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1. Prevalence of high-risk human papillomavirus genotypes in outpatient Malian women living with HIV: a pilot study

Author

Ban Traore, Yaya Kassogue, Brehima Diakite, Fousseyni Diarra, Kadidiatou Cisse, Oumar Kassogue, Modibo Diarra, Aissata Coulibaly, Bourama Coulibaly, Hama Diallo, Zoumana Diarra, Madani Ly, Aminata Maiga, Sidi Boula Sissoko, Adama Seydou Sissoko, Cheick Bougadari Traore, Bakarou Kamate, Ibrahima Teguete, Sekou Bah, Guimogo Dolo, Demirkan Besim Gursel, Jane Holl, Lifang Hou, and Mamoudou Maiga

Subjects
Self-sampling, WLWHIV, Hr-HPV, Genotypes, Mali, Infectious and parasitic diseases, RC109-216
Abstract

Abstract Introduction Long-term exposure to high-risk human papillomavirus (Hr-HPV) is a well-known necessary condition for development of cervical cancer. The aim of this study is to screen for Hr-HPV using vaginal self-sampling, which is a more effective approach to improve women’s adherence and increase screening rates. Methods This pilot study included a total of 100 Women living with HIV (WLWHIV), recruited from the Center for Listening, Care, Animation, and Counseling of People Living with HIV in Bamako. Hr-HPV genotyping was performed on Self-collected samples using the Cepheid GeneXpert instrument. Results The median age of WLWHIV was 44 (interquartile range [IQR], 37–50) years. Approximately 92% of the study participants preferred self-sampling at the clinic, and 90% opted to receive result notifications via mobile phone contact. The overall prevalence of Hr-HPV among study participants was 42.6%, and the most frequent Hr-HPV sub-types observed were HPV18/45 (19.1%), HPV31/35/33/52/58 (13.8%), and HPV39/68/56/66 (12.8%), followed by HPV16 (5.3%), and HPV51/59 (5.3%). WLWHIV under 35 years of age had a higher frequency of Hr-HPV compared to their older counterparts, with rates of 30% versus 11.1% (p = 0.03). The duration of antiretroviral treatment showed an inverse association with Hr-HPV negativity, with patients on treatment for 15 (IQR, 10–18) years versus 12 (IQR = 7–14) years for Hr-HPV positive patients (95% CI [1.2–5.8], t = 3.04, p = 0.003). WLWHIV with baseline CD4 T-Cell counts below 200 exhibited a higher frequency of Hr-HPV compared to those with baseline CD4 T-Cell counts above 200 (17.9% versus 1.9%, p = 0.009). However, other demographics and clinical factors, such as marital status, age of sexual debut, parity, education, history of abortion, history of preeclampsia, and cesarean delivery, did not influence the distribution of Hr-HPV genotypes. Conclusion Our findings indicate that WLWHIV under the age of 35 years old exhibited the highest prevalence of Hr-HPV infection, with HPV18/45 being the most prevalent subtype. Additionally, WLWHIV with baseline CD4 T-Cell counts below 200 showed the highest infection rates.

Published
2024
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2. Clinicopathological discrepancies in the diagnoses of childhood causes of death in the CHAMPS network: An analysis of antemortem diagnostic inaccuracies

Author

Khatia Munguambe, Quique Bassat, Robert F Breiman, Mahbubur Rahman, Sibone Mocumbi, Cynthia G Whitney, Amy Wise, Shams El Arifeen, Meerjady Sabrina Flora, Soter Ameh, Emily S Gurley, Mustafizur Rahman, Ariel Nhacolo, Carla Carrilho, Cheick Bougadari Traore, Lucy Liu, Inacio Mandomando, Clara Menendez, Chris A Rees, Janet Agaya, Jane Juma, Tadesse Gure, George Aol, Hennie Lombaard, Ziyaad Dangor, Shabir Madhi, James Bunn, Samba O Sow, Dickson Gethi, Sanwarul Bari, Jeffrey P Koplan, Natalia Rakislova, Fabiola Fernandes, Tacilta Nhampossa, Maria Maixenchs, Mohammed Kamal, Nega Assefa, Joseph Oundo, Lola Madrid, Tahmina Shirin, Nelesh P Govender, Addisu Alemu, Hailemariam Legesse, Uma U Onwuchekwa, Awa Traore, Portia C Mutevedzi, Victor Akelo, Sammy Khagayi, Dickens Onyango, Richard Omore, Yasmin Adam, Peter Otieno, Margaret Mannah, Vicky Baillie, Karen L Kotloff, John Blevins, Milagritos D Tapia, Rima Koka, Mohammad Zahid Hossain, Dickens Kowuor, Tom Sesay, James Squire, Francis Moses, Haleluya Leulseged, Christine Bethencourt, Kitiezo Aggrey Igunza, Ikechukwu U Ogbuanu, Andrew Moseray, Ima-Abasi Bassey, Afruna Rahman, Muntasir Alam, Yasir Y Abdullahi, Nana Kourouma, Seydou Sissoko, Rosauro Varo, Sana Mahtab, Martin Hale, Jeanie du Toit, Zachary J Madewell, Dianna M Blau, Roosecelis B Martines, Fatima Solomon, Gillian Sorour, Jeannette Wadula, Karen Petersen, Peter J Swart, Sanjay G Lala, Sithembiso Velaphi, Richard Chawana, Ashleigh Fritz, Nellie Myburgh, Pedzisai Ndagurwa, Cleopas Hwinya, Shahana Parveen, ASM Nawshad Uddin Ahmed, Mahbubul Hoque, Saria Tasnim, Ferdousi Islam, Farida Ariuman, Mohammad Mosiur Rahman, Ferdousi Begum K Zaman, Dilruba Ahmed, Alexander M Ibrahim, Fikremelekot Temesgen, Melisachew Mulatu Yeshi, Mahlet Abayneh Gizaw, Stian MS Orlien, Solomon Ali, Peter Nyamthimba Onyango, Richard Oliech, Joyce Akinyi Were, Thomas Misore, Harun Owuor, Christopher Muga, Bernard Oluoch, Christine Ochola, Sharon M Tennant, Carol L Greene, Ashka Mehta, J Kristie Johnson, Brigitte Gaume, Adama Mamby Keita, Karen D Fairchild, Diakaridia Kone, Diakaridia Sidibe, Doh Sanogo, Kounandji Diarra, Tiéman Diarra, Kiranpreet Chawla, Zara Manhique, Fatmata Bintu Tarawally, Martin Seppeh, Ronald Mash, Julius Ojulong, Babatunde Duduyemi, Alim Swaray-Deen, Joseph Bangura Amara Jambai, Okokon Ita, Cornell Chukwuegbo, Sulaiman Sannoh, Princewill Nwajiobi, Erick Kaluma, Oluseyi Balogun, Carrie Jo Cain, Solomon Samura, Samuel Pratt, Joseph Kamanda Sesay, Osman Kaykay, Binyam Halu, Francis Smart, Sartie Kenneh, Jana Ritter, Tais Wilson, Jonas Winchell, Jakob Witherbee, Navit T Salzberg, Margaret Basket, Ashutosh Wadhwa, Kyu Han Lee, Roosecelis Martines, Shamta Warang, Maureen Diaz, Jessica Waller, Shailesh Nair, Courtney Bursuc, Kristin LaHatte, Sarah Raymer, Solveig Argeseanu, Kurt Vyas, and Manu Bhandari

Subjects
Pediatrics, RJ1-570
Abstract

Introduction Determining aetiology of severe illness can be difficult, especially in settings with limited diagnostic resources, yet critical for providing life-saving care. Our objective was to describe the accuracy of antemortem clinical diagnoses in young children in high-mortality settings, compared with results of specific postmortem diagnoses obtained from Child Health and Mortality Prevention Surveillance (CHAMPS).Methods We analysed data collected during 2016–2022 from seven sites in Africa and South Asia. We compared antemortem clinical diagnoses from clinical records to a reference standard of postmortem diagnoses determined by expert panels at each site who reviewed the results of histopathological and microbiological testing of tissue, blood, and cerebrospinal fluid. We calculated test characteristics and 95% CIs of antemortem clinical diagnostic accuracy for the 10 most common causes of death. We classified diagnostic discrepancies as major and minor, per Goldman criteria later modified by Battle.Results CHAMPS enrolled 1454 deceased young children aged 1–59 months during the study period; 881 had available clinical records and were analysed. The median age at death was 11 months (IQR 4–21 months) and 47.3% (n=417) were female. We identified a clinicopathological discrepancy in 39.5% (n=348) of deaths; 82.3% of diagnostic errors were major. The sensitivity of clinician antemortem diagnosis ranged from 26% (95% CI 14.6% to 40.3%) for non-infectious respiratory diseases (eg, aspiration pneumonia, interstitial lung disease, etc) to 82.2% (95% CI 72.7% to 89.5%) for diarrhoeal diseases. Antemortem clinical diagnostic specificity ranged from 75.2% (95% CI 72.1% to 78.2%) for diarrhoeal diseases to 99.0% (95% CI 98.1% to 99.6%) for HIV.Conclusions Antemortem clinical diagnostic errors were common for young children who died in areas with high childhood mortality rates. To further reduce childhood mortality in resource-limited settings, there is an urgent need to improve antemortem diagnostic capability through advances in the availability of diagnostic testing and clinical skills.

Published
2024
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3. Provider adherence to clinical care recommendations for infants and children who died in seven low- and middle-income countries in the Child Health and Mortality Prevention Surveillance (CHAMPS) networkResearch in context

Author

Chris A. Rees, Kitiezo Aggrey Igunza, Zachary J. Madewell, Victor Akelo, Dickens Onyango, Shams El Arifeen, Emily S. Gurley, Mohammad Zahid Hossain, Afruna Rahman, Muntasir Alam, J. Anthony G. Scott, Nega Assefa, Lola Madrid, Anteneh Belachew, Haleluya Leulseged, Karen L. Kotloff, Samba O. Sow, Milagritos D. Tapia, Adama Mamby Keita, Diakaridia Sidibe, Antonio Sitoe, Rosauro Varo, Sara Ajanovic, Quique Bassat, Inácio Mandomando, Beth A. Tippett Barr, Ikechukwu Ogbuanu, Carrie Jo Cain, Ima-Abasi Bassey, Ronita Luke, Khadija Gassama, Shabir Madhi, Ziyaad Dangor, Sana Mahtab, Sithembiso Velaphi, Jeanie du Toit, Portia C. Mutevedzi, Dianna M. Blau, Robert F. Breiman, Cynthia G. Whitney, Fatima Solomon, Gillian Sorour, Hennie Lombaard, Jeannette Wadula, Karen Petersen, Martin Hale, Nelesh P. Govender, Peter J. Swart, Sanjay G. Lala, Richard Chawana, Yasmin Adam, Amy Wise, Ashleigh Fritz, Nellie Myburgh, Pedzisai Ndagurwa, Cleopas Hwinya, Sanwarul Bari, Shahana Parveen, Mohammed Kamal, A.S.M. Nawshad Uddin Ahmed, Mahbubul Hoque, Saria Tasnim, Ferdousi Islam, Farida Ariuman, Mohammad Mosiur Rahman, Ferdousi Begum, K. Zaman, Mustafizur Rahman, Dilruba Ahmed, Meerjady Sabrina Flora, Tahmina Shirin, Mahbubur Rahman, Joseph Oundo, Alexander M. Ibrahim, Fikremelekot Temesgen, Tadesse Gure, Addisu Alemu, Melisachew Mulatu Yeshi, Mahlet Abayneh Gizaw, Stian Orlien, Solomon Ali, Peter Otieno, Peter Nyamthimba Onyango, Janet Agaya, Richard Oliech, Joyce Akinyi Were, Dickson Gethi, Sammy Khagayi, George Aol, Thomas Misore, Harun Owuor, Christopher Mugah, Bernard Oluoch, Christine Ochola, Sharon M. Tennant, Carol L. Greene, Ashka Mehta, J. Kristie Johnson, Brigitte Gaume, Rima Koka, Karen D. Fairchild, Diakaridia Kone, Doh Sanogo, Uma U. Onwuchekwa, Nana Kourouma, Seydou Sissoko, Cheick Bougadari Traore, Jane Juma, Kounandji Diarra, Awa Traore, Tiéman Diarra, Kiranpreet Chawla, Tacilta Nhampossa, Zara Manhique, Sibone Mocumbi, Clara Menéndez, Khátia Munguambe, Ariel Nhacolo, Maria Maixenchs, Andrew Moseray, Fatmata Bintu Tarawally, Martin Seppeh, Ronald Mash, Julius Ojulong, Babatunde Duduyemi, James Bunn, Alim Swaray-Deen, Joseph Bangura, Amara Jambai, Margaret Mannah, Okokon Ita, Cornell Chukwuegbo, Sulaiman Sannoh, Princewill Nwajiobi, Dickens Kowuor, Erick Kaluma, Oluseyi Balogun, Solomon Samura, Samuel Pratt, Francis Moses, Tom Sesay, James Squire, Joseph Kamanda Sesay, Osman Kaykay, Binyam Halu, Hailemariam Legesse, Francis Smart, Sartie Kenneh, Soter Ameh, Jana Ritter, Tais Wilson, Jonas Winchell, Jakob Witherbee, Navit T. Salzberg, Jeffrey P. Koplan, Margaret Basket, Ashutosh Wadhwa, Kyu Han Lee, Valentine Wanga, Roosecelis Martines, Shamta Warang, Maureen Diaz, Jessica Waller, Shailesh Nair, Lucy Liu, Courtney Bursuc, Kristin LaHatte, Sarah Raymer, John Blevins, Solveig Argeseanu, Kurt Vyas, and Manu Bhandari

Subjects
Childhood, Mortality, Clinical care, Guideline adherence, Medicine (General), R5-920
Abstract

Summary: Background: Most childhood deaths globally are considered preventable through high-quality clinical care, which includes adherence to clinical care recommendations. Our objective was to describe adherence to World Health Organization recommendations for the management of leading causes of death among children. Methods: We conducted a retrospective, descriptive study examining clinical data for children aged 1–59 months who were hospitalized and died in a Child Health and Mortality Prevention Surveillance (CHAMPS) catchment, December 2016–June 2021. Catchment areas included: Baliakandi and Faridpur, Bangladesh; Kersa, Haramaya, and Harar, Ethiopia; Kisumu and Siaya, Kenya; Bamako, Mali; Manhiça and Quelimane, Mozambique; Makeni, Sierra Leone; Soweto, South Africa. We reviewed medical records of those who died from lower respiratory tract infections, sepsis, malnutrition, malaria, and diarrheal diseases to determine the proportion who received recommended treatments and compared adherence by hospitalization duration. Findings: CHAMPS enrolled 460 hospitalized children who died from the leading causes (median age 12 months, 53.0% male). Median hospital admission was 31 h. There were 51.0% (n = 127/249) of children who died from lower respiratory tract infections received supplemental oxygen. Administration of intravenous fluids for sepsis (15.9%, n = 36/226) and supplemental feeds for malnutrition (14.0%, n = 18/129) were uncommon. There were 51.4% (n = 55/107) of those who died from malaria received antimalarials. Of the 80 children who died from diarrheal diseases, 76.2% received intravenous fluids. Those admitted for ≥24 h more commonly received antibiotics for lower respiratory tract infections and sepsis, supplemental feeds for malnutrition, and intravenous fluids for sepsis than those admitted

Published
2023
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4. Association of the Interleukin-10-592C/A Polymorphism and Cervical Cancer Risk: A Meta-Analysis

Author

Brehima Diakite, Yaya Kassogue, Mamoudou Maiga, Guimogo Dolo, Oumar Kassogue, Jonah Musa, Imran Morhason-Bello, Ban Traore, Cheick Bougadari Traore, Bakarou Kamate, Aissata Coulibaly, Sekou Bah, Sellama Nadifi, Robert Murphy, Jane L. Holl, and Lifang Hou

Subjects
Genetics, QH426-470
Abstract

A literature review showed some discrepancies regarding the association of -592C/A with the risk of cervical cancer. To allow more precise analysis of the data by increasing the number of cases studied and more acceptable generalization by considering results from different sources, the present meta-analysis was performed on available published studies that explored the relationship between SNP-592C/A of the IL-10 gene and the risk of cervical cancer. Eleven available studies, including 4187 cases and 3311 controls, were included in this study investigating the relationship between the -592C/A polymorphism of IL-10 and cervical cancer risk. Fixed-effects or random-effects models were performed with pooled odds ratios (ORs). Heterogeneity and bias tests were performed by the inconsistency test and funnel plot, respectively. The overall analysis showed an increased susceptibility to cervical cancer with the -592C/A polymorphism of the IL-10 gene for the recessive model (OR = 1.30, 95% CI = 1.14–1.49), dominant model (OR = 1.36, 95% CI = 1.09–1.70), and additive model (OR = 1.25, 95% CI = 1.09–1.44). Regarding ethnicity, a significant association of the -592C/A polymorphism of the IL-10 gene was linked to an elevated risk of cervical cancer for all genetic models (recessive, dominant, and additive) in the Asian populations and for the recessive and additive models in Caucasians with P

Published
2022
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5. Prevalence and determinants of breast cancer screening in four sub-Saharan African countries: a population-based study

Author

Edeanya Agbese, Yanxu Yang, Ramata Cisse, Brehima Diakite, Cheick Bougadari Traore, Bakarou Kamate, Yaya Kassogue, Guimogo Dolo, Etienne Dembele, Hama Diallo, and Mamoudou Maiga

Subjects
Medicine
Abstract

Objectives Breast cancer is the most prevalent cancer and the second leading cause of cancer-related deaths among women after cervical cancer in much of sub-Saharan Africa. This study aims to examine the prevalence and sociodemographic–socioeconomic factors associated with breast cancer screening among women of reproductive age in sub-Saharan Africa.Design A weighted population-based cross-sectional study using Demographic and Health Surveys (DHS) data. We used all available data on breast cancer screening from the DHS for four sub-Saharan African countries (Burkina Faso, Ivory Coast, Kenya and Namibia). Breast cancer screening was the outcome of interest for this study. Multivariable Poisson regression was used to identify independent factors associated with breast cancer screening.Setting Four countries participating in the DHS from 2010 to 2014 with data on breast cancer screening.Participants Women of reproductive age 15–49 years (N=39 646).Results The overall prevalence of breast cancer screening was only 12.9% during the study period, ranging from 5.2% in Ivory Coast to 23.1% in Namibia. Factors associated with breast cancer screening were secondary/higher education with adjusted prevalence ratio (adjusted PR)=2.33 (95% CI: 2.05 to 2.66) compared with no education; older participants, 35–49 years (adjusted PR=1.73, 95% CI : 1.56 to 1.91) compared with younger participants 15–24 years; health insurance coverage (adjusted PR=1.57, 95% CI: 1.47 to 1.68) compared with those with no health insurance and highest socioeconomic status (adjusted PR=1.33, 95% CI : 1.19 to 1.49) compared with lowest socioeconomic status.Conclusion Despite high breast cancer mortality rates in sub-Saharan Africa, the prevalence of breast cancer screening is substantially low and varies gradually across countries and in relation to factors such as education, age, health insurance coverage and household wealth index level. These results highlight the need for increased efforts to improve the uptake of breast cancer screening in sub-Saharan Africa.

Published
2020
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6. Influence of CYP2B6 and CYP3A4 polymorphisms on the virologic and immunologic responses of patients treated with efavirenz-containing regimen

Author

Yaya Kassogue, Brehima Diakite, Mamoudou Maiga, Oumar Kassogue, Issa Konate, Kadidiatou Tamboura, Fousseyni Diarra, Zoumana Diarra, Mahamadou Karamoko Sawadogo, Yaya Goita, Sidi Boula Sissoko, Adama Seydou Sissoko, Nouhoum Guirou, Hind Dehbi, Sellama Nadifi, Sekou Bah, Cheick Bougadari Traore, Bakarou Kamate, Sounkalo Dao, and Guimogo Dolo

Subjects
Cyclopropanes, Genotype, Anti-HIV Agents, Cytochrome P-450 CYP2B6 Inhibitors, HIV Infections, Polymorphism, Single Nucleotide, Article, Benzoxazines, Cytochrome P-450 CYP2B6, Alkynes, Genetics, Molecular Medicine, Cytochrome P-450 CYP3A, Humans, General Pharmacology, Toxicology and Pharmaceutics, Molecular Biology, Genetics (clinical)
Abstract

OBJECTIVES: The main objective of this study was to evaluate the effect of CYP2B6 and CYP3A4 polymorphisms on the virological and immunologic responses of HIV patients. A total of 153 HIV-positive patients were enlisted for the study. PATIENTS AND METHODS: Viral load and median CD4 T cell counts were evaluated at baseline and month 6 (M6). Samples were identified using TaqMan genotyping assays. RESULTS: The AG in CYP2B6 rs2279343 was associated with VLS compared to homozygous AA. In the dominant model, the AG/GG genotypes were associated with VLS compared to the AA genotype. Moreover, in overdominant model, the AG genotype was associated with VLS compared to AA/GG. Regarding immunological response, only the AG in SNP rs2279343 CYP2B6 was associated with an increase in CD4 cell count between baseline and M6. In CYP2B6 rs3745274, the CD4 cell count at M6 was higher than that of baseline for GG carriers and for GT carriers. In CYP3A4 rs2740574, the TC carriers showed a higher median CD4 count at M6 compared to that of the baseline count, as well as for CC carriers. The best genotypes combination associated with CD4 cell count improvement were AA/AG in SNP rs2279343 and GG/GT in SNP rs3745274. CONCLUSION: Our findings support the fact that CYP2B6 rs2279343 could help in the prediction of VLS and both SNPs rs3745274 and rs2279343 in CYP2B6 and CYP3A4 rs2740574 were associated with immune recovery in Malian HIV-positive patients.

Published
2022

7. Cervical Cancer in Sub-Saharan Africa: A Multinational Population-Based Cohort Study of Care and Guideline Adherence

Author

Walburga Yvonne Joko-Fru, Biying Liu, Mirko Griesel, Amalado Ayemou, Christoph Thomssen, Ahmedin Jemal, Anne Korir, Nikolaus Christian Simon Mezger, Jana Feuchtner, Lucia Hämmerl, Mazvita Sengayi‐Muchengeti, Cesaltina Lorenzoni, Donald Maxwell Parkin, Tobias P. Seraphin, Gladys C. Chesumbai, Tigeneh Wondemagegnehu, Eva Johanna Kantelhardt, Marie‐Thérèse Akele‐Akpo, Andreas Wienke, Cheick Bougadari Traore, Sarah Nambooze, and Samukeliso Vuma

Subjects
Global Health and Cancer, Cancer Research, medicine.medical_specialty, Survival, Population, Psychological intervention, Uterine Cervical Neoplasms, Access to care, Disease, Cohort Studies, 03 medical and health sciences, 0302 clinical medicine, Sub‐Saharan Africa, Pregnancy, Internal medicine, medicine, Humans, Uganda, 030212 general & internal medicine, education, Cervical cancer, education.field_of_study, Radiotherapy, business.industry, Hazard ratio, Cancer, Guideline, medicine.disease, Kenya, Oncology, 030220 oncology & carcinogenesis, Population‐based, Female, Observational study, Ethiopia, Guideline Adherence, business
Abstract

Background Cervical cancer (CC) is the most common female cancer in many countries of sub‐Saharan Africa (SSA). We assessed treatment guideline adherence and its association with overall survival (OS). Methods Our observational study covered nine population‐based cancer registries in eight countries: Benin, Ethiopia, Ivory Coast, Kenya, Mali, Mozambique, Uganda, and Zimbabwe. Random samples of 44–125 patients diagnosed from 2010 to 2016 were selected in each. Cancer‐directed therapy (CDT) was evaluated for degree of adherence to National Comprehensive Cancer Network (U.S.) Guidelines. Results Of 632 patients, 15.8% received CDT with curative potential: 5.2% guideline‐adherent, 2.4% with minor deviations, and 8.2% with major deviations. CDT was not documented or was without curative potential in 22%; 15.7% were diagnosed with International Federation of Gynecology and Obstetrics (FIGO) stage IV disease. Adherence was not assessed in 46.9% (no stage or follow‐up documented, 11.9%, or records not traced, 35.1%). The largest share of guideline‐adherent CDT was observed in Nairobi (49%) and the smallest in Maputo (4%). In patients with FIGO stage I–III disease (n = 190), minor and major guideline deviations were associated with impaired OS (hazard rate ratio [HRR], 1.73; 95% confidence interval [CI], 0.36–8.37; HRR, 1.97; CI, 0.59–6.56, respectively). CDT without curative potential (HRR, 3.88; CI, 1.19–12.71) and no CDT (HRR, 9.43; CI, 3.03–29.33) showed substantially worse survival. Conclusion We found that only one in six patients with cervical cancer in SSA received CDT with curative potential. At least one‐fifth and possibly up to two‐thirds of women never accessed CDT, despite curable disease, resulting in impaired OS. Investments into more radiotherapy, chemotherapy, and surgical training could change the fatal outcomes of many patients. Implications for Practice Despite evidence‐based interventions including guideline‐adherent treatment for cervical cancer (CC), there is huge disparity in survival across the globe. This comprehensive multinational population‐based registry study aimed to assess the status quo of presentation, treatment guideline adherence, and survival in eight countries. Patients across sub‐Saharan Africa present in late stages, and treatment guideline adherence is remarkably low. Both factors were associated with unfavorable survival. This report warns about the inability of most women with cervical cancer in sub‐Saharan Africa to access timely and high‐quality diagnostic and treatment services, serving as guidance to institutions and policy makers. With regard to clinical practice, there might be cancer‐directed treatment options that, although not fully guideline adherent, have relevant survival benefit. Others should perhaps not be chosen even under resource‐constrained circumstances., With a multinational collection of registry data and multimodal evaluation of degree of therapy guideline adherence, this study adds population‐based evidence on the status of cervical cancer care and outcomes in the setting of sub‐Saharan Africa.

Published
2021

8. Worldwide trends in population-based survival for children, adolescents, and young adults diagnosed with leukaemia, by subtype, during 2000–14 (CONCORD-3): analysis of individual data from 258 cancer registries in 61 countries

Author

Ssenyonga, Naomi, primary, Stiller, Charles, additional, Nakata, Kayo, additional, Shalkow, Jaime, additional, Redmond, Shelagh, additional, Bulliard, Jean-Luc, additional, Girardi, Fabio, additional, Fowler, Christine, additional, Marcos-Gragera, Rafael, additional, Bonaventure, Audrey, additional, Saint-Jacques, Nathalie, additional, Minicozzi, Pamela, additional, De, Prithwish, additional, Rodríguez-Barranco, Miguel, additional, Larønningen, Siri, additional, Di Carlo, Veronica, additional, Mägi, Margit, additional, Valkov, Mikhail, additional, Seppä, Karri, additional, Wyn Huws, Dyfed, additional, Coleman, Michel P, additional, Allemani, Claudia, additional, Bouzbid, Sabiha, additional, Hamdi-Chérif, Mokhtar, additional, Kara, Lamia, additional, Meguenni, Kaouel, additional, Regagba, Derbali, additional, Bayo, Sine, additional, Cheick Bougadari, Traore, additional, Manraj, Shyam Shunker, additional, Bendahhou, Karima, additional, Ladipo, Akinade, additional, Ogunbiyi, Olufemi, additional, Somdyala, Nontuthuzelo, additional, Chaplin, María Agustina, additional, Moreno, Florencia, additional, Calabrano, Gladis, additional, Espinola, Silvia, additional, Carballo Quintero, Beatriz, additional, Fita, Rosalba, additional, Laspada, Walter, additional, Ibañez, Susana, additional, Lima, Carlos, additional, Mafra Da Costa, Allini, additional, De Souza, Paulo César, additional, Chaves, Juliana, additional, Laporte, Cyntia, additional, Curado, Maria Paula, additional, de Oliveira, Jose Carlos, additional, Veneziano, Claudia, additional, Veneziano, Donaldo, additional, Almeida, Ana Beatriz, additional, Latorre, Maria, additional, Azevedo e Silva, Gulnar, additional, Rebelo, Marise, additional, Santos, Marceli, additional, Galaz, Juan, additional, Aparicio Aravena, Mackarena, additional, Sanhueza Monsalve, Jocelyn, additional, Herrmann, Denise, additional, Vargas, Solange, additional, Herrera, Victor, additional, Uribe, Claudia, additional, Bravo, Luis Eduardo, additional, Garcia, Luz Stella, additional, Arias-Ortiz, Nelson, additional, Morantes, Daniela, additional, Jurado, Daniel, additional, Yépez Chamorro, María, additional, Delgado, Sandra, additional, Ramirez, Melissa, additional, Galán Alvarez, Yaima, additional, Torres, Priscila, additional, Martínez-Reyes, Fray, additional, Jaramillo, Leyda, additional, Quinto, Rina, additional, Castillo, Jhoanna, additional, Mendoza, Mariela, additional, Cueva, Patricia, additional, Yépez, José, additional, Bhakkan, Bernard, additional, Deloumeaux, Jacqueline, additional, Joachim, Clarisse, additional, Macni, Jonathan, additional, Carrillo, Rodolfo, additional, Shalkow Klincovstein, Jaime, additional, Rivera Gomez, Rebeca, additional, Perez, Patricia, additional, Poquioma, Ebert, additional, Tortolero-Luna, Guillermo, additional, Zavala, Diego, additional, Alonso, Rafael, additional, Barrios, Enrique, additional, Eckstrand, Angela, additional, Nikiforuk, Cindy, additional, Woods, Ryan, additional, Noonan, Gail, additional, Turner, Donna, additional, Kumar, Eshwar, additional, Zhang, Bin, additional, Dowden, Jeff, additional, Doyle, Gregory, additional, Walsh, Gordon, additional, Anam, Aniq, additional, McClure, Carol, additional, Vriends, Kim, additional, Bertrand, Christine, additional, Ramanakumar, Agnihotram, additional, Kozie, Serena, additional, Stuart-Panko, Heather, additional, Freeman, Tara, additional, George, Justin, additional, Avila, Rosa, additional, O'Brien, David, additional, Holt, Abby, additional, Almon, Lyn, additional, Ward, Kevin, additional, Kwong, Sandy, additional, Morris, Cyllene, additional, Rycroft, Randi, additional, Mueller, Lloyd, additional, Phillips, Cathryn, additional, Brown, Heather, additional, Cromartie, Betsy, additional, Ruterbusch, Julie, additional, Schwartz, Ann, additional, Levin, Gary, additional, Wohler, Brad, additional, Bayakly, Rana, additional, Gomez, Scarlett, additional, McKinley, Meg, additional, Cress, Rosemary, additional, Davis, Joni, additional, Hernandez, Brenda, additional, Johnson, Christopher, additional, Morawski, Bozena, additional, Ruppert, Laura, additional, Bentler, Suzanne, additional, Charlton, Mary, additional, Huang, Bin, additional, Tucker, Thomas, additional, Deapen, Dennis, additional, Liu, Lihua, additional, Hsieh, Mei-Chin, additional, Wu, Xiao-Cheng, additional, Schwenn, Molly, additional, Stern, Kimberly, additional, Gershman, Susan, additional, Knowlton, Richard, additional, Alverson, Georgetta, additional, Weaver, Tamara, additional, Desai, Jay, additional, Rogers, Deirdre, additional, Jackson-Thompson, Jeanette, additional, Lemons, Debbi, additional, Zimmerman, Heather, additional, Hood, Michelle, additional, Roberts-Johnson, Jenifer, additional, Hammond, Whitney, additional, Rees, Judith, additional, Pawlish, Karen, additional, Stroup, Antoinette, additional, Key, Charles, additional, Wiggins, Charles, additional, Kahn, Amy, additional, Schymura, Maria, additional, Radhakrishnan, Soundarya, additional, Rao, Chandrika, additional, Giljahn, Lynn, additional, Slocumb, Roberta, additional, Dabbs, Christy, additional, Espinoza, Raffaella, additional, Aird, Karen, additional, Beran, Todd, additional, Rubertone, Jim, additional, Slack, Stephen, additional, Oh, Junhie, additional, Janes, Tiffany, additional, Schwartz, Stephen, additional, Chiodini, Stephanie, additional, Hurley, Deborah, additional, Whiteside, Martin, additional, Rai, Saroj, additional, Williams, Melanie, additional, Herget, Kim, additional, Sweeney, Carol, additional, Johnson, Alison, additional, Keitheri Cheteri, Mahesh, additional, Migliore Santiago, Patti, additional, Blankenship, Steven, additional, Farley, Shawn, additional, Borchers, Robert, additional, Malicki, Robin, additional, Espinoza, Julia, additional, Grandpre, Joseph, additional, Edwards, Brenda, additional, Mariotto, Angela, additional, Weir, Hannah, additional, Wilson, Reda, additional, Wang, Ning, additional, Yang, Lei, additional, Chen, Jian-Shun, additional, He, Yu-Tong, additional, Song, Guo-Hui, additional, Gu, Xiao-Ping, additional, Mei, Dan, additional, Ge, Heng-Ming, additional, Wu, Tong-Hao, additional, Li, Yan-Yan, additional, Zhao, De-Li, additional, Jin, Feng, additional, Zhang, Jian-Hua, additional, Zhu, Feng-Dong, additional, Junhua, Qian, additional, Yang, Yan Lei, additional, Jiang, Chun-Xiao, additional, Biao, Wang, additional, Wang, Jian, additional, Li, Qi-Long, additional, Yi, He, additional, Zhou, Xin, additional, Dong, JianMei, additional, Li, WeiWei, additional, Fu, Fang-Xian, additional, Chen, Jian-Guo, additional, Zhu, Jian, additional, Li, Yan-Hua, additional, Lu, Yu-Qiang, additional, Fan, Min, additional, Huang, Su-Qin, additional, Guo, Guo-Ping, additional, Zhaolai, Hua, additional, Wei, Kuangrong, additional, Chen, Wan-Qing, additional, Wei, Wenqiang, additional, Zeng, Hongmei, additional, Demetriou, Anna, additional, Mang, Wai Kong, additional, Ngan, Kai Cheong, additional, Kataki, Amal, additional, Krishnatreya, Manigreeva, additional, Jayalekshmi, Padmavathi Amma, additional, Sebastian, Paul, additional, George, Preethi, additional, Mathew, Aleyamma, additional, Nandakumar, Ambakumar, additional, Malekzadeh, Reza, additional, Roshandel, Gholamreza, additional, Keinan-Boker, Lital, additional, Silverman, Barbara, additional, Ito, Hidemi, additional, Koyanagi, Yuriko, additional, Sato, Masako, additional, Tobori, Fumio, additional, Nakata, Ichiro, additional, Teramoto, Norihiro, additional, Hattori, Masakazu, additional, Kaizaki, Yasuharu, additional, Moki, Fumitaka, additional, Sugiyama, Hiromi, additional, Utada, Mai, additional, Nishimura, Makiko, additional, Yoshida, Keiichi, additional, Kurosawa, Katsuki, additional, Nemoto, Yuji, additional, Narimatsu, Hiroto, additional, Sakaguchi, Masahiko, additional, Kanemura, Seiki, additional, Naito, Michiko, additional, Narisawa, Rintaro, additional, Miyashiro, Isao, additional, Mori, Daisuke, additional, Yoshitake, Mayuko, additional, Oki, Izumi, additional, Fukushima, Norimasa, additional, Shibata, Akiko, additional, Iwasa, Keiichiro, additional, Ono, Chie, additional, Matsuda, Tomohiro, additional, Nimri, Omar, additional, Jung, Kyu-Won, additional, Won, Young-Joo, additional, Alawadhi, Eiman, additional, Elbasmi, Amani, additional, Ab Manan, Azizah, additional, Adam, Farzaana, additional, Nansalmaa, Erdenekhuu, additional, Tudev, Undarmaa, additional, Ochir, Chimedsuren, additional, Al Khater, Al Hareth, additional, El Mistiri, Mufid, additional, Lim, Gek Hsiang, additional, Teo, Yik Ying, additional, Chiang, Chun-Ju, additional, Lee, Wen-Chung, additional, Buasom, Rangsiya, additional, Sangrajrang, Suleeporn, additional, Suwanrungruang, Krittika, additional, Vatanasapt, Patravoot, additional, Daoprasert, Karnchana, additional, Pongnikorn, Donsuk, additional, Leklob, Atit, additional, Sangkitipaiboon, Somphob, additional, Geater, Sarayut, additional, Sriplung, Hutcha, additional, Ceylan, Okan, additional, Kög, Iskender, additional, Dirican, Oya, additional, Köse, Tülay, additional, Gurbuz, Tulın, additional, Karašahin, Füsun Emine, additional, Turhan, Duygu, additional, Aktaş, Umut, additional, Halat, Yakup, additional, Eser, Sultan, additional, Yakut, Cankut, additional, Altinisik, Merve, additional, Cavusoglu, Yasar, additional, Türkköylü, Ayşe, additional, Üçüncü, Nuršen, additional, Hackl, Monika, additional, Zborovskaya, Anna, additional, Aleinikova, Olga, additional, Henau, Kris, additional, Van Eycken, Liesbet, additional, Atanasov, Trayan, additional, Valerianova, Zdravka, additional, Šekerija, Mario, additional, Dušek, Ladislav, additional, Zvolský, Miroslav, additional, Steinrud Mørch, Lina, additional, Storm, Hans, additional, Wessel Skovlund, Charlotte, additional, Innos, Kaire, additional, Malila, Nea, additional, Jégu, Jérémie, additional, Velten, Michel, additional, Cornet, Edouard, additional, Troussard, Xavier, additional, Bouvier, Anne-Marie, additional, Guizard, Anne-Valérie, additional, Bouvier, Véronique, additional, Launoy, Guy, additional, Dabakuyo Yonli, Sandrine, additional, Poillot, Marie-Laure, additional, Maynadié, Marc, additional, Mounier, Morgane, additional, Vaconnet, Lina, additional, Woronoff, Anne-Sophie, additional, Daoulas, Mélanie, additional, Robaszkiewicz, Michel, additional, Clavel, Jacqueline, additional, Poulalhon, Claire, additional, Desandes, Emmanuel, additional, Lacour, Brigitte, additional, Baldi, Isabelle, additional, Pouchieu, Camille, additional, Amadeo, Brice, additional, Coureau, Gaëlle, additional, Monnereau, Alain, additional, Audoin, Magali, additional, D'Almeida, Tania, additional, Boyer, Séverine, additional, Hammas, Karima, additional, Trétarre, Brigitte, additional, Colonna, Marc, additional, Delafosse, Patricia, additional, Plouvier, Sandrine, additional, Cowppli-Bony, Anne, additional, Molinié, Florence, additional, Bara, Simona, additional, Ganry, Olivier, additional, Lapôtre-Ledoux, Bénédicte, additional, Daubisse-Marliac, Laetitia, additional, Bossard, Nadine, additional, Estève, Jacques, additional, Uhry, Zoé, additional, Stabenow, Roland, additional, Wilsdorf-Köhler, Heide, additional, Eberle, Andrea, additional, Luttmann, Sabine, additional, Löhden, Imma, additional, Nennecke, Alice, additional, Kieschke, Joachim, additional, Sirri, Eunice, additional, Justenhoven, Christina, additional, Zeissig, Sylke, additional, Holleczek, Bernd, additional, Eisemann, Nora, additional, Katalinic, Alexander, additional, Asquez, Rachelle, additional, Kumar, Vijay, additional, Petridou, Eleni, additional, Ólafsdóttir, Elínborg, additional, Tryggvadóttir, Laufey, additional, Murray, Deirdre, additional, Walsh, Paul, additional, Sundseth, Hildrun, additional, Mazzoleni, Guido, additional, Vittadello, Fabio, additional, Coviello, Enzo, additional, Cuccaro, Francesco, additional, Galasso, Rocco, additional, Sampietro, Giuseppe, additional, Magoni, Michele, additional, Ardizzone, Antonino, additional, D'Argenzio, Angelo, additional, Di Prima, Alessia Anna, additional, Ippolito, Antonella, additional, Lavecchia, Anna Maria, additional, Sutera Sardo, Antonella, additional, Gola, Gemma, additional, Ballotari, Paola, additional, Giacomazzi, Erica, additional, Ferretti, Stefano, additional, Dal Maso, Luigino, additional, Serraino, Diego, additional, Celesia, Maria Vittoria, additional, Filiberti, Rosa Angela, additional, Pannozzo, Fabio, additional, Melcarne, Anna, additional, Quarta, Fabrizio, additional, Andreano, Anita, additional, Russo, Antonio Giampiero, additional, Carrozzi, Giuliano, additional, Cirilli, Claudia, additional, Cavalieri d'Oro, Luca, additional, Rognoni, Magda, additional, Fusco, Mario, additional, Vitale, Maria Francesca, additional, Usala, Mario, additional, Cusimano, Rosanna, additional, Mazzucco, Walter, additional, Michiara, Maria, additional, Sgargi, Paolo, additional, Boschetti, Lorenza, additional, Chiaranda, Giorgio, additional, Seghini, Pietro, additional, Maule, Milena, additional, Merletti, Franco, additional, Spata, Eugenia, additional, Tumino, Rosario, additional, Mancuso, Pamela, additional, Vicentini, Massimo, additional, Cassetti, Tiziana, additional, Sassatelli, Romano, additional, Falcini, Fabio, additional, Giorgetti, Stefania, additional, Caiazzo, Anna Luisa, additional, Cavallo, Rossella, additional, Piras, Daniela, additional, Bella, Francesca, additional, Madeddu, Anselmo, additional, Fanetti, Anna Clara, additional, Maspero, Sergio, additional, Carone, Simona, additional, Mincuzzi, Antonia, additional, Candela, Giuseppa, additional, Scuderi, Tiziana, additional, Gentilini, Maria Adalgisa, additional, Rizzello, Roberto, additional, Rosso, Stefano, additional, Zanetti, Roberto, additional, Caldarella, Adele, additional, Intrieri, Teresa, additional, Bianconi, Fortunato, additional, Stracci, Fabrizio, additional, Contiero, Paolo, additional, Tagliabue, Giovanna, additional, Rugge, Massimo, additional, Zorzi, Manuel, additional, Beggiato, Simonetta, additional, Brustolin, Angelita, additional, De Angelis, Roberta, additional, Gatta, Gemma, additional, Maurina, Anita, additional, Oniščuka, Marija, additional, Mousavi, Mohsen, additional, Lipunova, Nadezda, additional, Vincerzevskienė, Ieva, additional, Agius, Dominic, additional, Calleja, Neville, additional, Siesling, Sabine, additional, Visser, Otto, additional, Johannesen, Tom, additional, Trojanowski, Maciej, additional, Mierzwa, Tomasz, additional, Rachtan, Jadwiga, additional, Kępska, Kamila, additional, Kościańska, Beata, additional, Wójcik-Tomaszewska, Joanna, additional, Motnyk, Marcin, additional, Gos, Anna, additional, Bielska-Lasota, Magdalena, additional, Didkowska, Joanna, additional, Wojciechowska, Urszula, additional, Forjaz de Lacerda, Gonçalo, additional, Rego, Raul, additional, Carrito, Branca, additional, Pais, Ana, additional, Bento, Maria José, additional, Rodrigues, Jessica, additional, Lourenço, Antonio, additional, Mayer-da-Silva, Alexandra, additional, Blaga, Luminita, additional, Coza, Daniela, additional, Gusenkova, Lubov, additional, Lazarevich, Olga, additional, Prudnikova, Olga, additional, Vjushkov, Dmitri Mikhailovich, additional, Egorova, Alla, additional, Orlov, Andrey, additional, Pikalova, Lidiya, additional, Zhuikova, Lilia, additional, Adamcik, Juraj, additional, Safaei Diba, Chakameh, additional, Zadnik, Vesna, additional, Zagar, Tina, additional, De-La-Cruz, Marta, additional, Lopez-de-Munain, Arantza, additional, Aleman, Araceli, additional, Rojas, Dolores, additional, Chillarón, Rosario Jiménez, additional, Navarro, Ana Isabel Marcos, additional, Puigdemont, Montse, additional, Sánchez Perez, María-José, additional, Franch Sureda, Paula, additional, Ramos Montserrat, Maria, additional, Chirlaque López, Maria Dolores, additional, Sánchez Gil, Antonia, additional, Ardanaz, Eva, additional, Guevara, Marcela, additional, Cañete-Nieto, Adela, additional, Peris-Bonet, Rafael, additional, Carulla, Marià, additional, Galceran, Jaume, additional, Almela, Fernando, additional, Sabater, Consol, additional, Khan, Staffan, additional, Pettersson, David, additional, Dickman, Paul, additional, Staehelin, Katharina, additional, Struchen, Benjamin, additional, Herrmann, Christian, additional, Mousavi, Seyed Mohsen, additional, Egger Hayoz, Céline, additional, Bouchardy, Christine, additional, Schaffar, Robin, additional, Went, Philip, additional, Maspoli-Conconi, Manuela, additional, Kuehni, Claudia, additional, Bordoni, Andrea, additional, Ortelli, Laura, additional, Chiolero, Arnaud, additional, Konzelmann, Isabelle, additional, Rohrmann, Sabine, additional, Wanner, Miriam, additional, Broggio, John, additional, Rashbass, Jem, additional, Fitzpatrick, Deirdre, additional, Gavin, Anna, additional, Morrison, David, additional, Thomson, Catherine, additional, Greene, Giles, additional, Huws, Dyfed, additional, Coleman, Michel, additional, Matz, Melissa, additional, Sanz, Natalia, additional, Ssenyonga, Naomi, additional, Stephens, Richard, additional, Chalker, Elizabeth, additional, Smith, Mirka, additional, Gugusheff, Jessica, additional, You, Hui, additional, Qin Li, Shu, additional, Dugdale, Sarah, additional, Moore, Julie, additional, Philpot, Shoni, additional, Pfeiffer, Rhonda, additional, Thomas, Helen, additional, Silva Ragaini, Bruna, additional, Venn, Alison, additional, Evans, Sue, additional, Te Marvelde, Luc, additional, Savietto, Vedrana, additional, Trevithick, Richard, additional, Currow, David, additional, and Lewis, Chris, additional

Published
2022
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9. Association of theiInterleukin-10-592C/A/iPolymorphism and Cervical Cancer Risk: A Meta-Analysis

Author

Brehima Diakite, Yaya Kassogue, Mamoudou Maiga, Guimogo Dolo, Oumar Kassogue, Jonah Musa, Imran Morhason-Bello, Ban Traore, Cheick Bougadari Traore, Bakarou Kamate, Aissata Coulibaly, Sekou Bah, Sellama Nadifi, Robert Murphy, Jane L. Holl, and Lifang Hou

Subjects
Asian People, Risk Factors, Genetics, Humans, Uterine Cervical Neoplasms, Female, Genetic Predisposition to Disease, General Medicine, Polymorphism, Single Nucleotide, Interleukin-10
Abstract

A literature review showed some discrepancies regarding the association of -592C/A with the risk of cervical cancer. To allow more precise analysis of the data by increasing the number of cases studied and more acceptable generalization by considering results from different sources, the present meta-analysis was performed on available published studies that explored the relationship between SNP-592C/A of the IL-10 gene and the risk of cervical cancer. Eleven available studies, including 4187 cases and 3311 controls, were included in this study investigating the relationship between the -592C/A polymorphism of IL-10 and cervical cancer risk. Fixed-effects or random-effects models were performed with pooled odds ratios (ORs). Heterogeneity and bias tests were performed by the inconsistency test and funnel plot, respectively. The overall analysis showed an increased susceptibility to cervical cancer with the -592C/A polymorphism of the IL-10 gene for the recessive model (OR = 1.30, 95% CI = 1.14–1.49), dominant model (OR = 1.36, 95% CI = 1.09–1.70), and additive model (OR = 1.25, 95% CI = 1.09–1.44). Regarding ethnicity, a significant association of the -592C/A polymorphism of the IL-10 gene was linked to an elevated risk of cervical cancer for all genetic models (recessive, dominant, and additive) in the Asian populations and for the recessive and additive models in Caucasians with P < 0.05 . The -592C/A polymorphism of the IL-10 gene may be considered a risk factor for cervical cancer.

Published
2022

10. Genetic polymorphism of drug metabolism enzymes (GSTM1, GSTT1 and GSTP1) in the healthy Malian population

Author

Cheick Bougadari Traore, Sounkalo Dao, Oumar Kassogue, Guimogo Dolo, Sellama Nadifi, Zoumana Diarra, Kadidiatou Tamboura, Seydou Doumbia, Issa Konaté, Brehima Diakite, Yaya Kassogue, and Hind Dehbi

Subjects
Adult, Male, 0301 basic medicine, Adolescent, Genotype, Population, Biology, Mali, law.invention, 03 medical and health sciences, 0302 clinical medicine, Gene Frequency, Risk Factors, law, Genetics, Genetic predisposition, Humans, Genetic Predisposition to Disease, Allele, education, Molecular Biology, Alleles, Polymerase chain reaction, Aged, Glutathione Transferase, education.field_of_study, Polymorphism, Genetic, General Medicine, Middle Aged, Healthy Volunteers, Metabolic Detoxication, Phase II, Genotype frequency, 030104 developmental biology, Glutathione S-Transferase pi, 030220 oncology & carcinogenesis, Female, Restriction fragment length polymorphism, Pharmacogenetics
Abstract

Glutathione S-transferase genes, known to be highly polymorphic, are implicated in the process of phase II metabolism of many substrates, including xenobiotics, anticancer and anti-infective drugs. The detoxification activity is linked to individual genetic makeup. Therefore, the identification of alleles and genotypes in these genes within a population may help to better design genetic susceptibility and pharmacogenetic studies. We performed the present study to establish the frequencies of the GSTM1, GSTT1, and GSTP1 c. 313A > G (rs1695) polymorphisms in 206 individuals of the Malian healthy population. GSTM1 and GSTT1 were genotyped by using multiplex polymerase chain reaction, whereas genotypes of GSTP1 were identified by polymerase chain reaction followed by restriction fragment length polymorphism. The frequencies of GSTM1-null and GSTT1-null genotypes were respectively 24.3 and 41.3%. The observed genotype frequencies for GSTP1 were 25.73% homozygous wild-type AA, 49.03% heterozygous AG and 25.24% homozygous mutant GG. The frequency of GSTP1-A allele was 50.24% versus 49.76% for the GSTP1-G allele. The distribution of these three genes was homogeneous between men and women (p > 0.05). We found no statistical association between the presence of a particular profile of GSTM1 or GSTT1 with the genotypes of GSTP1 (p > 0.05). Nevertheless, we noticed that the majority of the individuals harboring the GSTM1-present or the GSTT1-present harbor also the GSTP1-AG genotype. In addition, the triple genotype GSTM1-present/GSTT1-present/AG was the most frequent with 25.2%. Our findings will facilitate future studies regarding genetic associations of multifactorial diseases and pharmacogenetic, thus opening the way to personalized medicine in our population.

Published
2019

11. Breast cancer survival in sub‐Saharan Africa by age, stage at diagnosis and human development index: A population‐based registry study

Author

Mathewos Assefa, Walburga Yvonne Joko-Fru, Isabelle Soerjomataram, Tatenda Chingonzoh, Marcel Egue, Shyam Manraj, Henry Wabinga, Carla Carrilho, Biying Liu, Eric Chokunonga, Ntuthu Somdyala, Rolf Hansen, Guy N'da, Donald Maxwell Parkin, Eva Johanna Kantelhardt, Marie‐Thérèse Akele‐Akpo, Adalberto Miranda-Filho, Margaret Borok, Paul McGale, Bakarou Kamate, Cheick Bougadari Traore, Anne Korir, Nathan Buziba, Anne Finesse, and Cesaltina Lorenzoni

Subjects
Cancer Research, Colorectal cancer, Population, Breast Neoplasms, Kaplan-Meier Estimate, survival, Risk Assessment, Health Services Accessibility, 03 medical and health sciences, breast cancer, 0302 clinical medicine, Breast cancer, parasitic diseases, medicine, Humans, Breast, Registries, Stage (cooking), education, Africa South of the Sahara, Neoplasm Staging, Cervical cancer, education.field_of_study, Relative survival, business.industry, Age Factors, Cancer, Middle Aged, medicine.disease, stage, Quality Improvement, Cancer registry, Survival Rate, Socioeconomic Factors, Oncology, human development index, 030220 oncology & carcinogenesis, Africa, Female, business, Cancer Epidemiology, Follow-Up Studies, Demography
Abstract

Breast cancer is the leading cancer diagnosis and second most common cause of cancer deaths in sub‐Saharan Africa (SSA). Yet, there are few population‐level survival data from Africa and none on the survival differences by stage at diagnosis. Here, we estimate breast cancer survival within SSA by area, stage and country‐level human development index (HDI). We obtained data on a random sample of 2,588 breast cancer incident cases, diagnosed in 2008–2015 from 14 population‐based cancer registries in 12 countries (Benin, Cote d'Ivoire, Ethiopia, Kenya, Mali, Mauritius, Mozambique, Namibia, Seychelles, South Africa, Uganda and Zimbabwe) through the African Cancer Registry Network. Of these, 2,311 were included for survival analyses. The 1‐, 3‐ and 5‐year observed and relative survival (RS) were estimated by registry, stage and country‐level HDI. We equally estimated the excess hazards adjusting for potential confounders. Among patients with known stage, 64.9% were diagnosed in late stages, with 18.4% being metastatic at diagnosis. The RS varied by registry, ranging from 21.6%(8.2–39.8) at Year 3 in Bulawayo to 84.5% (70.6–93.5) in Namibia. Patients diagnosed at early stages had a 3‐year RS of 78% (71.6–83.3) in contrast to 40.3% (34.9–45.7) at advanced stages (III and IV). The overall RS at Year 1 was 86.1% (84.4–87.6), 65.8% (63.5–68.1) at Year 3 and 59.0% (56.3–61.6) at Year 5. Age at diagnosis was not independently associated with increased mortality risk after adjusting for the effect of stage and country‐level HDI. In conclusion, downstaging breast cancer at diagnosis and improving access to quality care could be pivotal in improving breast cancer survival outcomes in Africa., What's new? Breast cancer is the leading cancer diagnosis and second most common cause of cancer deaths in sub‐Saharan Africa (SSA). Yet there have been few studies in this region on survival differences by stage at diagnosis. Here, the authors used cancer registry data to analyze differences in breast‐cancer survival by age, stage at diagnosis and country‐level human development index. They conclude that downstaging and improving access to quality care could be pivotal in improving breast‐cancer survival outcomes in Africa.

Published
2019

12. Prevalence and Determinants of Cervical Cancer Screening in Five Sub-Saharan African Countries: A Population-Based Study

Author

Djibril M. Ba, Paddy Ssentongo, Cheick Bougadari Traore, Jonah Musa, Brehima Diakite, Edeanya Agbese, Steve Wang, and Mamoudou Maiga

Subjects
Adult, Cancer Research, Epidemiology, Population, Psychological intervention, Uterine Cervical Neoplasms, Cervical cancer screening, Article, 03 medical and health sciences, symbols.namesake, Young Adult, 0302 clinical medicine, parasitic diseases, medicine, Prevalence, Humans, 030212 general & internal medicine, Poisson regression, education, Socioeconomic status, Africa South of the Sahara, Early Detection of Cancer, Cervical cancer, education.field_of_study, business.industry, Cancer, Middle Aged, medicine.disease, Cross-Sectional Studies, Oncology, Socioeconomic Factors, 030220 oncology & carcinogenesis, symbols, Population study, Female, business, Demography
Abstract

Background Cervical cancer is the fourth most common cancer among women worldwide, with an estimate of 570,000 new cases and about 311,000 deaths annually. Low-resource countries, including those in sub-Saharan Africa, have the highest-burden with an estimate of 84 % of all cervical cancers. This study examines the prevalence and socio-demographic-economic factors associated with cervical cancer screening in sub-Saharan Africa. Methods A weighted population-based cross-sectional study using Demographic and Health Surveys data. We used available data on cervical cancer screening between 2011 and 2018 from the Demographic and Health Surveys for five sub-Saharan African countries (Benin, Ivory Coast, Kenya, Namibia, and Zimbabwe). The study population included women of childbearing age, 21–49 years (n = 28,976). We fit a multivariable Poisson regression model to identify independent factors associated with cervical cancer screening. Results The overall weighted prevalence of cervical cancer screening was 19.0 % (95 % CI: 18.5 %–19.5 %) ranging from 0.7 % in Benin to 45.9 % in Namibia. Independent determinants of cervical cancer screening were: older age (40−49 years) adjusted prevalence ratio (aPR) = 1.77 (95 % CI: 1.64, 1.90) compared with younger age (21−29 years), secondary/higher education (aPR = 1.51, 95 CI: 1.28–1.79) compared with no education, health insurance (aPR = 1.53, 95 % CI: 1.44–1.61) compared with no insurance, and highest socioeconomic status (aPR = 1.39, 95 % CI: 1.26–1.52) compared with lowest. Conclusion The prevalence of cervical cancer screening is substantially low in sub-Saharan Africa countries and shows a high degree of between-country variation. Interventions aimed at increasing the uptake of cervical cancer screening in sub-Saharan Africa are critically needed.

Published
2021

13. Impact of the COVID-19 pandemic on global health research training and education

Author

Kate Klein, Chad J. Achenbach, Godwin E. Imade, Jane L. Holl, Rose I Anorlu, Elizabeth Christian, Atiene S. Sagay, Edith N. Okeke, Robert L. Murphy, Olufunmilayo A. Lesi, Supriya D. Mehta, Lifang Hou, Jonah Musah, Ashti Doobay-Persaud, Alani S Akanmu, Brian T. Joyce, Firas Wehbe, Folasade Ogunsola, Jian Jun Wei, Demirkan B. Gursel, Cheick Bougadari Traore, and Mamoudou Maiga

Subjects
Adult, Male, 2019-20 coronavirus outbreak, medicine.medical_specialty, Biomedical Research, Coronavirus disease 2019 (COVID-19), business.industry, Health Policy, Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), Public Health, Environmental and Occupational Health, MEDLINE, COVID-19, Middle Aged, Global Health, Viewpoints, Education, Distance, Young Adult, Family medicine, Pandemic, Global health, medicine, Humans, Female, business, Pandemics
Published
2020

14. p.Arg72Pro polymorphism of P53 and Breast Cancer Risk: A meta-analysis of case-control studies

Author

Erin Neuschler, Jun Wang, Brehima Diakite, Seydou Doumbia, Guimogo Dolo, Cheick Bougadari Traore, Oumar Kassogue, Sellama Nadifi, Etienne Dembele, Mamoudou Maiga, Lifang Hou, Mamadou Keita, Robert L. Murphy, Yaya Kassogue, and Bakarou Kamate

Subjects
0301 basic medicine, Oncology, lcsh:Internal medicine, medicine.medical_specialty, lcsh:QH426-470, Genotype, Breast Neoplasms, Disease, Polymorphism, Single Nucleotide, p.Arg/pro polymorphism, 03 medical and health sciences, Breast cancer, 0302 clinical medicine, Gene Frequency, Risk Factors, Internal medicine, Genetics, medicine, Humans, Genetic Predisposition to Disease, Allele, lcsh:RC31-1245, Alleles, Genetics (clinical), P53 gene, business.industry, Case-control study, Odds ratio, Publication bias, medicine.disease, Genotype frequency, lcsh:Genetics, Meta-analysis, 030104 developmental biology, Amino Acid Substitution, Case-Control Studies, 030220 oncology & carcinogenesis, Female, Tumor Suppressor Protein p53, business, Research Article
Abstract

Background The effect of the p.Arg72Pro variant of the P53 gene on the risk of development ofbreast cancer remains variable in populations. However, the use ofstrategies such aspoolingage-matched controls with disease may provide a consistent meta-analysis. Our goal was to perform a meta-analysis in order to assess the association of p.Arg72Pro variant of P53 gene with the risk of breast cancer. Methods Databases such as PubMed, Genetics Medical Literature, Harvard University Library, Web of Science and Genesis Library were used to search articles. Case-control studies with age-matched on breast cancer havingevaluated the genotype frequencies of the TP53 p.Arg72Pro polymorphism were selected. The fixed and random effects (Mantel-Haenszel) were calculated using pooled odds ratio of 95% CI to determine the risk of disease. Inconsistency was calculated to determine heterogeneity among the studies. The publication bias was estimated using the funnel plot. Results Twenty-one publications with 7841 cases and 8876 controls were evaluated in this meta-analysis. Overall, our results suggested that TP53 p.Arg72Pro was associated with the risk of breast cancer for the dominant model (OR = 1.09, 95% CI = 1.02–1.16, P = 0.01) and the additive model (OR = 1.09, 95% CI = 1.01–1.17, P = 0.03), but not for the recessive model (OR = 1.07, 95% CI = 0.97–1.18, P = 0.19). According to the ethnic group analysis, Pro allele was associated with the risk of breast cancer in Caucasians for the dominant model and additive model (P = 0.02), and Africans for the recessive model and additive model (P = 0.03). Conclusions This meta-analysis found a significant association between TP53 p.Arg72Pro polymorphism and the risk of breast cancer. Individuals carrying at least one Pro allele were more likely to have breast cancer than individuals harboring the Arg allele.

Published
2020

15. Health system organisation and patient pathways: breast care patients’ trajectories and medical doctors’ practice in Mali

Author

Eva Johanna Kantelhardt, Kirstin Grosse Frie, Cheick Bougadari Traore, Bourama Coulibaly, Brahima Mallé, and Bakarou Kamate

Subjects
Adult, Male, medicine.medical_specialty, Delayed Diagnosis, Referral, Entry Level, 030209 endocrinology & metabolism, Breast Neoplasms, Mali, Health Services Accessibility, Breast cancer early detection, 03 medical and health sciences, 0302 clinical medicine, Breast cancer, Surveys and Questionnaires, Health care, Epidemiology, medicine, Health system, Humans, 030212 general & internal medicine, Community Health Services, Referral and Consultation, Early Detection of Cancer, Healthcare-seeking behaviour, Aged, Retrospective Studies, Sub-Saharan Africa, business.industry, lcsh:Public aspects of medicine, Public health, Public Health, Environmental and Occupational Health, lcsh:RA1-1270, Middle Aged, Patient Acceptance of Health Care, medicine.disease, Triage, 3. Good health, Government Programs, Patient pathways, Family medicine, Female, Biostatistics, business, Research Article
Abstract

Background Information on pathways of women seeking diagnostic services due to breast- related symptoms can help highlight challenges related to the healthcare system in improving early diagnosis of breast cancer. Methods We retrospectively analysed the entire patient pathway, from first symptom recognition via initial healthcare visit up to final diagnosis at the pathology service in Mali. Data from questionnaire-based structured patient interviews (n = 124) were used to calculate time to first healthcare visit (median 91 days) and consecutive time to diagnosis (median 21 days) and to extract information on type of initially visited healthcare facility (community healthcare centre, referral hospital, tertiary hospital, private clinic). Median time to first healthcare visit and time to diagnosis and type of initially-visited healthcare facility were cross-tabulated with patient characteristics. An additional survey among (n = 30) medical doctors in the community healthcare centres and referral hospitals in Bamako was conducted to understand current knowledge and referral practice with respect to female patients with breast-related symptoms. Results Patients who initially visited private clinics had the shortest time to first healthcare visit (median 44 days), but the longest time to diagnosis (median 170 days). Patients visiting community healthcare centres and referral hospitals took longest for a first healthcare visit (median 153 and 206 days, respectively), but the time to diagnosis was shorter (median 95 and 7 days, respectively). The majority of patients (45%) initially visited a tertiary hospital; these patients had shortest total time to diagnosis (median 56 days health seeking and 8 days diagnostic time), but did not follow the recommended pathway for patients in the pyramidal healthcare system in Mali. The doctors’ survey showed lower breast cancer knowledge in the community healthcare centres than in the referral hospitals. However, most doctors felt able to recognise suspected cases of cancer and referred patients directly to a hospital. Conclusions The role of different healthcare facilities in ensuring triage of patients with breast-related symptoms needs to be defined before any early detection initiatives are implemented. Especially at the entry level of the healthcare system, the access and quality of health services need to be strengthened.

Published
2019

16. Prevalence and determinants of breast cancer screening in four sub-Saharan African countries: a population-based study

Author

Paddy Ssentongo, Yanxu Yang, Bakarou Kamate, Edeanya Agbese, Djibril M. Ba, Hama Diallo, Etienne Dembele, Yaya Kassogue, Guimogo Dolo, Mamoudou Maiga, Brehima Diakite, Cheick Bougadari Traore, and Ramata Cisse

Subjects
Adult, medicine.medical_specialty, Adolescent, Epidemiology, Population, Breast Neoplasms, breast tumours, preventive medicine, Young Adult, Breast cancer screening, Breast cancer, Burkina Faso, Prevalence, medicine, Humans, education, Socioeconomic status, Early Detection of Cancer, Preventive healthcare, Cervical cancer, education.field_of_study, medicine.diagnostic_test, business.industry, Cancer, General Medicine, Middle Aged, medicine.disease, Kenya, Namibia, Cote d'Ivoire, Cross-Sectional Studies, Medicine, Female, business, Demography
Abstract

ObjectivesBreast cancer is the most prevalent cancer and the second leading cause of cancer-related deaths among women after cervical cancer in much of sub-Saharan Africa. This study aims to examine the prevalence and sociodemographic–socioeconomic factors associated with breast cancer screening among women of reproductive age in sub-Saharan Africa.DesignA weighted population-based cross-sectional study using Demographic and Health Surveys (DHS) data. We used all available data on breast cancer screening from the DHS for four sub-Saharan African countries (Burkina Faso, Ivory Coast, Kenya and Namibia). Breast cancer screening was the outcome of interest for this study. Multivariable Poisson regression was used to identify independent factors associated with breast cancer screening.SettingFour countries participating in the DHS from 2010 to 2014 with data on breast cancer screening.ParticipantsWomen of reproductive age 15–49 years (N=39 646).ResultsThe overall prevalence of breast cancer screening was only 12.9% during the study period, ranging from 5.2% in Ivory Coast to 23.1% in Namibia. Factors associated with breast cancer screening were secondary/higher education with adjusted prevalence ratio (adjusted PR)=2.33 (95% CI: 2.05 to 2.66) compared with no education; older participants, 35–49 years (adjusted PR=1.73, 95% CI : 1.56 to 1.91) compared with younger participants 15–24 years; health insurance coverage (adjusted PR=1.57, 95% CI: 1.47 to 1.68) compared with those with no health insurance and highest socioeconomic status (adjusted PR=1.33, 95% CI : 1.19 to 1.49) compared with lowest socioeconomic status.ConclusionDespite high breast cancer mortality rates in sub-Saharan Africa, the prevalence of breast cancer screening is substantially low and varies gradually across countries and in relation to factors such as education, age, health insurance coverage and household wealth index level. These results highlight the need for increased efforts to improve the uptake of breast cancer screening in sub-Saharan Africa.

Published
2020

17. Why Do Women with Breast Cancer Get Diagnosed and Treated Late in Sub-Saharan Africa? Perspectives from Women and Patients in Bamako, Mali

Author

Bourama Coulibaly, Hatouma Samoura, Bakarou Kamate, Cheick Bougadari Traore, Kirstin Grosse Frie, Eva Johanna Kantelhardt, Samba Diop, and Brahima Mallé

Subjects
medicine.medical_specialty, business.industry, Mortality rate, Psychological intervention, Cancer, medicine.disease, Focus group, 03 medical and health sciences, Social support, 0302 clinical medicine, Breast cancer, Oncology, 030220 oncology & carcinogenesis, Family medicine, Health care, Medicine, Surgery, 030212 general & internal medicine, business, Qualitative research, Research Article
Abstract

Background: Breast cancer, the most common cancer among women worldwide, has a high mortality rate in low-income countries. In sub-Saharan Africa, most breast cancer patients are diagnosed with advanced disease. Some studies have quantified the time delay to diagnosis in sub-Saharan Africa, but very few have used qualitative methods to understand barriers leading to delay. This study analyses barriers throughout a breast cancer patient's pathway from symptom recognition to treatment in Mali. Method: Three focus group discussions were conducted. The model of pathways to treatment was used to structure the results into 4 time intervals: appraisal, help-seeking, diagnosis, and treatment, with a focus on barriers during each interval. Results: The main barriers during the appraisal interval were a low level of breast cancer knowledge among women, their families, and medical professionals, and during the help-seeking interval, mistrust in the community health care centers and economic hardship. Barriers during the diagnosis interval were low quality of health care services and lack of social support, and during the pretreatment interval high costs and lack of specialized services. Conclusion: Multilevel interventions are needed to ensure access, availability, and affordability of a minimum standard of care for breast cancer patients in sub-Saharan Africa.

Published
2018

18. Breast cancer in pre-menopausal women in West Africa: Analysis of temporal trends and evaluation of risk factors associated with reproductive life

Author

Denis Bourgeois, Pierre Hainaut, Dominique Sighoko, Bourama Coulibaly, Brahima Mallé, Coulibaly Diallo, Siné Bayo, Maria Paula Curado, Valerie McCormack, Bakarou Kamate, Richard Muwonge, Emmanuelle Gormally, Ebrima Bah, Cheick Bougadari Traore, and Agnès Karidiatou

Subjects
Adult, medicine.medical_specialty, Adolescent, Population, Breast Neoplasms, Gravidity, Mali, Rate ratio, West africa, Young Adult, Breast cancer, Pregnancy, Risk Factors, parasitic diseases, medicine, Humans, Registries, Child, education, Aged, Aged, 80 and over, Menarche, Gynecology, education.field_of_study, business.industry, Incidence, Carcinoma, Age Factors, Reproductive life, Cancer, General Medicine, Middle Aged, medicine.disease, Postmenopause, Premenopause, Risk factors for breast cancer, Case-Control Studies, Female, Gambia, Surgery, business, Demography
Abstract

Background In West Africa, trends and risk factors for breast cancer (BC) have been rarely studied. Methods Here we have analyzed trends of BC over two periods in two population-based cancer registries, in Mali-Bamako (1987–1997; 1998–2009) and in The Gambia (1988–1997; 1998–2006). We have conducted a case–control study ( n = 253 cases, 249 controls) on risk factors associated with reproductive life stratified by menopausal status in Bamako. Results Between the two periods, BC incidence rates increased by 20% (incidence rate ratio (IRR) 1.20 (95% CI [1.07–1.35])) in Bamako, with an annual percentage change of 2% (95% CI [0.4–3.6]). The increase was of 30% in women under 55 years (IRR 1.30 (95% CI [1.14–1.60])). A similar pattern was observed in The Gambia for women under 50 years (IRR 1.47 (95% CI [1.07–2.01])). Overall, pre-menopausal breast cancer was predominant in both countries. In contrary to what is well established, case–control study showed that late age at menarche (>14 years) increased the risk of BC among pre-menopausal women (OR: 2.02 (95% CI [1.08–3.78])) while it tended to be protective in post-menopausal women (OR: 0.61 (95% CI [0.29–1.29])). Later age at a first pregnancy (>20 years) was associated with a reduction of risk in pre-menopausal women (OR: 0.41 (95% CI [0.18–0.89])). Conclusion These results indicate that the burden of pre-menopausal BC is increasing in West African countries. These cancers appear to be associated with distinct reproductive risk factors, highlighting the need for better understanding the biological bases of early BC in African populations.

Published
2013

19. Health system organisation and patient pathways: breast care patients’ trajectories and medical doctors’ practice in Mali

Author

Kirstin Grosse Frie, Bakarou Kamaté, Cheick Bougadari Traoré, Bourama Coulibaly, Brahima Mallé, and Eva Johanna Kantelhardt

Subjects
Breast cancer early detection, Patient pathways, Healthcare-seeking behaviour, Health system, Sub-Saharan Africa, Public aspects of medicine, RA1-1270
Abstract

Abstract Background Information on pathways of women seeking diagnostic services due to breast- related symptoms can help highlight challenges related to the healthcare system in improving early diagnosis of breast cancer. Methods We retrospectively analysed the entire patient pathway, from first symptom recognition via initial healthcare visit up to final diagnosis at the pathology service in Mali. Data from questionnaire-based structured patient interviews (n = 124) were used to calculate time to first healthcare visit (median 91 days) and consecutive time to diagnosis (median 21 days) and to extract information on type of initially visited healthcare facility (community healthcare centre, referral hospital, tertiary hospital, private clinic). Median time to first healthcare visit and time to diagnosis and type of initially-visited healthcare facility were cross-tabulated with patient characteristics. An additional survey among (n = 30) medical doctors in the community healthcare centres and referral hospitals in Bamako was conducted to understand current knowledge and referral practice with respect to female patients with breast-related symptoms. Results Patients who initially visited private clinics had the shortest time to first healthcare visit (median 44 days), but the longest time to diagnosis (median 170 days). Patients visiting community healthcare centres and referral hospitals took longest for a first healthcare visit (median 153 and 206 days, respectively), but the time to diagnosis was shorter (median 95 and 7 days, respectively). The majority of patients (45%) initially visited a tertiary hospital; these patients had shortest total time to diagnosis (median 56 days health seeking and 8 days diagnostic time), but did not follow the recommended pathway for patients in the pyramidal healthcare system in Mali. The doctors’ survey showed lower breast cancer knowledge in the community healthcare centres than in the referral hospitals. However, most doctors felt able to recognise suspected cases of cancer and referred patients directly to a hospital. Conclusions The role of different healthcare facilities in ensuring triage of patients with breast-related symptoms needs to be defined before any early detection initiatives are implemented. Especially at the entry level of the healthcare system, the access and quality of health services need to be strengthened.

Published
2019
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