinicopathologic Profile and Psychosocial Experiences of Nigerian Breast Cancer Survivors.

Author: Wuraola FO, Olasehinde O, Di Bernardo M, Aderounmu AA, Adisa AO, Omoyiola OZ, Omisore AD, Kingham TP, Mango V, and Alatise OI
Subjects: Humans, Female, Survivors psychology, Social Support, Adaptation, Psychological, Cancer Survivors, Breast Neoplasms therapy, Breast Neoplasms diagnosis
Abstract: Purpose: Breast cancer survivors are a distinct category of patients with unique characteristics and needs. The population of survivors is expected to increase, given the rising incidence of breast cancer in Nigeria, and the improvements in breast cancer outcomes. This study evaluated the clinicopathologic characteristics and the psychosocial experiences of a cohort of Nigerian breast cancer survivors., Methods: From an institutional breast cancer database, patients managed between January 2010 and December 2016 were evaluated. Clinicopathologic characteristics, treatment details, and survival estimates were assessed. These were compared with nonsurvivors managed during the same period. Survivors were defined as those who have been alive for at least 5 years from the date of presentation. Qualitatively, a purposive sample of 20 survivors was evaluated using one-on-one in-depth interviews to assess their experiences and coping mechanisms after treatment., Results: Of the 355 patients in the database during the study period, there were 163 survivors (45.9%), while 192 (54.1%) died. Age, stage at presentation, tumor size, and receipt of multiple treatment modalities were significantly associated with survival. Five themes were identified in qualitative analysis: initial reaction to the diagnosis, experiences during treatment, social support, coping strategies, and advocacy. Strong family support and spirituality were prominent coping strategies identified in this cohort., Conclusion: Despite obvious infrastructural and manpower limitations, Nigerian patients who present early and receive multimodal therapy and different breast cancer treatments have better odds of survival. Survivors have some unmet psychosocial and physical needs requiring intervention.
Published: 2023
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46. Africa Guidelines for Hepatocellular Carcinoma Buildup Process.

Author: Abou-Alfa GK, Afihene M, Capanu M, Li Y, Chou JF, Asombang A, Alatise OI, Bounedjar A, Cunha L, Mekonnen HD, Diop PS, Elwakil R, Ali MM, Ndlovu N, Ndumbalo J, Makondi PT, Tzeuton C, Biachi de Castria T, Agyei-Nkansah AA, Balogun F, Bougouma A, Atipo Ibara BI, Jonas E, Kimani S, Kingham P, Kurrimbukus R, Hammad N, Fouad M, El Baghdady N, Servais Albert Fiacre EB, Sewram V, Spearman CW, Yang JD, Roberts LR, and Abdelaziz AO
Subjects: Humans, Sorafenib therapeutic use, Africa epidemiology, Carcinoma, Hepatocellular therapy, Carcinoma, Hepatocellular drug therapy, Liver Neoplasms therapy, Liver Neoplasms drug therapy, Hepatitis B
Abstract: Purpose: Hepatocellular carcinoma (HCC), the fourth most common cancer in Africa, has a dismal overall survival of only 3 months like in sub-Saharan Africa. This is affected by the low gross domestic product and human development index, absence of coherent guidelines, and other factors., Methods: An open forum for HCC-experienced health care workers from Africa and the rest of the world was held in October 2021. Participants completed a survey to help assess the real-life access to screening, diagnoses, and treatment in the North and Southern Africa (NS), East and West Africa (EW), Central Africa (C), and the rest of the world., Results: Of 461 participants from all relevant subspecialties, 372 were from Africa. Most African participants provided hepatitis B vaccination and treatment for hepatitis B and C. More than half of the participants use serum alpha-fetoprotein and ultrasound for surveillance. Only 20% reported using image-guided diagnostic liver biopsy. The Barcelona Clinic Liver Cancer is the most used staging system (52%). Liver transplant is available for only 28% of NS and 3% EW. C reported a significantly lower availability of resection. Availability of local therapy ranged from 94% in NS to 62% in C. Sorafenib is the most commonly used systemic therapy (66%). Only 12.9% reported access to other medications including immune checkpoint inhibitors. Besides 42% access to regorafenib in NS, second-line treatments were not provided., Conclusion: Similarities and differences in the care for patients with HCC in Africa are reported. This reconfirms the major gaps in access and availability especially in C and marginally less so in EW. This is a call for concerted multidisciplinary efforts to achieve and sustain a reduction in incidence and mortality from HCC in Africa.
Published: 2023
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47. Improving access to breast cancer screening and treatment in Nigeria: The triple mobile assessment and patient navigation model (NCT05321823): A study protocol.

Author: Omisore AD, Olasehinde O, Wuraola FO, Sutton EJ, Sevilimedu V, Omoyiola OZ, Romanoff A, Owoade IA, Olaitan AF, Kingham TP, Alatise OI, and Mango VL
Subjects: Humans, Female, Early Detection of Cancer, Nigeria epidemiology, Local Government, Randomized Controlled Trials as Topic, Breast Neoplasms diagnostic imaging, Breast Neoplasms epidemiology, Patient Navigation
Abstract: Background: In Nigeria, breast cancer incidence is rising, late presentation is common, and outcomes are poor. Patient-related factors such as lack of awareness and misperceptions in addition to health system deficiencies such as lack of a clearly defined framework for breast cancer screening and referral are some of the major drivers of this poor outlook. Guidelines for breast cancer screening in high-income countries have limited applicability in low-middle-income countries, hence the need for innovative, resource-compatible strategies to combat the negative trend. This manuscript presents our study protocol which aims to evaluate the impact of a novel breast cancer early detection program developed to address delayed presentation and lack of access to diagnostic and treatment facilities in South-West Nigeria. This entails the use of mobile technology (innovative handheld iBreast Exam [iBE] device, mobile breast ultrasound, and mobile mammography) and patient navigation as interventions at the community level., Methods: The study (ClinicalTrials.gov identifier: NCT05321823) will adopt a randomized two group clinical trial design with one local government area (LGA) serving as an intervention arm and another serving as the control. Both LGAs will receive breast cancer awareness education but only one will receive the interventions. In the intervention arm, asymptomatic (40-70 years) and symptomatic (30-70 years) women will be invited for breast evaluation which will be performed by trained Community Health Nurses using Clinical Breast Exam (CBE), and iBE. Those with positive findings will proceed to imaging using mobile mammography and ultrasound brought to the LGA every month. Symptomatic women with negative findings on CBE and iBE will be scheduled for repeat clinical evaluation on a short-term basis (one month). The Radiologist will obtain core needle biopsies as indicated and transfer them for prompt pathological assessment. Women presenting to the Primary Healthcare Centers in the control LGA will be referred directly to Obafemi Awolowo University Teaching Hospitals Complex as per the current standard of care. Records of all breast cancer cases seen in the two LGAs during the study period will be obtained. The program metrics will include screening participation rate, cancer detection rate, stage at diagnosis, and timeline from detection to initiation of treatment. The stage at diagnosis and timeline from detection to treatment compared between the two LGAs will be used to assess the impact of the intervention. The study is proposed for 2 years; however, a descriptive analysis will be carried out at 1.5 years to evaluate the retention of the study participants., Study Significance: It is anticipated that this study will provide vital data to support wider breast cancer screening efforts in Nigeria., Competing Interests: The authors have declared that no competing interests exist., (Copyright: This is an open access article, free of all copyright, and may be freely reproduced, distributed, transmitted, modified, built upon, or otherwise used by anyone for any lawful purpose. The work is made available under the Creative Commons CC0 public domain dedication.)
Published: 2023
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48. Validating a semi-quantitative food frequency questionnaire to assess regional diet in a study of cancer in South West Nigeria.

Author: Samson ML, Peeri NC, Alatise OI, O'Connell K, Sharma A, Ogunleye SG, Aderounmu AA, Olasehinde O, Ogundokun AO, Ikujenlola AV, Fatusi A, Kingham TP, and Du M
Subjects: Humans, Nigeria epidemiology, Surveys and Questionnaires, Diet Surveys, Reproducibility of Results, Diet, Carbohydrates, Diet Records, Energy Intake, Neoplasms epidemiology
Abstract: Purpose: Cancer burden is rising rapidly in Nigeria, the most populous country in sub-Saharan Africa; this trend may in part be attributable to diet. We developed and validated a semi-quantitative food frequency questionnaire (FFQ) to assess regional diet in Nigeria., Methods: We recruited 68 adult participants from rural and urban settings in South West Nigeria. We developed an FFQ administered at baseline and assessed its validity using 3 dietary recalls (baseline, 7 days post baseline, 3 months post baseline). We calculated Spearman's rank correlation coefficients and energy-adjusted de-attenuated correlation coefficients for food items and macronutrients. We evaluated cross-classification using quartiles of macronutrient intake., Results: Energy-adjusted de-attenuated food item correlations between the FFQ and dietary recalls ranged from -0.08 (smoked beef/goat) to 0.73 (fried snacks) for the average intake from the first 2 recalls (2DR) and from -0.05 (smoked beef/goat) to 0.75 (smoked fish) for the average of all 3 recalls (3DR). Macronutrient correlations ranged from 0.15 (fat) to 0.37 (fiber) for the 2DR and from 0.08 (fat) to 0.41 (carbohydrates) for the 3DR. The percent of participants classified in the same quartile ranged from 16.4% (fat) to 32.8% (fiber, protein) for the 2DR and from 25.6% (fat) to 34.9% (carbohydrates) for the 3DR. Agreement improved when including adjacent quartiles, from 65.5% (carbohydrates) to 70.5% (fat, fiber) for the 2DR and from 62.8% (protein) to 76.8% (carbohydrate) for the 3DR., Conclusion: Our semi-quantitative FFQ was reasonably valid for ranking intake of certain foods and macronutrients in adults in South West Nigeria., (© 2023. The Author(s), under exclusive licence to Springer Nature Switzerland AG.)
Published: 2023
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49. Surgery: a crucial ally for universal palliative care access.

Author: Rosa WE, Lumati JS, Alatise OI, Namisango E, Bogale N, Pérez-Cruz PE, Rajagopal MR, Taylor L, and Kingham TP
Subjects: Humans, Palliative Care, Health Services Accessibility
Abstract: Competing Interests: WER received grants from Cambia Health Foundation, Robert Wood Johnson Foundation, and Rita & Alex Hillman Foundation. All other authors declare no competing interests.
Published: 2023
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50. Breast cancer in elderly patients: a clinicopathological review of a Nigerian database.

Author: Wuraola FO, Olasehinde O, Di Bernardo M, Akinkuolie AA, Adisa AO, Aderounmu AA, Mohammed TO, Omoyiola OZ, Kingham TP, and Alatise OI
Abstract: Background: Breast cancer in the elderly population has not been evaluated in the Nigerian context. With the rising incidence of breast cancer and the changing demographics, it is likely that an increasing number of elderly patients will be managed in the coming years in Nigeria. This review describes the clinicopathological profile of elderly patients with breast cancer in a Nigerian database., Method: From a prospective institutional database, elderly patients (65 years and above) managed for breast cancer over a 9-year period were reviewed. Details of their socio-demographic characteristics, patterns of presentation, pathology, treatment and outcome were obtained and analysed., Results: Of the 607 patients managed during the study period, there were 87 older patients accounting for 14.3% of the total. There was a progressive rise in the number of patients with breast cancer towards the latter part of the study. Expectedly, they were all post-menopausal, with their ages ranging from 65 to 92 years, with a mean of 71 ± 6.58 years. Systemic hypertension was the commonest co-morbidity (29.8%). The mean tumour size at presentation was 10 cm, with the majority presenting with stage 3 disease. Invasive ductal carcinoma was the predominant histological type 83 (95.4%); 44.4% of those who had immunohistochemistry were oestrogen receptor-positive. Approximately half underwent mastectomy (52.8%), 63 (72.4%) had chemotherapy, 8 (44.4%) had hormonal therapy and only 6 (6.9%) had combined multimodal therapy in addition to surgery. Overall 5-year survival was 42.1%., Conclusion: The pattern of presentation and outcomes of care in this elderly cohort is similar to the general population. Early presentation and use of multimodal treatment is still the mainstay of survival., Competing Interests: The authors declare no conflicts of interest., (© the authors; licensee ecancermedicalscience.)
Published: 2022
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