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1. A global research priority agenda to advance public health responses to fatty liver disease

Author: Lazarus, J, Mark, H, Allen, A, Arab, J, Carrieri, P, Noureddin, M, Alazawi, W, Alkhouri, N, Alqahtani, S, Arrese, M, Bataller, R, Berg, T, Brennan, P, Burra, P, Castro-Narro, G, Cortez-Pinto, H, Cusi, K, Dedes, N, Duseja, A, Francque, S, Hagstrom, H, Huang, T, Wajcman, D, Kautz, A, Kopka, C, Krag, A, Miller, V, Newsome, P, Rinella, M, Romero, D, Sarin, S, Silva, M, Spearman, C, Tsochatzis, E, Valenti, L, Villota-Rivas, M, Zelber-Sagi, S, Schattenberg, J, Wong, V, Younossi, Z, Aberg, F, Adams, L, Al-Naamani, K, Albadawy, R, Alexa, Z, Allison, M, Alnaser, F, Alswat, K, Alvares-da-Silva, M, Alvaro, D, Alves-Bezerra, M, Andrade, R, Anstee, Q, Awuku, Y, Baatarkhuu, O, Baffy, G, Bakieva, S, Bansal, M, Barouki, R, Batterham, R, Behling, C, Belfort-DeAguiar, R, Berzigotti, A, Betel, M, Bianco, C, Bosi, E, Boursier, J, Brunt, E, Bugianesi, E, Byrne, C, Cabrera Cabrejos, M, Caldwell, S, Carr, R, Castellanos Fernandez, M, Castera, L, Castillo-Lopez, M, Caussy, C, Cerda-Reyes, E, Ceriello, A, Chan, W, Chang, Y, Charatcharoenwitthaya, P, Chavez-Tapia, N, Chung, R, Colombo, M, Coppell, K, Cotrim, H, Craxi, A, Crespo, J, Dassanayake, A, Davidson, N, De Knegt, R, de Ledinghen, V, Demir, M, Desalegn, H, Diago, M, Dillon, J, Dimmig, B, Dirac, M, Dirchwolf, M, Dufour, J, Dvorak, K, Ekstedt, M, El-Kassas, M, Elsanousi, O, Elsharkawy, A, Elwakil, R, Eskridge, W, Eslam, M, Esmat, G, Fan, J, Ferraz, M, Flisiak, R, Fortin, D, Fouad, Y, Freidman, S, Fuchs, M, Gadano, A, Gastaldelli, A, Geerts, A, Geier, A, George, J, Gerber, L, Ghazinyan, H, Gheorghe, L, Kile, D, Girala, M, Boon Bee, G, Goossens, N, Graupera, I, Gronbaek, H, Hamid, S, Hebditch, V, Henry, Z, Hickman, I, Hobbs, L, Hocking, S, Hofmann, W, Idilman, R, Iruzubieta, P, Isaacs, S, Isakov, V, Ismail, M, Jamal, M, Jarvis, H, Jepsen, P, Jornayvaz, F, Sudhamshu, K, Kakizaki, S, Karpen, S, Kawaguchi, T, Keating, S, Khader, Y, Kim, S, Kim, W, Kleiner, D, Koek, G, Joseph Komas, N, Kondili, L, Koot, B, Korenjak, M, Kotsiliti, E, Koulla, Y, Kugelmas, C, Kugelmas, M, Labidi, A, Lange, N, Lavine, J, Lazo, M, Leite, N, Lin, H, Lkhagvaa, U, Long, M, Lopez-Jaramillo, P, Lozano, A, Macedo, M, Malekzadeh, R, Marchesini, G, Marciano, S, Martinez, K, Martinez Vazquez, S, Mateva, L, Mato, J, Nlombi, C, Mccary, A, Mcintyre, J, Mckee, M, Mendive, J, Mikolasevic, I, Miller, P, Milovanovic, T, Milton, T, Moreno-Alcantar, R, Morgan, T, Motala, A, Muris, J, Musso, C, Nava-Gonzalez, E, Negro, F, Nersesov, A, Neuschwander-Tetri, B, Nikolova, D, Norris, S, Novak, K, Ocama, P, Ong, J, Ong-Go, A, Onyekwere, C, Padilla, M, Pais, R, Pan, C, Panduro, A, Panigrahi, M, Papatheodoridis, G, Paruk, I, Patel, K, Goncalves, C, Figueroa, M, Perez-Escobar, J, Pericas, J, Perseghin, G, Pessoa, M, Petta, S, Marques Souza de Oliveira, C, Prabhakaran, D, Pyrsopoulous, N, Rabiee, A, Ramji, A, Ratziu, V, Ravendhran, N, Ray, K, Roden, M, Romeo, S, Romero-Gomez, M, Rotman, Y, Rouabhia, S, Rowe, I, Sadirova, S, Alkhatry, M, Salupere, R, Satapathy, S, Schwimmer, J, Sebastiani, G, Seim, L, Seki, Y, Serme, A, Shapiro, D, Sharvadze, L, Shaw, J, Shawa, I, Shenoy, T, Shibolet, O, Shimakawa, Y, Shubrook, J, Singh, S, Sinkala, E, Skladany, L, Skrypnyk, I, Song, M, Sookoian, S, Sridharan, K, Stefan, N, Stine, J, Stratakis, N, Sheriff, D, Sundaram, S, Svegliati-Baroni, G, Swain, M, Tacke, F, Taheri, S, Tan, S, Tapper, E, Targher, G, Tcaciuc, E, Thiele, M, Tiniakos, D, Tolmane, I, Torre, A, Torres, E, Treeprasertsuk, S, Trenell, M, Turcan, S, Turcanu, A, Valantinas, J, van Kleef, L, Velarde Ruiz Velasco, J, Vesterhus, M, Vilar-Gomez, E, Waked, I, Wattacheril, J, Wedemeyer, H, Wilkins, F, Willemse, J, Wong, R, Yilmaz, Y, Yki-Jarvinen, H, Yu, M, Yumuk, V, Zeybel, M, Zheng, K, Zheng, M, Lazarus J. V., Mark H. E., Allen A. M., Arab J. P., Carrieri P., Noureddin M., Alazawi W., Alkhouri N., Alqahtani S. A., Arrese M., Bataller R., Berg T., Brennan P. N., Burra P., Castro-Narro G. E., Cortez-Pinto H., Cusi K., Dedes N., Duseja A., Francque S. M., Hagstrom H., Huang T. T. -K., Wajcman D. I., Kautz A., Kopka C. J., Krag A., Miller V., Newsome P. N., Rinella M. E., Romero D., Sarin S. K., Silva M., Spearman C. W., Tsochatzis E. A., Valenti L., Villota-Rivas M., Zelber-Sagi S., Schattenberg J. M., Wong V. W. -S., Younossi Z. M., Aberg F., Adams L., Al-Naamani K., Albadawy R. M., Alexa Z., Allison M., Alnaser F. A., Alswat K., Alvares-da-Silva M. R., Alvaro D., Alves-Bezerra M., Andrade R. J., Anstee Q. M., Awuku Y. A., Baatarkhuu O., Baffy G., Bakieva S., Bansal M. B., Barouki R., Batterham R. L., Behling C., Belfort-DeAguiar R., Berzigotti A., Betel M., Bianco C., Bosi E., Boursier J., Brunt E. M., Bugianesi E., Byrne C. J., Cabrera Cabrejos M. C., Caldwell S., Carr R., Castellanos Fernandez M. I., Castera L., Castillo-Lopez M. G., Caussy C., Cerda-Reyes E., Ceriello A., Chan W. -K., Chang Y., Charatcharoenwitthaya P., Chavez-Tapia N., Chung R. T., Colombo M., Coppell K., Cotrim H. P., Craxi A., Crespo J., Dassanayake A., Davidson N. O., De Knegt R., de Ledinghen V., Demir M., Desalegn H., Diago M., Dillon J. F., Dimmig B., Dirac M. A., Dirchwolf M., Dufour J. -F., Dvorak K., Ekstedt M., El-Kassas M., Elsanousi O. M., Elsharkawy A. M., Elwakil R., Eskridge W., Eslam M., Esmat G., Fan J. -G., Ferraz M. L., Flisiak R., Fortin D., Fouad Y., Freidman S. L., Fuchs M., Gadano A., Gastaldelli A., Geerts A., Geier A., George J., Gerber L. H., Ghazinyan H., Gheorghe L., Kile D. G., Girala M., Boon Bee G. G., Goossens N., Graupera I., Gronbaek H., Hamid S., Hebditch V., Henry Z., Hickman I. J., Hobbs L. A., Hocking S. L., Hofmann W. P., Idilman R., Iruzubieta P., Isaacs S., Isakov V. A., Ismail M. H., Jamal M. H., Jarvis H., Jepsen P., Jornayvaz F., Sudhamshu K. C., Kakizaki S., Karpen S., Kawaguchi T., Keating S. E., Khader Y., Kim S. U., Kim W., Kleiner D. E., Koek G., Joseph Komas N. P., Kondili L. A., Koot B. G., Korenjak M., Kotsiliti E., Koulla Y., Kugelmas C., Kugelmas M., Labidi A., Lange N. F., Lavine J. E., Lazo M., Leite N., Lin H. -C., Lkhagvaa U., Long M. T., Lopez-Jaramillo P., Lozano A., Macedo M. P., Malekzadeh R., Marchesini G., Marciano S., Martinez K., Martinez Vazquez S. E., Mateva L., Mato J. M., Nlombi C. M., McCary A. G., McIntyre J., McKee M., Mendive J. M., Mikolasevic I., Miller P. S., Milovanovic T., Milton T., Moreno-Alcantar R., Morgan T. R., Motala A., Muris J., Musso C., Nava-Gonzalez E. J., Negro F., Nersesov A. V., Neuschwander-Tetri B. A., Nikolova D., Norris S., Novak K., Ocama P., Ong J. P., Ong-Go A., Onyekwere C., Padilla M., Pais R., Pan C., Panduro A., Panigrahi M. K., Papatheodoridis G., Paruk I., Patel K., Goncalves C. P., Figueroa M. P., Perez-Escobar J., Pericas J. M., Perseghin G., Pessoa M. G., Petta S., Marques Souza de Oliveira C. P., Prabhakaran D., Pyrsopoulous N., Rabiee A., Ramji A., Ratziu V., Ravendhran N., Ray K., Roden M., Romeo S., Romero-Gomez M., Rotman Y., Rouabhia S., Rowe I. A., Sadirova S., Alkhatry M. S., Salupere R., Satapathy S. K., Schwimmer J. B., Sebastiani G., Seim L., Seki Y., Serme A. K., Shapiro D., Sharvadze L., Shaw J. E., Shawa I. T., Shenoy T., Shibolet O., Shimakawa Y., Shubrook J. H., Singh S. P., Sinkala E., Skladany L., Skrypnyk I., Song M. J., Sookoian S., Sridharan K., Stefan N., Stine J. G., Stratakis N., Sheriff D. S., Sundaram S. S., Svegliati-Baroni G., Swain M. G., Tacke F., Taheri S., Tan S. -S., Tapper E. B., Targher G., Tcaciuc E., Thiele M., Tiniakos D., Tolmane I., Torre A., Torres E. A., Treeprasertsuk S., Trenell M., Turcan S., Turcanu A., Valantinas J., van Kleef L. A., Velarde Ruiz Velasco J. A., Vesterhus M., Vilar-Gomez E., Waked I., Wattacheril J., Wedemeyer H., Wilkins F., Willemse J., Wong R. J., Yilmaz Y., Yki-Jarvinen H., Yu M. -L., Yumuk V., Zeybel M., Zheng K. I., Zheng M. -H., Lazarus, J, Mark, H, Allen, A, Arab, J, Carrieri, P, Noureddin, M, Alazawi, W, Alkhouri, N, Alqahtani, S, Arrese, M, Bataller, R, Berg, T, Brennan, P, Burra, P, Castro-Narro, G, Cortez-Pinto, H, Cusi, K, Dedes, N, Duseja, A, Francque, S, Hagstrom, H, Huang, T, Wajcman, D, Kautz, A, Kopka, C, Krag, A, Miller, V, Newsome, P, Rinella, M, Romero, D, Sarin, S, Silva, M, Spearman, C, Tsochatzis, E, Valenti, L, Villota-Rivas, M, Zelber-Sagi, S, Schattenberg, J, Wong, V, Younossi, Z, Aberg, F, Adams, L, Al-Naamani, K, Albadawy, R, Alexa, Z, Allison, M, Alnaser, F, Alswat, K, Alvares-da-Silva, M, Alvaro, D, Alves-Bezerra, M, Andrade, R, Anstee, Q, Awuku, Y, Baatarkhuu, O, Baffy, G, Bakieva, S, Bansal, M, Barouki, R, Batterham, R, Behling, C, Belfort-DeAguiar, R, Berzigotti, A, Betel, M, Bianco, C, Bosi, E, Boursier, J, Brunt, E, Bugianesi, E, Byrne, C, Cabrera Cabrejos, M, Caldwell, S, Carr, R, Castellanos Fernandez, M, Castera, L, Castillo-Lopez, M, Caussy, C, Cerda-Reyes, E, Ceriello, A, Chan, W, Chang, Y, Charatcharoenwitthaya, P, Chavez-Tapia, N, Chung, R, Colombo, M, Coppell, K, Cotrim, H, Craxi, A, Crespo, J, Dassanayake, A, Davidson, N, De Knegt, R, de Ledinghen, V, Demir, M, Desalegn, H, Diago, M, Dillon, J, Dimmig, B, Dirac, M, Dirchwolf, M, Dufour, J, Dvorak, K, Ekstedt, M, El-Kassas, M, Elsanousi, O, Elsharkawy, A, Elwakil, R, Eskridge, W, Eslam, M, Esmat, G, Fan, J, Ferraz, M, Flisiak, R, Fortin, D, Fouad, Y, Freidman, S, Fuchs, M, Gadano, A, Gastaldelli, A, Geerts, A, Geier, A, George, J, Gerber, L, Ghazinyan, H, Gheorghe, L, Kile, D, Girala, M, Boon Bee, G, Goossens, N, Graupera, I, Gronbaek, H, Hamid, S, Hebditch, V, Henry, Z, Hickman, I, Hobbs, L, Hocking, S, Hofmann, W, Idilman, R, Iruzubieta, P, Isaacs, S, Isakov, V, Ismail, M, Jamal, M, Jarvis, H, Jepsen, P, Jornayvaz, F, Sudhamshu, K, Kakizaki, S, Karpen, S, Kawaguchi, T, Keating, S, Khader, Y, Kim, S, Kim, W, Kleiner, D, Koek, G, Joseph Komas, N, Kondili, L, Koot, B, Korenjak, M, Kotsiliti, E, Koulla, Y, Kugelmas, C, Kugelmas, M, Labidi, A, Lange, N, Lavine, J, Lazo, M, Leite, N, Lin, H, Lkhagvaa, U, Long, M, Lopez-Jaramillo, P, Lozano, A, Macedo, M, Malekzadeh, R, Marchesini, G, Marciano, S, Martinez, K, Martinez Vazquez, S, Mateva, L, Mato, J, Nlombi, C, Mccary, A, Mcintyre, J, Mckee, M, Mendive, J, Mikolasevic, I, Miller, P, Milovanovic, T, Milton, T, Moreno-Alcantar, R, Morgan, T, Motala, A, Muris, J, Musso, C, Nava-Gonzalez, E, Negro, F, Nersesov, A, Neuschwander-Tetri, B, Nikolova, D, Norris, S, Novak, K, Ocama, P, Ong, J, Ong-Go, A, Onyekwere, C, Padilla, M, Pais, R, Pan, C, Panduro, A, Panigrahi, M, Papatheodoridis, G, Paruk, I, Patel, K, Goncalves, C, Figueroa, M, Perez-Escobar, J, Pericas, J, Perseghin, G, Pessoa, M, Petta, S, Marques Souza de Oliveira, C, Prabhakaran, D, Pyrsopoulous, N, Rabiee, A, Ramji, A, Ratziu, V, Ravendhran, N, Ray, K, Roden, M, Romeo, S, Romero-Gomez, M, Rotman, Y, Rouabhia, S, Rowe, I, Sadirova, S, Alkhatry, M, Salupere, R, Satapathy, S, Schwimmer, J, Sebastiani, G, Seim, L, Seki, Y, Serme, A, Shapiro, D, Sharvadze, L, Shaw, J, Shawa, I, Shenoy, T, Shibolet, O, Shimakawa, Y, Shubrook, J, Singh, S, Sinkala, E, Skladany, L, Skrypnyk, I, Song, M, Sookoian, S, Sridharan, K, Stefan, N, Stine, J, Stratakis, N, Sheriff, D, Sundaram, S, Svegliati-Baroni, G, Swain, M, Tacke, F, Taheri, S, Tan, S, Tapper, E, Targher, G, Tcaciuc, E, Thiele, M, Tiniakos, D, Tolmane, I, Torre, A, Torres, E, Treeprasertsuk, S, Trenell, M, Turcan, S, Turcanu, A, Valantinas, J, van Kleef, L, Velarde Ruiz Velasco, J, Vesterhus, M, Vilar-Gomez, E, Waked, I, Wattacheril, J, Wedemeyer, H, Wilkins, F, Willemse, J, Wong, R, Yilmaz, Y, Yki-Jarvinen, H, Yu, M, Yumuk, V, Zeybel, M, Zheng, K, Zheng, M, Lazarus J. V., Mark H. E., Allen A. M., Arab J. P., Carrieri P., Noureddin M., Alazawi W., Alkhouri N., Alqahtani S. A., Arrese M., Bataller R., Berg T., Brennan P. N., Burra P., Castro-Narro G. E., Cortez-Pinto H., Cusi K., Dedes N., Duseja A., Francque S. M., Hagstrom H., Huang T. T. -K., Wajcman D. I., Kautz A., Kopka C. J., Krag A., Miller V., Newsome P. N., Rinella M. E., Romero D., Sarin S. K., Silva M., Spearman C. W., Tsochatzis E. A., Valenti L., Villota-Rivas M., Zelber-Sagi S., Schattenberg J. M., Wong V. W. -S., Younossi Z. M., Aberg F., Adams L., Al-Naamani K., Albadawy R. M., Alexa Z., Allison M., Alnaser F. A., Alswat K., Alvares-da-Silva M. R., Alvaro D., Alves-Bezerra M., Andrade R. J., Anstee Q. M., Awuku Y. A., Baatarkhuu O., Baffy G., Bakieva S., Bansal M. B., Barouki R., Batterham R. L., Behling C., Belfort-DeAguiar R., Berzigotti A., Betel M., Bianco C., Bosi E., Boursier J., Brunt E. M., Bugianesi E., Byrne C. J., Cabrera Cabrejos M. C., Caldwell S., Carr R., Castellanos Fernandez M. I., Castera L., Castillo-Lopez M. G., Caussy C., Cerda-Reyes E., Ceriello A., Chan W. -K., Chang Y., Charatcharoenwitthaya P., Chavez-Tapia N., Chung R. T., Colombo M., Coppell K., Cotrim H. P., Craxi A., Crespo J., Dassanayake A., Davidson N. O., De Knegt R., de Ledinghen V., Demir M., Desalegn H., Diago M., Dillon J. F., Dimmig B., Dirac M. A., Dirchwolf M., Dufour J. -F., Dvorak K., Ekstedt M., El-Kassas M., Elsanousi O. M., Elsharkawy A. M., Elwakil R., Eskridge W., Eslam M., Esmat G., Fan J. -G., Ferraz M. L., Flisiak R., Fortin D., Fouad Y., Freidman S. L., Fuchs M., Gadano A., Gastaldelli A., Geerts A., Geier A., George J., Gerber L. H., Ghazinyan H., Gheorghe L., Kile D. G., Girala M., Boon Bee G. G., Goossens N., Graupera I., Gronbaek H., Hamid S., Hebditch V., Henry Z., Hickman I. J., Hobbs L. A., Hocking S. L., Hofmann W. P., Idilman R., Iruzubieta P., Isaacs S., Isakov V. A., Ismail M. H., Jamal M. H., Jarvis H., Jepsen P., Jornayvaz F., Sudhamshu K. C., Kakizaki S., Karpen S., Kawaguchi T., Keating S. E., Khader Y., Kim S. U., Kim W., Kleiner D. E., Koek G., Joseph Komas N. P., Kondili L. A., Koot B. G., Korenjak M., Kotsiliti E., Koulla Y., Kugelmas C., Kugelmas M., Labidi A., Lange N. F., Lavine J. E., Lazo M., Leite N., Lin H. -C., Lkhagvaa U., Long M. T., Lopez-Jaramillo P., Lozano A., Macedo M. P., Malekzadeh R., Marchesini G., Marciano S., Martinez K., Martinez Vazquez S. E., Mateva L., Mato J. M., Nlombi C. M., McCary A. G., McIntyre J., McKee M., Mendive J. M., Mikolasevic I., Miller P. S., Milovanovic T., Milton T., Moreno-Alcantar R., Morgan T. R., Motala A., Muris J., Musso C., Nava-Gonzalez E. J., Negro F., Nersesov A. V., Neuschwander-Tetri B. A., Nikolova D., Norris S., Novak K., Ocama P., Ong J. P., Ong-Go A., Onyekwere C., Padilla M., Pais R., Pan C., Panduro A., Panigrahi M. K., Papatheodoridis G., Paruk I., Patel K., Goncalves C. P., Figueroa M. P., Perez-Escobar J., Pericas J. M., Perseghin G., Pessoa M. G., Petta S., Marques Souza de Oliveira C. P., Prabhakaran D., Pyrsopoulous N., Rabiee A., Ramji A., Ratziu V., Ravendhran N., Ray K., Roden M., Romeo S., Romero-Gomez M., Rotman Y., Rouabhia S., Rowe I. A., Sadirova S., Alkhatry M. S., Salupere R., Satapathy S. K., Schwimmer J. B., Sebastiani G., Seim L., Seki Y., Serme A. K., Shapiro D., Sharvadze L., Shaw J. E., Shawa I. T., Shenoy T., Shibolet O., Shimakawa Y., Shubrook J. H., Singh S. P., Sinkala E., Skladany L., Skrypnyk I., Song M. J., Sookoian S., Sridharan K., Stefan N., Stine J. G., Stratakis N., Sheriff D. S., Sundaram S. S., Svegliati-Baroni G., Swain M. G., Tacke F., Taheri S., Tan S. -S., Tapper E. B., Targher G., Tcaciuc E., Thiele M., Tiniakos D., Tolmane I., Torre A., Torres E. A., Treeprasertsuk S., Trenell M., Turcan S., Turcanu A., Valantinas J., van Kleef L. A., Velarde Ruiz Velasco J. A., Vesterhus M., Vilar-Gomez E., Waked I., Wattacheril J., Wedemeyer H., Wilkins F., Willemse J., Wong R. J., Yilmaz Y., Yki-Jarvinen H., Yu M. -L., Yumuk V., Zeybel M., Zheng K. I., and Zheng M. -H.
Abstract: Background & aims: An estimated 38% of adults worldwide have non-alcoholic fatty liver disease (NAFLD). From individual impacts to widespread public health and economic consequences, the implications of this disease are profound. This study aimed to develop an aligned, prioritised fatty liver disease research agenda for the global health community. Methods: Nine co-chairs drafted initial research priorities, subsequently reviewed by 40 core authors and debated during a three-day in-person meeting. Following a Delphi methodology, over two rounds, a large panel (R1 n = 344, R2 n = 288) reviewed the priorities, via Qualtrics XM, indicating agreement using a four-point Likert-scale and providing written feedback. The core group revised the draft priorities between rounds. In R2, panellists also ranked the priorities within six domains: epidemiology, models of care, treatment and care, education and awareness, patient and community perspectives, and leadership and public health policy. Results: The consensus-built fatty liver disease research agenda encompasses 28 priorities. The mean percentage of ‘agree’ responses increased from 78.3 in R1 to 81.1 in R2. Five priorities received unanimous combined agreement (‘agree’ + ‘somewhat agree’); the remaining 23 priorities had >90% combined agreement. While all but one of the priorities exhibited at least a super-majority of agreement (>66.7% ‘agree’), 13 priorities had [removed]90% combined agreement. Conclusions: Adopting this multidisciplinary consensus-built research priorities agenda can deliver a step-change in addressing fatty liver disease, mitigating against its individual and societal harms and proactively altering its natural history through prevention, identification, treatment, and care. This agenda should catalyse the global health community's efforts to advance and accelerate responses to this widespread and fast-growing public health threat. Impact and implications: An estimated 38% of adults and 13% o
Published: 2023

2. Human Health and Ecological Risks Assessment of Potentially Toxic Elements in Automobile and Non-Erosive Sites in Ebonyi State, Nigeria

Author: Nworie F S, Nwabue F I, Omaka N O, Ngele SO, Oroke C E, Ike-Amadi AC, Mgbemena N, and Onyekwere C
Subjects: General Earth and Planetary Sciences, General Environmental Science
Abstract: Global concern is on the rise of ecological and human health risk associated with unregulated and unabated discharge of potentially toxic elements (PTEs) into the environment. This work investigated the concentration of PTEs, evaluated the sources and level of soil pollution and analyzed the level of ecological and human health risks. The study involves sample size (n =120) of one hundred and twenty soil samples collected from six spatial different areas of Ebonyi State. Determination of the concentration of the PTEs was executed using atomic absorption spectrophotometry. The degree of discrete distribution of the concentration of PTEs and relationship among them was achieved using descriptive statistical analysis and correlation coefficient. Automobile sites based on the result proved to have higher concentrations of PTEs in relation to nonerosive soils. The mean concentration of Zn, Cd, Pb, Ni, Fe and Cu were 689.48, 0.649, 694, 48.84, 6039.82 and 91.02 mg/kg respectively in automobile sites while in nonerosive soils, it was 8.33, 0.26, 2.82, 1.21, 11.99 and 4.36 mg/kg respectively. The overall ecological risk index and degree of contamination are 317.21 and 59.69 for automobile sites and 72.22 and 2.76 for non –erosive sites respectively. This indicates automobile sites to be of high degree of contamination and of high ecological risk. Evaluation of carcinogenic risk shows that Zn, Cu, Ni and Pb are of high cancer risks in the automobile sites for children and adults. Among all the studied PTEs, Zn and Pb poses significant health and ecological risks.
Published: 2022

3. Registry to Understand Patient Characteristics, Treatment Patterns, and Therapy Outcomes in Adults with Chronic Hepatitis C Virus Infection in Asia, Africa, and Eastern Europe

Author: Choudhry AA, Onyekwere C, Purnomo HD, Sollano JJr, Madan K, Katsidzira L, Nath P, Ravishankar AC, Hadigal S, Pirathvisuth T, Ismoilov U, Pandey V, Watanna S, and Ul Haque Z
Subjects: Cultural Studies, Public Administration, Social Psychology, Sociology and Political Science, Visual Arts and Performing Arts, General Mathematics, Strategy and Management, Communication, Geography, Planning and Development, General Social Sciences, Ocean Engineering, Management, Monitoring, Policy and Law, Development, Urban Studies, Philosophy, History and Philosophy of Science, Management of Technology and Innovation, Architecture, General Earth and Planetary Sciences, Business and International Management, General Agricultural and Biological Sciences, Engineering (miscellaneous), General Environmental Science, Civil and Structural Engineering
Abstract: Background: Several patient, government, payer, and provider-level barriers to Hepatitis C virus (HCV) treatment have been identified in regions like Asia, Africa, and the Commonwealth of Independent States (CIS). A patient registry was created in these regions to understand the patterns of clinical care and outcomes in real-world settings. Methods: This prospective study was conducted between 2018 to 2021 across 14 centers. Adult patients considered eligible for treatment with directly acting antivirals (DAAs) were included in the study. The primary endpoint was to understand the prevalence of HCV genotypes (GTs) and DAA treatment strategies The secondary endpoint was to evaluate efficacy and safety of various DAA regimens. Results: A total of 476 patients were enrolled of which 386 (81.1%) completed the study and remaining 90 were lost to follow-up. The most prevalent GT were GT 3 (30.5%) and GT 1 (19%). Patients with GT1 and GT 6 have demonstrated high SVR 12 cure rates(100%; n=55, n=24) followed by GT3 (95.9%, n=94). The most commonly prescribed DAAs were Daclatasvir (60mg)/ Sofosbuvir (SOF/DCV; 43.7%, n=208), Sofosbuvir/Ledipasvir (SOF/LDV; 16.2%, n=77), and Sofosbuvir/Velpatasvir (SOF/VEL; 14.3%, n=68). The SVR12 rates were as follows: SOF/LED, 98.2%, n= 54/55; SOF/VEL, 97.6%, n=35/36; and SOF/DCV, 90.8%, n=128/141. Adverse events were reported in 13 patients, with one death that was not considered treatment-related. Conclusion: Overall, sofosbuvir-based regimens were found to be safe and efficacious. GT 3 and 1 were the most prevalent HCV genotypes.
Published: 2023

4. Advancing the global public health agenda for NAFLD: a consensus statement

Author: Lazarus, J.V. Mark, H.E. Anstee, Q.M. Arab, J.P. Batterham, R.L. Castera, L. Cortez-Pinto, H. Crespo, J. Cusi, K. Dirac, M.A. Francque, S. George, J. Hagström, H. Huang, T.T.-K. Ismail, M.H. Kautz, A. Sarin, S.K. Loomba, R. Miller, V. Newsome, P.N. Ninburg, M. Ocama, P. Ratziu, V. Rinella, M. Romero, D. Romero-Gómez, M. Schattenberg, J.M. Tsochatzis, E.A. Valenti, L. Wong, V.W.-S. Yilmaz, Y. Younossi, Z.M. Zelber-Sagi, S. Åberg, F. Adams, L. Khatry, M.S.A. Naamani, K.A. Murillo, O.A. Allen, A.M. Alnaser, F. Alqahtani, S.A. Alswat, K. Alvaro, D. Andrade, R.J. Arrese, M. Awuku, Y.A. Ayesha, M. Baatarkhuu, O. Bakieva, S. Basu, R. Bataller, R. Bedri, S. Bosi, E. Bourliere, M. Bruha, R. Bugianesi, E. Burra, P. Buti, M. Byrne, C.D. Calleja, J.L. Carrieri, P. Carter, F. Fernandez, M.I.C. Castillo-Lopez, G. Castro-Narro, G.E. Chan, H.L.Y. Chan, W.-K. Chang, Y. Colombo, M. Coppell, K.J. Corey, K. Craxi, A. Cryer, D. Dassanayake, A. Martins, A.A.S. de Ledinghen, V. DelPrato, S. Demaio, A. Desalegn, H. Dillon, J. Duseja, A. Dorairaj, P. Ekstedt, M. El Kassas, M. Elsanousi, O.M. Esmat, G. Fan, J.-G. Farpour-Lambert, N. Flisiak, R. Fouad, Y. Fuchs, M. Gani, R.A. Gerber, L. Ghazinyan, H. Gheorghe, L. Goh, G.B.-B. Grønbæk, H. Gulnara, A. Hamid, S. Hebditch, V. Hickman, I.J. Hocking, S.L. Hunyady, B. Idilman, R. Isakov, V.A. Jamal, M.H. Jepsen, P. Iskandar, N.J. Song, M.J. Sudhamshu, K.C. Kakizaki, S. Kalamitsis, G. Kanwal, F. Kao, J.-H. Kaplan, L. Kawaguchi, T. Khader, Y. Kim, S.U. Kodjoh, N. Koek, G. Koike, K. Komas, N.P. Korenjak, M. Kugelmas, M. Labidi, A. Lange, N.F. Lavine, J.E. Lazo, M. Lee, N. Lesmana, C.R.A. Liu, C.-J. Long, M.T. Lopez-Jaramillo, P. Malekzadeh, R. Mahtab, M.A. Marchesini, G. Marinho, R. Vázquez, S.E.M. Mateva, L. Nlombi, C.M. Melin, P. Mikolasevic, I. Milovanovic, T. Musso, C. Nakajima, A. Nava, E. Nersesov, A.V. Nikolova, D. Norris, S. Novak, K. Oben, J. Ong, J.P. Onyekwere, C. Papatheodoridis, G. Paruk, I. Patel, K. Macedo, M.P. Penha-Gonçalves, C. Figueroa, M.P. Hofmann, W.P. Petta, S. de Oliveira, C.P.M.S. Puri, P. Pan, C.Q. Rac, M. Ralston, J. Ramji, A. Razavi, H. Alvares-da-Silva, M.R. Roberts, S. Roden, M. Rose, T. Rouabhia, S. Rovere-Querini, P. Rowe, I.A. Sadirova, S. Salupere, R. Saparbu, T. Sayegh, R. Sebastiani, G. Seki, Y. Selmo, J. Serme, A.K. Shaw, J.E. Shenoy, T. Sheron, N. Shibolet, O. Silva, M. Skrypnyk, I. Socha, P. Soriano, J. Spearman, C.W. Sridharan, K. Suárez, J.J. Sheriff, D.S. Sung, K.-C. Swain, M. Tacke, F. Taheri, S. Tan, S.-S. Tapper, E.B. Yki-Järvinen, H. Thiele, M. Shawa, I.T. Tolmane, I. Torres, E.A. Trauner, M. Treeprasertsuk, S. Turcanu, A. Valantinas, J. Vesterhus, M. Waked, I. Wild, S.H. Willemse, J. Wong, R.J. Xanthakos, S. Young, D.Y. Yu, M.-L. Zheng, K.I. Zeybel, M. Zheng, M.-H. the NAFLD Consensus Consortium
Abstract: Non-alcoholic fatty liver disease (NAFLD) is a potentially serious liver disease that affects approximately one-quarter of the global adult population, causing a substantial burden of ill health with wide-ranging social and economic implications. It is a multisystem disease and is considered the hepatic component of metabolic syndrome. Unlike other highly prevalent conditions, NAFLD has received little attention from the global public health community. Health system and public health responses to NAFLD have been weak and fragmented, and, despite its pervasiveness, NAFLD is largely unknown outside hepatology and gastroenterology. There is only a nascent global public health movement addressing NAFLD, and the disease is absent from nearly all national and international strategies and policies for non-communicable diseases, including obesity. In this global Delphi study, a multidisciplinary group of experts developed consensus statements and recommendations, which a larger group of collaborators reviewed over three rounds until consensus was achieved. The resulting consensus statements and recommendations address a broad range of topics — from epidemiology, awareness, care and treatment to public health policies and leadership — that have general relevance for policy-makers, health-care practitioners, civil society groups, research institutions and affected populations. These recommendations should provide a strong foundation for a comprehensive public health response to NAFLD. © 2021, Springer Nature Limited.
Published: 2022

5. On the Characteristics and Application of Inverse Power Pranav Distribution

Author: Nwankwo, K. C., primary, Onyeagu, I. S., primary, Nwankwo, C. H., primary, Osuji, G. A., primary, and Onyekwere, C. K., primary
Published: 2021
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6. COMPARISON OF ENDOSCOPIC FINDINGS FROM NIGERIAN PATIENTS WITH GASTRODUODENAL DISEASES WITH H. PYLORI VIRULENCE FACTORS: Abstract no.: P10.08

Author: Fowora, M. A., Breithaupt, U., Otegbayo, A., Akere, A., Onyekwere, C., Ndububa, D., Lesi, O. A., Abdulkareem, F., Anomneze, E. E., Seriki, A. T., Adeleye, A., Omonigbehin, E., Moses, B., Ijeh, M., Muller, S., Haas, R., and Smith, S. I.
Published: 2013

7. Exposures to polyvinyl chloride, methyl ketone and other chemicals: The pulmonary and non-pulmonary effect

Author: Oleru, U. G. and Onyekwere, C.
Published: 1992
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8. Irritable bowel syndrome amongst patients with chronic abdominal pain in Lagos, Nigeria: their profile and dietary associations

Author: Duro-Emanuel, A, Onyekwere, C, and Okeke, E
Subjects: Functional gastrointestinal disorder, Irritable bowel syndrome, Chronic abdominal pain, Small intestinal bacterial overgrowth
Abstract: Background: Irritable bowel syndrome (IBS) is a common functional gastrointestinal disorder in which bowel habits are altered in association with abdominal pain or discomfort. Reports of prevalence vary worldwide, with that of the sub-Sahara region ranging from 8% to 31% among apparently healthy subjects.Aim: To determine the prevalence of IBS amongst patients presenting with chronic recurrent abdominal pain, their IBS sub-types and socio-demographic profile as well as their dietary habits. To determine the prevalence of small intestinal bacteria overgrowth (SIBO) in the cohort with IBS.Subjects and Methods: Following ethical approval, 350 consecutive patients with recurrent abdominal pain who presented to the general outpatient departments of three (3) General hospitals in Lagos were evaluated for the presence of IBS, using the Rome III criteria via an interviewer administered questionnaire. 65 of them, who fulfilled the criteria, were clinically examined, with blood and fresh stool samples taken. Hydrogen breath test, after a lactulose drink, was performed and used to determine those IBS subjects with SIBO.Results: The overall IBS prevalence was 18.6%. The IBS-subtypes were IBS-mixed (64.6%), IBS-constipatory type (24.6%) and IBS-diarrhoea type (10.8%). Most of the IBS patients (41.5%) were in the third decade of life, with a slight female preponderance (1.2: 1). Lower educational status (p=
Published: 2018

9. Hepatitis D infection in Nigeria

Author: Onyekwere, C. A., Audu, R. A., Duro-Emmanuel, F., and Ige, F. A.
Published: 2012
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10. Gastrointestinal stromal tumours: a review of cases seen at a university hospital over an eight year period

Author: Oludara, MA, Onyekwere, C, Ibrahim, NA, Popoola, A, and Omodele, FO
Subjects: GIST
Abstract: Gastrointestinal stroma tumours are uncommon mesenchymal tumours affecting the gastrointestinal tract. We report four cases of GIST involving the stomach seen at the Lagos state university teaching hospital, (LASUTH), Lagos, Nigeria between 2004 and 2012. Their ages ranged from 59 to 65yrs with three females and one male. All had successful excision surgery except the 4th case who declined surgery but has responded favourably to Imantinib. There was melting away of the tumour with significant weight gain. One patient had further immunohistochemical confirmation, drug treatment with imantinib and surgery overseas. This report highlights the diagnostic challenges resulting from lack of facilities for proper immunohistochemistry locally and calls for regional mapping and collaboration with few centers performing this diagnostic procedure. Only one case treated locally had drug treatment with imantinib. Others underwent conventional chemotherapy following surgery.Keywords: GIST.
Published: 2013

11. Pattern of hepatitis and HIV infection among dialysis patients in urban hospitals in Lagos Nigeria; implication for control

Author: Onyekwere, C A, Awobusuyi, and Ogbera, A O
Abstract: No Abstract. Nigerian Medical Practitioner Vol. 51 (5) 2006: pp. 100-102
Published: 2008

12. Colonoscopy Practice in Lagos, Nigeria: A Report of an Audit

Author: Onyekwere, C. A., primary, Odiagah, J. N., additional, Ogunleye, O. O., additional, Chibututu, C., additional, and Lesi, O. A., additional
Published: 2013
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13. PWE-002 IBS in Nigeria; is there a decline in prevalence?

Author: Onyekwere, C A, primary, Asiyanbi, A, additional, and Obi, J, additional
Published: 2012
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14. Typhoid Fever: Misdiagnosis or Overdiagnosis

Author: Onyekwere, C A, primary
Published: 2007
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15. Nonalcoholic fatty liver disease: Synopsis of current developments.

Author: Onyekwere, C. A., Ogbera, A. O., Samaila, A. A., Balogun, B. O., and Abdulkareem, F. B.
Published: 2015
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16. Chronic liver disease and hepatic encephalopathy: Clinical profile and outcomes.

Author: Onyekwere, C. A., Ogbera, A. O., and Hameed, L.
Published: 2011
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17. KRAS and BRAF mutations in Nigerian colorectal cancers

Author: Abdulkareem, F. B., Sanni, L. A., Richman, S. D., Chambers, P., Hemmings, G., Grabsch, H., Quirke, P., Elesha, S. O., Banjo, A. F., Oluwole Atoyebi, Adesanya, A. A., Onyekwere, C. A., Ojukwu, J., Anomneze, E. E., and Rotimi, O.

18. Non-alcoholic fatty liver disease and the metabolic syndrome in an urban hospital serving an African community

Author: Onyekwere, C. A., Anthonia Ogbera, and Balogun, B. O.

19. Diagnostic methods for the detection of Helicobacter pylori in Nigeria

Author: Stella Smith, Omonigbehin, E. A., Goodluck, H. A., Abdulkareem, F. B., Onyekwere, C. A., Agomo, C., Ndububa, D. A., Fowora, M. A., Otegbayo, J. A., Contreras, M., Haas, R., and Rieder, G.

20. Ulcerative colitis in a Nigerian girl: A case report

Author: Senbanjo Idowu O, Oshikoya Kazeem A, Onyekwere Charles A, Abdulkareem Fatimah B, and Njokanma Olisamedua F
Subjects: Ulcerative colitis, Child, Nigerian, Medicine, Biology (General), QH301-705.5, Science (General), Q1-390
Abstract: Abstract Background Ulcerative colitis (UC) is uncommon in the tropics and sub-tropics. We report a case of UC in a 7 year old girl whose parents were both Nigerians. This report is to alert healthcare professionals in sub-Saharan Africa that UC is not a rare health problem, especially in children. Case presentation The patient presented with frequent passage of blood stained stool, abdominal pain and significant weight loss. The diagnosis was entertained after she was investigated for common causes of chronic diarrhea in our setting and the findings were negative. The patient symptoms abated after she was commenced on steroid therapy. Conclusion Under-diagnosis and misdiagnosis may account for a dearth of information on UC in African children.
Published: 2012
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21. Evaluation of blood reservation and use for caesarean sections in a tertiary maternity unit in south western Nigeria

Author: Oshodi Yussuf A, Rabiu Kabiru A, Tayo Adetokunbo O, Fabamwo Adetokunbo O, Akinola Oluwarotimi I, and Onyekwere Chioma A
Subjects: Gynecology and obstetrics, RG1-991
Abstract: Abstract Background Haemorrhage from obstetric causes is the most common cause of maternal mortality in the developing world. Prevention of mortality from haemorrhage will necessarily involve prompt blood transfusions among other life saving measures. There are however limited stocks of fresh or stored blood in many health care facilities in Sub Saharan Africa. Caesarean section has been identified as a common indication for blood transfusion in obstetrics practice and its performance is often delayed by non availability of blood in our centre. An evaluation of blood reservation and use at caesarean sections in a tertiary maternity unit in Lagos, south western Nigeria should therefore assist in formulating the most rational blood transfusion policies. Methods Case records of 327 patients who had elective and emergency caesarian sections at the Lagos State University Teaching Hospital between 1st October and 31st December 2007 were reviewed. Data pertaining to age, parity, booking status, type and indication for Caesarean section, pre- and post-operative packed cell volume, blood loss at surgery, units of blood reserved in the blood bank, unit(s) of blood transfused and duration of hospital stay was extracted and the data analysed. Results There were 1056 deliveries out of which 327 (31%) were by Caesarean section. During the study period, a total of 654 units of blood were reserved in the blood bank and subsequently made available in theatre. Out of this number, only 89 (13.6%) were transfused to 41 patients. Amongst those transfused, twenty-six (54%) were booked and 31 (75.6%) had primary caesarian section. About 81% of those transfused had emergency caesarean section. The most common indication for surgery among those transfused were placenta praevia (9 patients with 21 units of blood) and cephalo-pelvic disproportion (8 patients with 13 units). Conclusion Even though a large number of units of blood was reserved and made available in the theatre at the time of operation, majority of the patients operated did not need blood transfusion. Provision of a mini- blood bank within the obstetric unit and careful patient categorization will ensure timely availability of blood for surgery without necessarily tying down stock in the central blood bank.
Published: 2010
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22. Advancing the global public health agenda for NAFLD: a consensus statement

Author: Lazarus, Jeffrey V., Mark, Henry E., Anstee, Quentin M., Arab, Juan Pablo, Batterham, Rachel L., Castera, Laurent, Cortez-Pinto, Helena, Crespo, Javier, Cusi, Kenneth, Dirac, M. Ashworth, Francque, Sven, Hickman, Ingrid J., Hocking, Samantha L., Hunyady, Bela, Idilman, Ramazan, Isakov, Vasily A., Jamal, Mohammad H., Jepsen, Peter, Iskandar, Natacha Jreige, Song, Myeong Jun, Sudhamshu, K. C., George, Jacob, Kakizaki, Satoru, Kalamitsis, George, Kanwal, Fasiha, Kao, Jia-Horng, Kaplan, Lee, Kawaguchi, Takumi, Khader, Yousef, Kim, Seung Up, Kodjoh, Nicolas, Koek, Ger, Hagström, Hannes, Koike, Kazuhiko, Komas, Narcisse Patrice, Korenjak, Marko, Kugelmas, Marcelo, Labidi, Asma, Lange, Naomi F., Lavine, Joel E., Lazo, Mariana, Lee, Nancy, Lesmana, Cosmas Rinaldi A., Huang, Terry T.-K., Liu, Chun-Jen, Long, Michelle T., Lopez-Jaramillo, Patricio, Malekzadeh, Reza, Mahtab, Mamun Al, Marchesini, Giulio, Marinho, Rui, Vázquez, Sophia E. Martínez, Mateva, Lyudmila, Nlombi, Charles Mbendi, Ismail, Mona H., Melin, Pascal, Mikolasevic, Ivana, Milovanovic, Tamara, Musso, Carla, Nakajima, Atsushi, Nava, Edna, Nersesov, Alexander V., Nikolova, Dafina, Norris, Suzanne, Novak, Katja, Kautz, Achim, Oben, Jude, Ong, Janus P., Onyekwere, Charles, Papatheodoridis, George, Paruk, Imran, Patel, Keyur, Macedo, M. Paula, Penha-Gonçalves, Carlos, Figueroa, Marlene Pérez, Hofmann, Wolf Peter, Sarin, Shiv Kumar, Petta, Salvatore, de Oliveira, Claudia Pinto Marques Souza, Puri, Puneet, Pan, Calvin Q., Rac, Marek, Ralston, Johanna, Ramji, Alnoor, Razavi, Homie, Alvares-da-Silva, Mario Reis, Roberts, Stuart, Loomba, Rohit, Roden, Michael, Rose, Tamsin, Rouabhia, Samir, Rovere-Querini, Patrizia, Rowe, Ian A., Sadirova, Shakhlo, Salupere, Riina, Saparbu, Tobokalova, Sayegh, Raymond, Sebastiani, Giada, Miller, Veronica, Seki, Yosuke, Selmo, Josefina, Serme, Abdel Karim, Shaw, Jonathan E., Shenoy, Thrivikrama, Sheron, Nick, Shibolet, Oren, Silva, Marcelo, Skrypnyk, Igor, Socha, Piotr, Newsome, Philip N., Soriano, Joan, Spearman, C. Wendy, Sridharan, Kannan, Suárez, Juan José, Sheriff, Dhastagir Sultan, Sung, Ki-Chul, Swain, Mark, Tacke, Frank, Taheri, Shahrad, Tan, Soek-Siam, Ninburg, Michael, Tapper, Elliot B., Yki-Järvinen, Hannele, Thiele, Maja, Shawa, Isaac Thom, Tolmane, Ieva, Torres, Esther A., Trauner, Michael, Treeprasertsuk, Sombat, Turcanu, Adela, Valantinas, Jonas, Ocama, Ponsiano, Vesterhus, Mette, Waked, Imam, Wild, Sarah H., Willemse, Jose, Wong, Robert J., Xanthakos, Stavra, Young, Dan Yock, Yu, Ming-Lung, Zheng, Kenneth I., Zeybel, Mudjat, Ratziu, Vlad, Zheng, Ming-Hua, Rinella, Mary, Romero, Diana, Romero-Gómez, Manuel, Schattenberg, Jörn M., Tsochatzis, Emmanuel A., Valenti, Luca, Wong, Vincent Wai-Sun, Yilmaz, Yusuf, Younossi, Zobair M., Zelber-Sagi, Shira, Åberg, Fredrik, Adams, Leon, Khatry, Maryam Salem Al, Naamani, Khalid Al, Murillo, Omar Alfaro, Allen, Alina M., Alnaser, Faisal, Alqahtani, Saleh A., Alswat, Khalid, Alvaro, Domenico, Andrade, Raúl J., Arrese, Marco, Awuku, Yaw Asante, Ayesha, Motala, Baatarkhuu, Oidov, Bakieva, Shokhista, Basu, Rita, Bataller, Ramon, Bedri, Shahinaz, Bosi, Emanuele, Bourliere, Marc, Bruha, Radan, Bugianesi, Elisabetta, Burra, Patrizia, Buti, Maria, Byrne, Christopher D., Calleja, Jose Luis, Carrieri, Patrizia, Carter, Flloyd, Fernandez, Marlen Ivon Castellanos, Castillo-Lopez, Gabriela, Castro-Narro, Graciela E., Chan, Henry Lik Yuen, Chan, Wah-Kheong, Chang, Yoosoo, Colombo, Massimo, Coppell, Kirsten J., Corey, Kathleen, Craxi, Antonio, Cryer, Donna, Dassanayake, Anuradha, Martins, Antonieta de Ascenção Soares, de Ledinghen, Victor, DelPrato, Stefano, Demaio, Alessandro, Desalegn, Hailemichael, Dillon, John, Duseja, Ajay, Dorairaj, Prabhakaran, Ekstedt, Mattias, El Kassas, Mohamed, Elsanousi, Osama M., Esmat, Gamal, Fan, Jian-Gao, Farpour-Lambert, Nathalie, Flisiak, Robert, Fouad, Yasser, Fuchs, Michael, Gani, Rino A., Gerber, Lynn, Ghazinyan, Hasmik, Gheorghe, Liana, Goh, George Boon-Bee, Grønbæk, Henning, Gulnara, Aghayeva, Hamid, Saeed, Hebditch, Vanessa, Repositório da Universidade de Lisboa, Masira, Lazarus, Jeffrey, V, Mark, Henry E., Anstee, Quentin M., Arab, Juan Pablo, Batterham, Rachel L., Castera, Laurent, Cortez-Pinto, Helena, Crespo, Javier, Cusi, Kenneth, Dirac, M. Ashworth, Francque, Sven, George, Jacob, Hagstrom, Hannes, Huang, Terry T-K, Ismail, Mona H., Kautz, Achim, Sarin, Shiv Kumar, Loomba, Rohit, Miller, Veronica, Newsome, Philip N., Ninburg, Michael, Ocama, Ponsiano, Ratziu, Vlad, Rinella, Mary, Romero, Diana, Romero-Gomez, Manuel, Schattenberg, Jorn M., Tsochatzis, Emmanuel A., Valenti, Luca, Wong, Vincent Wai-Sun, Yilmaz, Yusuf, Younossi, Zobair M., Zelber-Sagi, Shira, Lazarus, J. V., Mark, H. E., Anstee, Q. M., Arab, J. P., Batterham, R. L., Castera, L., Cortez-Pinto, H., Crespo, J., Cusi, K., Dirac, M. A., Francque, S., George, J., Hagstrom, H., Huang, T. T. -K., Ismail, M. H., Kautz, A., Sarin, S. K., Loomba, R., Miller, V., Newsome, P. N., Ninburg, M., Ocama, P., Ratziu, V., Rinella, M., Romero, D., Romero-Gomez, M., Schattenberg, J. M., Tsochatzis, E. A., Valenti, L., Wong, V. W. -S., Yilmaz, Y., Younossi, Z. M., Zelber-Sagi, S., Aberg, F., Adams, L., Khatry, M. S. A., Naamani, K. A., Murillo, O. A., Allen, A. M., Alnaser, F., Alqahtani, S. A., Alswat, K., Alvaro, D., Andrade, R. J., Arrese, M., Awuku, Y. A., Ayesha, M., Baatarkhuu, O., Bakieva, S., Basu, R., Bataller, R., Bedri, S., Bosi, E., Bourliere, M., Bruha, R., Bugianesi, E., Burra, P., Buti, M., Byrne, C. D., Calleja, J. L., Carrieri, P., Carter, F., Fernandez, M. I. C., Castillo-Lopez, G., Castro-Narro, G. E., Chan, H. L. Y., Chan, W. -K., Chang, Y., Colombo, M., Coppell, K. J., Corey, K., Craxi, A., Cryer, D., Dassanayake, A., Martins, A. A. S., de Ledinghen, V., Delprato, S., Demaio, A., Desalegn, H., Dillon, J., Duseja, A., Dorairaj, P., Ekstedt, M., El Kassas, M., Elsanousi, O. M., Esmat, G., Fan, J. -G., Farpour-Lambert, N., Flisiak, R., Fouad, Y., Fuchs, M., Gani, R. A., Gerber, L., Ghazinyan, H., Gheorghe, L., Goh, G. B. -B., Gronbaek, H., Gulnara, A., Hamid, S., Hebditch, V., Hickman, I. J., Hocking, S. L., Hunyady, B., Idilman, R., Isakov, V. A., Jamal, M. H., Jepsen, P., Iskandar, N. J., Song, M. J., Sudhamshu, K. C., Kakizaki, S., Kalamitsis, G., Kanwal, F., Kao, J. -H., Kaplan, L., Kawaguchi, T., Khader, Y., Kim, S. U., Kodjoh, N., Koek, G., Koike, K., Komas, N. P., Korenjak, M., Kugelmas, M., Labidi, A., Lange, N. F., Lavine, J. E., Lazo, M., Lee, N., Lesmana, C. R. A., Liu, C. -J., Long, M. T., Lopez-Jaramillo, P., Malekzadeh, R., Mahtab, M. A., Marchesini, G., Marinho, R., Vazquez, S. E. M., Mateva, L., Nlombi, C. M., Melin, P., Mikolasevic, I., Milovanovic, T., Musso, C., Nakajima, A., Nava, E., Nersesov, A. V., Nikolova, D., Norris, S., Novak, K., Oben, J., Ong, J. P., Onyekwere, C., Papatheodoridis, G., Paruk, I., Patel, K., Macedo, M. P., Penha-Goncalves, C., Figueroa, M. P., Hofmann, W. P., Petta, S., de Oliveira, C. P. M. S., Puri, P., Pan, C. Q., Rac, M., Ralston, J., Ramji, A., Razavi, H., Alvares-da-Silva, M. R., Roberts, S., Roden, M., Rose, T., Rouabhia, S., Rovere-Querini, P., Rowe, I. A., Sadirova, S., Salupere, R., Saparbu, T., Sayegh, R., Sebastiani, G., Seki, Y., Selmo, J., Serme, A. K., Shaw, J. E., Shenoy, T., Sheron, N., Shibolet, O., Silva, M., Skrypnyk, I., Socha, P., Soriano, J., Spearman, C. W., Sridharan, K., Suarez, J. J., Sheriff, D. S., Sung, K. -C., Swain, M., Tacke, F., Taheri, S., Tan, S. -S., Tapper, E. B., Yki-Jarvinen, H., Thiele, M., Shawa, I. T., Tolmane, I., Torres, E. A., Trauner, M., Treeprasertsuk, S., Turcanu, A., Valantinas, J., Vesterhus, M., Waked, I., Wild, S. H., Willemse, J., Wong, R. J., Xanthakos, S., Young, D. Y., Yu, M. -L., Zheng, K. I., Zeybel, M., Zheng, M. -H., NAFLD Consensus Consortium, Lazarus J.V., Mark H.E., Anstee Q.M., Arab J.P., Batterham R.L., Castera L., Cortez-Pinto H., Crespo J., Cusi K., Dirac M.A., Francque S., George J., Hagstrom H., Huang T.T.-K., Ismail M.H., Kautz A., Sarin S.K., Loomba R., Miller V., Newsome P.N., Ninburg M., Ocama P., Ratziu V., Rinella M., Romero D., Romero-Gomez M., Schattenberg J.M., Tsochatzis E.A., Valenti L., Wong V.W.-S., Yilmaz Y., Younossi Z.M., Zelber-Sagi S., Aberg F., Adams L., Khatry M.S.A., Naamani K.A., Murillo O.A., Allen A.M., Alnaser F., Alqahtani S.A., Alswat K., Alvaro D., Andrade R.J., Arrese M., Awuku Y.A., Ayesha M., Baatarkhuu O., Bakieva S., Basu R., Bataller R., Bedri S., Bosi E., Bourliere M., Bruha R., Bugianesi E., Burra P., Buti M., Byrne C.D., Calleja J.L., Carrieri P., Carter F., Fernandez M.I.C., Castillo-Lopez G., Castro-Narro G.E., Chan H.L.Y., Chan W.-K., Chang Y., Colombo M., Coppell K.J., Corey K., Craxi A., Cryer D., Dassanayake A., Martins A.A.S., de Ledinghen V., DelPrato S., Demaio A., Desalegn H., Dillon J., Duseja A., Dorairaj P., Ekstedt M., El Kassas M., Elsanousi O.M., Esmat G., Fan J.-G., Farpour-Lambert N., Flisiak R., Fouad Y., Fuchs M., Gani R.A., Gerber L., Ghazinyan H., Gheorghe L., Goh G.B.-B., Gronbaek H., Gulnara A., Hamid S., Hebditch V., Hickman I.J., Hocking S.L., Hunyady B., Idilman R., Isakov V.A., Jamal M.H., Jepsen P., Iskandar N.J., Song M.J., Sudhamshu K.C., Kakizaki S., Kalamitsis G., Kanwal F., Kao J.-H., Kaplan L., Kawaguchi T., Khader Y., Kim S.U., Kodjoh N., Koek G., Koike K., Komas N.P., Korenjak M., Kugelmas M., Labidi A., Lange N.F., Lavine J.E., Lazo M., Lee N., Lesmana C.R.A., Liu C.-J., Long M.T., Lopez-Jaramillo P., Malekzadeh R., Mahtab M.A., Marchesini G., Marinho R., Vazquez S.E.M., Mateva L., Nlombi C.M., Melin P., Mikolasevic I., Milovanovic T., Musso C., Nakajima A., Nava E., Nersesov A.V., Nikolova D., Norris S., Novak K., Oben J., Ong J.P., Onyekwere C., Papatheodoridis G., Paruk I., Patel K., Macedo M.P., Penha-Goncalves C., Figueroa M.P., Hofmann W.P., Petta S., de Oliveira C.P.M.S., Puri P., Pan C.Q., Rac M., Ralston J., Ramji A., Razavi H., Alvares-da-Silva M.R., Roberts S., Roden M., Rose T., Rouabhia S., Rovere-Querini P., Rowe I.A., Sadirova S., Salupere R., Saparbu T., Sayegh R., Sebastiani G., Seki Y., Selmo J., Serme A.K., Shaw J.E., Shenoy T., Sheron N., Shibolet O., Silva M., Skrypnyk I., Socha P., Soriano J., Spearman C.W., Sridharan K., Suarez J.J., Sheriff D.S., Sung K.-C., Swain M., Tacke F., Taheri S., Tan S.-S., Tapper E.B., Yki-Jarvinen H., Thiele M., Shawa I.T., Tolmane I., Torres E.A., Trauner M., Treeprasertsuk S., Turcanu A., Valantinas J., Vesterhus M., Waked I., Wild S.H., Willemse J., Wong R.J., Xanthakos S., Young D.Y., Yu M.-L., Zheng K.I., Zeybel M., and Zheng M.-H.
Subjects: medicine.medical_specialty, Civil society, Delphi method, MEDLINE, Nash, MULTIDISCIPLINARY APPROACH, Disease, LATIN-AMERICAN ASSOCIATION, Multidisciplinary approach, QUALITY-OF-LIFE, Non-alcoholic Fatty Liver Disease, Epidemiology, Medicine, Humans, POSITION STATEMENT, BIOMEDICINE AND HEALTHCARE. Clinical Medical Sciences. Internal Medicine, FATTY LIVER-DISEASE, BIOMEDICINA I ZDRAVSTVO. Kliničke medicinske znanosti. Interna medicina, Hepatology, business.industry, Public health, Gastroenterology, ALCOHOLIC STEATOHEPATITIS, NONINVASIVE DIAGNOSIS, medicine.disease, Obesity, CARDIOVASCULAR-DISEASE, PRACTICE GUIDELINES, Family medicine, PRACTICAL APPROACH, Human medicine, business
Abstract: Digital, Non-alcoholic fatty liver disease (NAFLD) is a potentially serious liver disease that affects approximately one-quarter of the global adult population, causing a substantial burden of ill health with wide-ranging social and economic implications. It is a multisystem disease and is considered the hepatic component of metabolic syndrome. Unlike other highly prevalent conditions, NAFLD has received little attention from the global public health community. Health system and public health responses to NAFLD have been weak and fragmented, and, despite its pervasiveness, NAFLD is largely unknown outside hepatology and gastroenterology. There is only a nascent global public health movement addressing NAFLD, and the disease is absent from nearly all national and international strategies and policies for non-communicable diseases, including obesity. In this global Delphi study, a multidisciplinary group of experts developed consensus statements and recommendations, which a larger group of collaborators reviewed over three rounds until consensus was achieved. The resulting consensus statements and recommendations address a broad range of topics — from epidemiology, awareness, care and treatment to public health policies and leadership — that have general relevance for policy-makers, health-care practitioners, civil society groups, research institutions and affected populations. These recommendations should provide a strong foundation for a comprehensive public health response to NAFLD., Ciencias Médicas y de la Salud
Published: 2021

23. Helicobacter pylori Diagnosis and Treatment in Africa: The First Lagos Consensus Statement of the African Helicobacter and Microbiota Study Group.

Author: Smith SI, Schulz C, Ugiagbe R, Ndip R, Dieye Y, Leja M, Onyekwere C, Ndububa D, Ajayi A, Jolaiya TF, Jaka H, Setshedi M, Gunturu R, Otegbayo JA, Lahbabi-Amrani N, Arigbabu AO, Kayamba V, and Nashidengo PA
Subjects: Humans, Africa epidemiology, Prevalence, Helicobacter Infections diagnosis, Helicobacter Infections drug therapy, Helicobacter Infections epidemiology, Helicobacter Infections therapy, Helicobacter pylori, Consensus
Abstract: Background: Helicobacter pylori (H. pylori) infection is the most prevalent type of bacterial infection. Current guidelines from different regions of the world neglect specific African conditions and requirements. The African Helicobacter and Microbiota Study Group (AHMSG), founded in 2022, aimed to create an Africa-specific consensus report reflecting Africa-specific issues., Summary: Eighteen experts from nine African countries and two European delegates supported by nine African collaborators from eight other countries prepared statements on the most important African issues in four working groups: (1) epidemiology, (2) diagnosis, (3) indications and prevention, and (4) treatment. Limited resources, restricted access to medical systems, and underdeveloped diagnostic facilities differ from those of other regions. The results of the individual working groups were presented for the final consensus voting, which included all board members., Key Messages: There is a need for further studies on H. pylori prevalence in Africa, with diagnosis hinged on specific African situation. Treatment of H. pylori in the African setting should be based on accessibility and reimbursement, while indication and prevention should be defined in specific African countries., (© 2024 S. Karger AG, Basel.)
Published: 2024
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24. Knowledge and Willingness to Accept Vasectomy as a Method of Family Planning among Married Male Workers in the University of Nigeria, Enugu Campus, Enugu State, Nigeria.

Author: Umeobieri AK, Kassy CW, Umeh VC, Uzoagba-Onyekwere CW, Uko EW, and Ukonu OJ
Subjects: Male, Humans, Nigeria, Cross-Sectional Studies, Contraceptive Agents, Family Planning Services, Vasectomy
Abstract: Background: Vasectomy is a safe and effective contraceptive option available to men, yet the practice is very low. The study aimed to assess the knowledge and willingness to accept vasectomy as a method of family planning among male married workers in a university in Enugu, Nigeria., Methods: This was a cross-sectional study conducted among 405 male married workers in a tertiary institution in Enugu, Nigeria. Samples were selected using multistage sampling technique. Data was collected using pretested structured questionnaire and analyzed using proportion, chi - square and logistic regression. Statistical significance was set at < 0.05., Results: Very few of the respondents, 10.6% had good knowledge of vasectomy and about 20.7% showed willingness to accept vasectomy as a contraceptive option. Educational level (AOR = 2.441, C.I = 1.158 - 5.146), wife support (AOR = 0.201, C.I = 0.071 - 0.571) and completed family size (AOR = 0.063, P = 0.030 - 0.136) were found to be the predictors of willingness to use vasectomy as a contraceptive among male workers of University of Nigeria, Enugu., Conclusion: Knowledge of vasectomy and willingness to accept it as a contraceptive were found to be poor. Awareness campaign and health education on vasectomy and ensuring that family planning services are attended by couples with completed family size will improve knowledge and willingness to accept vasectomy., Competing Interests: The Authors declare that no competing interest exists, (Copyright © 2023 by West African Journal of Medicine.)
Published: 2023

25. The views of African and Middle Eastern Gastroenterologists on the management of mild-to-moderate, non-erosive gastro-esophageal reflux disease (GERD).

Author: Al-Marhabi A, Hashem A, Zuberi BF, Onyekwere C, Lodhi I, Mounir M, Alkhowaiter S, Al Awadhi S, Naidoo VG, and Hamada Y
Subjects: Africa epidemiology, Humans, Middle East, Gastroenterologists, Gastroesophageal Reflux diagnosis, Gastroesophageal Reflux therapy
Abstract: Introduction: Gastro-esophageal reflux disease (GERD) is a common gastrointestinal disorder that occurs when backflow of the gastric contents into the esophagus results in troublesome symptoms. Though GERD has been extensively studied in Western populations, literature on the management of GERD in patients in Africa and Middle East (AME) is scarce., Areas Covered: In this review, we provide an overview of the management of mild-to-moderate GERD in AME. Here we focus on the efficacy and safety of currently available treatments for GERD to help physicians and community pharmacists appropriately manage patients with mild-to-moderate GERD in the primary healthcare setting, detailing specific situations and patient scenarios that are relevant to the region, including management of GERD during Ramadan and post-bariatric surgery., Expert Opinion: Under-appreciation of the burden of GERD in the region has resulted in a lack of consensus on management. Barriers that currently prevent the adoption of treatment guidelines in the primary healthcare setting may include lack of availability of local guidelines and referral systems, a paucity of region-specific research, and dogmatic adherence to traditional practice. By increasing awareness, strengthening knowledge, and by more effective utilization of resources, physicians and pharmacists could optimize GERD management strategies to better support patients.
Published: 2022
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26. Helicobacter pylori Infection in Africa: Update of the Current Situation and Challenges.

Author: Smith SI, Ajayi A, Jolaiya T, Onyekwere C, Setshedi M, Schulz C, Otegbayo JA, Ndip R, Dieye Y, Alboraie M, Ally R, Gunturu R, Hyasinta J, Ugiagbe R, Ndububa D, and Arigbabu A
Subjects: Adult, Africa epidemiology, Child, Humans, Prevalence, Helicobacter Infections diagnosis, Helicobacter Infections drug therapy, Helicobacter Infections epidemiology, Helicobacter pylori, Stomach Neoplasms epidemiology, Stomach Neoplasms therapy
Abstract: Background: The burden of Helicobacter pylori infection (HPI) in Africa remains high with varying levels of prevalence among children and adults reported in different regions of the continent. Persistent and uneradicated HPI could result in gastric cancer, although less severe pathological outcomes have been reported among Africans - the so-called "African enigma.", Summary: Analysis of endoscopic findings of the upper gastrointestinal tract demonstrates similarities with that of patients from the West. Thus, it could be asserted that the true picture of HPI in Africa is yet to be unveiled due to several challenges including inadequate health-care system, lack of treatment guidelines and standardized protocol for diagnosis, and lack of data. This review explores the prevalence, diagnosis, treatment, and health-care system in Africa as it relates to HPI, thus providing an update and highlighting the need for an African HPI guideline., Key Messages: There is high prevalence of Helicobacter pylori infection (HPI) in Africa with an increasing burden of antibiotic resistance. Various methods including invasive and noninvasive methods are deployed in the diagnosis of HPI in Africa. There is a need for consensus on diagnosis and treatment of HPI in Africa., (© 2021 S. Karger AG, Basel.)
Published: 2022
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27. H Pylori Infection in Nigeria and associated Risk Factors; Implication in Infection Control.

Author: Onyekwere CA
Subjects: Humans, Infection Control, Nigeria epidemiology, Risk Factors, Helicobacter Infections epidemiology, Helicobacter pylori
Published: 2021

28. Helicobacter pylori patient isolates from South Africa and Nigeria differ in virulence factor pathogenicity profile and associated gastric disease outcome.

Author: Palamides P, Jolaiya T, Idowu A, Loell E, Onyekwere C, Ugiagbe R, Agbo I, Lesi O, Ndububa D, Adekanle O, Carranza M, Ally R, Njom H, Adeleye IA, Harrison U, Clarke A, Fischer W, Smith S, and Haas R
Subjects: Breath Tests, Cephalosporins, Endoscopy, Evolution, Molecular, Female, Geography, Humans, Male, Microbial Sensitivity Tests, Nigeria epidemiology, Phenotype, Phylogeny, Polymerase Chain Reaction, Prevalence, South Africa epidemiology, Surveys and Questionnaires, Urea, Virulence, Helicobacter pylori, Stomach Diseases epidemiology, Stomach Diseases microbiology, Virulence Factors metabolism
Abstract: Helicobacter pylori is a gram-negative, spiral-shaped bacterial pathogen and the causative agent for gastritis, peptic ulcer disease and classified as a WHO class I carcinogen. While the prevalence of H. pylori infections in Africa is among the highest in the world, the incidence of gastric cancer is comparably low. Little is known about other symptoms related to the H. pylori infection in Africa and the association with certain phenotypes of bacterial virulence. We established a network of study sites in Nigeria (NG) and South Africa (ZA) to gain an overview on the epidemiological situation. In total 220 isolates from 114 patients were analyzed and 118 different patient isolates examined for the presence of the virulence factors cagA, vacA, dupA, their phylogenetic origin and their resistance against the commonly used antibiotics amoxicillin, clarithromycin, metronidazole and tetracycline. We report that H. pylori isolates from Nigeria and South Africa differ significantly in their phylogenetic profiles and in their expression of virulence factors. VacA mosaicism is intensive, resulting in m1-m2 vacA chimeras and frequent s1m1 and s1m2 vacA subtypes in hpAfrica2 strains. Gastric lesions were diagnosed more frequent in Nigerian versus South African patients and H. pylori isolates that are resistant against one or multiple antibiotics occur frequently in both countries.
Published: 2020
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29. Duodenal ulcer promoting gene (DupA), plasticity region genes and sigma factors in H. pyloristrains from Nigeria.

Author: Jolaiya TF, Fowora MA, Onyekwere C, Ugiagbe R, Agbo II, Lesi O, Ndububa DA, Adekanle O, Njom HA, Idowu A, Adeleye IA, Bamidele M, Ngoka FN, Palamides PF, and Smith SI
Subjects: Adolescent, Adult, Aged, Aged, 80 and over, Biopsy, Child, Female, Genes, Bacterial, Helicobacter pylori isolation & purification, Humans, Male, Middle Aged, Nigeria, Polymerase Chain Reaction, Young Adult, Duodenal Ulcer epidemiology, Helicobacter Infections epidemiology, Helicobacter pylori genetics, Sigma Factor genetics, Virulence Factors genetics
Abstract: Introduction: Helicobacter pylori is a principal cause of gastric cancer. The aim of this study was to determine the prevalence and contribution of duodenal ulcer promoting gene A (dupA), the plasticity region genes and sigma factors in relation to their pathological expression of H. pylori infections in the Nigerian population., Methodology: Polymerase Chain Reaction was used to analyze a total of forty-nine H. pylori strains isolated from patients attending various endoscopic units in tertiary hospitals in Nigeria for complete dupA (G27 variant), jhp0917, jhp0918, other plasticity region genes jhp 914/917, jhp0914, jhp0940 and sigma factors., Results: PCR results indicated that the prevalence of complete dupA (G27 variants), jhp0917, jhp0918 and other plasticity region genes jhp0914, jhp0914/0917 and jhp0940 in the H. pylori strains were 4%, 53%, 88%, 73%, 12% and 0% respectively. The prevalence values of the sigma factors were 96%, 92%, 80% for rpoN, fliA and rpoD respectively. However, the endoscopic findings showed that erosion, normal mucosal, ulcer, hyperaemic stomach, mucosal atrophy and oedematous stomach in the patients where the H. pylori strains were isolated were 40.8%, 32.7%, 10.2%, 8.2%, 2.0% and 6.1% respectively. There was significant association between jhp0917, jhp914/917 and G27 variant and the endoscopic findings, while other plasticity genes showed no association with the endoscopic findings., Conclusion: These results suggest that the presence of jhp0917, jhp0914/917 and G27 variant could be used as marker to predict the pathological effect of severity in Nigeria patients with H. pylori infection., Competing Interests: No Conflict of Interest is declared, (Copyright (c) 2020 Tolulope Funbi Jolaiya, Muinah A Fowora, Charles Onyekwere, Rose Ugiagbe, Ifeanyi Agbo, Dennis Ndububa, Olusegun Adekanle, Henry Njom, Idowu Ayodeji, Isaac Adeleye, Moses Bamidele, Favor Ngoka, Pia Palamides, Stella Smith, Olufunmilayo Lesi.)
Published: 2020
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30. Prevalence of Helicobacter pylori infection among dyspeptic patients with and without type 2 diabetes mellitus in Nigeria.

Author: Smith SI, Jolaiya T, Onyekwere C, Fowora M, Ugiagbe R, Agbo I, Cookey C, Lesi O, Ndububa D, Adekanle O, Palamides P, Adeleye I, Njom H, Idowu A, Clarke A, and Pellicano R
Subjects: Adolescent, Adult, Aged, Aged, 80 and over, Breath Tests, Child, Cohort Studies, Cross-Sectional Studies, Humans, Middle Aged, Nigeria epidemiology, Prevalence, Young Adult, Diabetes Mellitus, Type 2 epidemiology, Dyspepsia epidemiology, Helicobacter Infections epidemiology
Abstract: Background: This multicenter study was undertaken to determine the prevalence of Helicobacter pylori (H. pylori) infection among dyspeptic patients with and without type 2 diabetes mellitus (T2DM)., Methods: Patients with dyspepsia were recruited from tertiary teaching hospitals, three in the South-West and one in the South-South regions of Nigeria, between November 2016 and August 2017. The participants had breath samples analyzed for H. pylori by the Urea Breath Test (UBT) following manufacturer's instructions. Dyspeptic patients who were diagnosed previously with T2DM were recorded. Crosstab using chi-square and correlation analyses were used to test (hypothesis) variables., Results: The entire cohort included 471 dyspeptics, 19 (4%) of whom had T2DM. H. pylori infection was reported in 232/471 (49.3%) dyspeptics and 13/19 T2DM patients, without significant difference between diabetics and nondiabetics. The majority (84.6%) of those positive for UBT and T2DM were in the age group 52-71 years, while none was in the age group 72-91 years. There was no statistical significance (P>0.05) between the age group, UBT and T2DM positive., Conclusions: Our study showed that, in Nigeria, there is no difference in prevalence of H. pylori in dyspeptic patients with and without T2DM.
Published: 2019
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31. The Prevalence of Occult Hepatitis B Infection among Blood Donors in Lagos, Nigeria.

Author: Akinbami A, Badiru M, Uche E, Onyekwere C, Ismail K, Olowoselu O, Oluwole E, Suleiman A, Augustine B, and Olaosebikan H
Abstract: Background: In occult hepatitis B virus (HBV) infection, the HBV DNA is present in the blood or liver tissue in patients negative for hepatitis B surface antigen (HBsAg) with or without anti-HBV antibodies. Thus, the absence of HBsAg in the blood only reduces the risk of transmission and is not sufficient enough to ensure the absence of HBV infection., Aim: This study was aimed at determining the prevalence of occult HBV infection among blood donors in Lagos., Study Designs: A cross-sectional study was done among 101 consenting blood donors at Lagos State University Teaching Hospital, Ikeja, between November 2016 and January 2017., Materials and Methods: HBV DNA analysis and viral load were done at the Molecular Laboratory of National Sickle Cell Centre, Idi Araba, Lagos, for all the HBsAg negative blood donors screened by rapid kit at Ikeja., Results: The prevalence of occult HBV DNA among the participants was 3% consisting of 3% prevalence of HBV DNA surface antigen and 0% prevalence for precore and core of the HBV DNA., Conclusion: The low prevalence (3%) of occult HBV seen in our study does not make it cost-effective to routinely screen blood donors or the general population for HBV infection using DNA polymerase chain reaction., Competing Interests: There are no conflicts of interest.
Published: 2019
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32. Clinical and Socio- Demographic Risk Factors for Acquisition of Helicobacter pylori Infection in Nigeria

Author: Smith S, Jolaiya T, Fowora M, Palamides P, Ngoka F, Bamidele M, Lesi O, Onyekwere C, Ugiagbe R, Agbo I, Ndububa D, Adekanle O, Adedeji A, Adeleye I, and Harrison U
Subjects: Adult, Breath Tests, Female, Follow-Up Studies, Humans, Male, Middle Aged, Nigeria epidemiology, Prevalence, Prognosis, Risk Factors, Young Adult, Demography, Helicobacter Infections epidemiology, Helicobacter Infections virology, Helicobacter pylori pathogenicity, Socioeconomic Factors
Abstract: Background: The aim of the study was to assess clinical and socio-demographic characteristics as well as prior drug usage as risk factors for Helicobacter pylori (H. pylori) infection in Nigeria. Methods: A total of 347 respondents were surveyed by assessing their clinical and socio-demographic characteristics in comparison with the non-invasive gold standard for H. pylori diagnosis, the urea breath test (UBT). Chi-square test and odds ratio analyses were conducted in order to assess if variables such as socio-demographic factors, drug intake, and history of ulcer/gastritis/ gastric cancer within the family significantly predicted test results. Results: A total of 130 (37.5%) respondents were positive for H. pylori by the UBT. Living with more than three people in an apartment and a history of ulcer/gastritis within the family were significantly associated with H. pylori (p ≤0.05), as well as current antibiotic intake (p ≤0.05). Nationality, stay outside Nigeria, level of education, main occupation, smoking and drinking habits, sources of drinking water, number of children and history of gastric cancer had no significant association with H. pylori infection (p ≥ 0.05). Conclusion: The results of the questionnaire revealed that most socio-demographic characteristics of the respondents had no significant association with H. pylori. Overcrowding, having siblings/parents with history of ulcer/gastritis as well as prior antibiotic usage had a significant association., (Creative Commons Attribution License)
Published: 2018
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33. Characteristics, management, and outcomes of patients with hepatocellular carcinoma in Africa: a multicountry observational study from the Africa Liver Cancer Consortium.

Author: Yang JD, Mohamed EA, Aziz AO, Shousha HI, Hashem MB, Nabeel MM, Abdelmaksoud AH, Elbaz TM, Afihene MY, Duduyemi BM, Ayawin JP, Gyedu A, Lohouès-Kouacou MJ, Ndam AW, Moustafa EF, Hassany SM, Moussa AM, Ugiagbe RA, Omuemu CE, Anthony R, Palmer D, Nyanga AF, Malu AO, Obekpa S, Abdo AE, Siddig AI, Mudawi HM, Okonkwo U, Kooffreh-Ada M, Awuku YA, Nartey YA, Abbew ET, Awuku NA, Otegbayo JA, Akande KO, Desalegn HM, Omonisi AE, Ajayi AO, Okeke EN, Duguru MJ, Davwar PM, Okorie MC, Mustapha S, Debes JD, Ocama P, Lesi OA, Odeghe E, Bello R, Onyekwere C, Ekere F, Igetei R, Mah'moud MA, Addissie B, Ali HM, Gores GJ, Topazian MD, and Roberts LR
Subjects: Adult, Africa epidemiology, Age of Onset, Carcinoma, Hepatocellular etiology, Carcinoma, Hepatocellular mortality, Carcinoma, Hepatocellular therapy, Egypt epidemiology, Female, Hepatitis C complications, Humans, Incidence, Liver Neoplasms etiology, Liver Neoplasms mortality, Liver Neoplasms therapy, Male, Middle Aged, Prevalence, Retrospective Studies, Survival Rate, Carcinoma, Hepatocellular epidemiology, Liver Neoplasms epidemiology
Abstract: Background: Hepatocellular carcinoma is a leading cause of cancer-related death in Africa, but there is still no comprehensive description of the current status of its epidemiology in Africa. We therefore initiated an African hepatocellular carcinoma consortium aiming to describe the clinical presentation, management, and outcomes of patients with hepatocellular carcinoma in Africa., Methods: We did a multicentre, multicountry, retrospective observational cohort study, inviting investigators from the African Network for Gastrointestinal and Liver Diseases to participate in the consortium to develop hepatocellular carcinoma research databases and biospecimen repositories. Participating institutions were from Cameroon, Egypt, Ethiopia, Ghana, Ivory Coast, Nigeria, Sudan, Tanzania, and Uganda. Clinical information-demographic characteristics, cause of disease, liver-related blood tests, tumour characteristics, treatments, last follow-up date, and survival status-for patients diagnosed with hepatocellular carcinoma between Aug 1, 2006, and April 1, 2016, were extracted from medical records by participating investigators. Because patients from Egypt showed differences in characteristics compared with patients from the other countries, we divided patients into two groups for analysis; Egypt versus other African countries. We undertook a multifactorial analysis using the Cox proportional hazards model to identify factors affecting survival (assessed from the time of diagnosis to last known follow-up or death)., Findings: We obtained information for 2566 patients at 21 tertiary referral centres (two in Egypt, nine in Nigeria, four in Ghana, and one each in the Ivory Coast, Cameroon, Sudan, Ethiopia, Tanzania, and Uganda). 1251 patients were from Egypt and 1315 were from the other African countries (491 from Ghana, 363 from Nigeria, 277 from Ivory Coast, 59 from Cameroon, 51 from Sudan, 33 from Ethiopia, 21 from Tanzania, and 20 from Uganda). The median age at which hepatocellular carcinoma was diagnosed significantly later in Egypt than the other African countries (58 years [IQR 53-63] vs 46 years [36-58]; p<0·0001). Hepatitis C virus was the leading cause of hepatocellular carcinoma in Egypt (1054 [84%] of 1251 patients), and hepatitis B virus was the leading cause in the other African countries (597 [55%] of 1082 patients). Substantially fewer patients received treatment specifically for hepatocellular carcinoma in the other African countries than in Egypt (43 [3%] of 1315 vs 956 [76%] of 1251; p<0·0001). Among patients with survival information (605 [48%] of 1251 in Egypt and 583 [44%] of 1315 in other African countries), median survival was shorter in the other African countries than in Egypt (2·5 months [95% CI 2·0-3·1] vs 10·9 months [9·6-12·0]; p<0·0001). Factors independently associated with poor survival were: being from an African countries other than Egypt (hazard ratio [HR] 1·59 [95% CI 1·13-2·20]; p=0·01), hepatic encephalopathy (2·81 [1·72-4·42]; p=0·0004), diameter of the largest tumour (1·07 per cm increase [1·04-1·11]; p<0·0001), log α-fetoprotein (1·10 per unit increase [1·02-1·20]; p=0·0188), Eastern Cooperative Oncology Group performance status 3-4 (2·92 [2·13-3·93]; p<0·0001) and no treatment (1·79 [1·44-2·22]; p<0·0001)., Interpretation: Characteristics of hepatocellular carcinoma differ between Egypt and other African countries. The proportion of patients receiving specific treatment in other African countries was low and their outcomes were extremely poor. Urgent efforts are needed to develop health policy strategies to decrease the burden of hepatocellular carcinoma in Africa., Funding: None., (Copyright © 2017 Elsevier Ltd. All rights reserved.)
Published: 2017
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34. Hepatocellular Carcinoma Occurs at an Earlier Age in Africans, Particularly in Association With Chronic Hepatitis B.

Author: Yang JD, Gyedu A, Afihene MY, Duduyemi BM, Micah E, Kingham TP, Nyirenda M, Nkansah AA, Bandoh S, Duguru MJ, Okeke EN, Kouakou-Lohoues MJ, Abdo A, Awuku YA, Ajayi AO, Omonisi AE, Ocama P, Malu AO, Mustapha S, Okonkwo U, Kooffreh-Ada M, Debes JD, Onyekwere C, Ekere F, Rufina I, and Roberts LR
Subjects: Adolescent, Adult, Africa epidemiology, Age of Onset, Aged, Aged, 80 and over, Carcinoma, Hepatocellular diagnosis, Child, Coinfection complications, Coinfection diagnosis, Female, Hepatitis B, Chronic diagnosis, Hepatitis C, Chronic diagnosis, Humans, Liver Neoplasms diagnosis, Male, Middle Aged, Young Adult, Carcinoma, Hepatocellular epidemiology, Carcinoma, Hepatocellular virology, Hepatitis B, Chronic complications, Hepatitis C, Chronic complications, Liver Neoplasms epidemiology, Liver Neoplasms virology
Published: 2015
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35. Problem of hepatocellular carcinoma in West Africa.

Author: Ladep NG, Lesi OA, Mark P, Lemoine M, Onyekwere C, Afihene M, Crossey MM, and Taylor-Robinson SD
Abstract: The incidence of hepatocellular carcinoma (HCC) is known to be high in West Africa with an approximate yearly mortality rate of 200000. Several factors are responsible for this. Early acquisition of risk factors; with vertical or horizontal transmission of hepatitis B (HBV), environmental food contaminants (aflatoxins), poor management of predisposing risk factors and poorly-managed strategies for health delivery. There has been a low uptake of childhood immunisation for hepatitis B in many West African countries. Owing to late presentations, most sufferers of HCC die within weeks of their diagnosis. Highlighted reasons for the specific disease pattern of HCC in West Africa include: (1) high rate of risk factors; (2) failure to identify at risk populations; (3) lack of effective treatment; and (4) scarce resources for timely diagnosis. This is contrasted to the developed world, which generally has sufficient resources to detect cases early for curative treatment. Provision of palliative care for HCC patients is limited by availability and affordability of potent analgesics. Regional efforts, as well as collaborative networking activities hold promise that could change the epidemiology of HCC in West Africa.
Published: 2014
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36. KRAS and BRAF mutations in Nigerian colorectal cancers.

Author: Abdulkareem FB, Sanni LA, Richman SD, Chambers P, Hemmings G, Grabsch H, Quirke P, Elesha SO, Banjo AF, Atoyebi OA, Adesanya AA, Onyekwere CA, Ojukwu J, Anomneze EE, and Rotimi O
Subjects: Adolescent, Adult, Aged, Aged, 80 and over, Biomarkers, Tumor genetics, Codon, Colorectal Neoplasms pathology, Female, Humans, Male, Middle Aged, Mutation, Nigeria, Young Adult, Black People genetics, Colorectal Neoplasms genetics, Genes, ras genetics, Proto-Oncogene Proteins B-raf genetics
Abstract: Purpose: Activation of the KRAS oncogene is implicated in colorectal carcinogenesis and mutations have been reported in 30-50% of cases. BRAF mutation, though less common, is also reported and importantly associated with shorter progression-free interval. This study aims to determine the KRAS and BRAF mutation statuses of Nigerian colorectal cancers (CRC)., Methods: Mutation analysis was carried out on archival paraffin-embedded blocks of CRC tissues. KRAS codons 12, 13 and 61 and BRAF V600E were assessed by pyrosequencing after DNA extraction from 200 cases at the Leeds Institute of Molecular Medicine, St. James's University Hospital, UK. Mutation rates and the spectra were determined., Results: Pyrosequencing was successful in 112 of 200 cases. KRAS mutation in codons 12 and 13 was demonstrated in 23 of 112 cases (21%); none in codon 61. BRAF mutation in codon 600 was demonstrated in 4.5%., Conclusion: This study shows that 21% of Nigerian CRC patients carry a KRAS mutation; half the rate in Caucasians; and that BRAF mutation also occurs in Nigerian CRC cancers.
Published: 2012

37. Clinico-pathological review of malignant gastric tumours in Lagos, Nigeria.

Author: Abdulkareem FB, Onyekwere CA, Awolola NA, and Ajekigbe AT
Subjects: Adenocarcinoma epidemiology, Adenocarcinoma microbiology, Adult, Aged, Female, Helicobacter Infections complications, Helicobacter Infections epidemiology, Humans, Male, Middle Aged, Nigeria epidemiology, Prevalence, Retrospective Studies, Stomach Neoplasms epidemiology, Stomach Neoplasms microbiology, Young Adult, Adenocarcinoma pathology, Helicobacter pylori, Stomach Neoplasms pathology
Abstract: Background: Gastric cancer is one of the most common cancers and the 2d most common cause of cancer deaths worldwide. Contrary to earlier reports from Africa, prevalence of this cancer has been found to be comparable to that of other parts of the world., Objective: To describe the clinico-pathological features of gastric cancer diagnosed in Lagos and determine the prevalence of H. pylori infection in gastric adenocarcinoma., Methods: This was a retrospective histopathological study of all gastric cancer seen between 1995 and 2007 in the Morbid Anatomy Department of Lagos University Teaching Hospital as well as two other private histopathology laboratories in Lagos (2002-2007). The blocks and slides of gastric cancer tissue were the materials used for the study. The patients' bio data and relevant clinical details were extracted from the demographic records., Results: There were 105 cases of gastric cancer (M:F = 2:1, mean age-55.3 years), 81% of which occurred above 45 yrs. There were 95 cases (90%) of adenocarcinomas, 8 (7.6%) mesenchymal tumours with one case each of small cell non-Hodgkin's lymphoma and carcinoid tumour. H. pylori was detected in 15.5% of 45 cases of adenocarcinoma with 36% showing evidence of chronic gastritis in adjacent non cancerous gastric tissue. All patients with clinical data had one or more alarm features; most recurring being abdominal fullness, recurrent vomiting, anorexia and weight loss., Conclusion: This study suggests that gastric malignancies are not uncommon in Lagos and often manifest with alarm features which should raise a suspicion particularly in our setting with poor diagnostic endoscopic facilities.
Published: 2010
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38. Upper gastrointestinal endoscopy findings in Nigerians: a review of 170 cases in Lagos.

Author: Onyekwere CA, Hameed H, Anomneze EE, and Chibututu C
Subjects: Adult, Age Distribution, Aged, Aged, 80 and over, Diagnosis, Differential, Female, Gastrointestinal Diseases epidemiology, Hospitals, University, Humans, Incidence, Male, Middle Aged, Nigeria epidemiology, Reproducibility of Results, Retrospective Studies, Sex Distribution, Endoscopy, Gastrointestinal methods, Gastrointestinal Diseases diagnosis
Abstract: Background: The advent of flexible endoscopy has made it possible to visualise the mucosa of virtually the entire intestine. This service is yet to be widely available in Nigeria. Existing reports on indications and findings at endoscopies are sometimes conflicting, with some recent reports suggesting a changing pattern of gastrointestinal diseases., Objective: The study set out to evaluate the indications, endoscopic findings and their frequencies as well as any adverse outcome from the endoscopic examinations., Methodology: This was a retrospective study in which we reviewed the endoscopy records of the first one hundred and seventy patients that underwent upper gastrointestinal endoscopy at the Lagos State University Teaching Hospital. The patients' bio data, indications and findings during endoscopic examinations as well as any adverse outcome were documented. Data obtained were analysed using SPSS version 11., Results: The majority of the patients were in the middle to elderly age with a peak in the 5th decade. The commonest indications for upper gastrointestinal endoscopy were; Dyspepsia, upper gastrointestinal haemorrhage, previously diagnosed peptic ulcer unresponsive to treatment and retrosternal discomfort or pain. Endoscopic request for variceal screening were uncommon. The commonest endoscopic findings were; features of gastroesophageal reflux disease, followed by gastroduodenitis (non-ulcer mucosal lesions in stomach and duodenum) and peptic ulcer disease. In 14 patients the endoscopy examination revealed normal findings., Conclusion: The role of endoscopy in the diagnosis and management of gastrointestinal disorders cannot be overemphasised. It is hereby recommended that provision of endoscopic facilities and training of necessary personnel be encouraged by all relevant agencies so that the services can be accessible and affordable by all who require it in view of its importance in patient management.
Published: 2008

39. A clinicopathologic review of oesophageal carcinoma in Lagos.

Author: Abdulkareem FB, Onyekwere CA, Awolola NA, and Banjo AA
Subjects: Age Distribution, Aged, Carcinoma, Squamous Cell diagnosis, Carcinoma, Squamous Cell epidemiology, Carcinoma, Squamous Cell surgery, Esophageal Neoplasms diagnosis, Esophageal Neoplasms epidemiology, Esophageal Neoplasms surgery, Female, Humans, Incidence, Male, Nigeria epidemiology, Prognosis, Risk Factors, Sex Distribution, Carcinoma, Squamous Cell pathology, Esophageal Neoplasms pathology
Abstract: Background: Oesophageal cancer is the 6th most common cause of cancer death world wide. While the incidence is low in some parts of Africa such as Nigeria accounting for 0.4-0.6% of all malignant tumours, it is endemic in Transkei, in South Africa, which is regarded as an epicentre of the disease in Africa., Objective: To document the age and sex distribution, clinical as well as histopathological characteristics of oesophageal carcinoma in Lagos, SW Nigeria,, Methods: The paraffin embedded blocks and slides as well as pathology reports of oesophageal carcinoma collected between 1995 and 2007 from Morbid Anatomy Department of the Lagos University Teaching Hospital and between 2002 and 2007 from two private histopathology laboratories in Lagos State were reviewed. The clinical data such as the age, sex, and clinical summary were extracted from demographic information in patients' case file., Results: Twenty cases representing 2.8% of all gastrointestinal tumours were recorded. The mean age was 65.4 years (SD-12.3) with M:F ratio of 1:1. Squamous cell carcinoma predominated; 18 cases (90%); the remaining two cases (one of which showed evidence of Barrett's oesophagus) were adenocarcinoma (10%). All presented at advanced stage with dysphagia and weight loss with or without vomiting, regurgitation, and/or haematamesis. Two third had mid oesophageal fungating masses, the remaining were located in the lower third. Two cases had surgery, the rest were not fit for any intervention., Conclusion: Oesophageal cancer is not common in Lagos, Nigeria, majority are squamous cell carcinoma. Late presentation gives it a dismal outlook. Although the overall survival is poor, efforts at improving quality of life by palliative measures should be encouraged.
Published: 2008
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40. Prevalence of serological markers of chronic hepatitis B virus infection in diabetics in the Lagos University Teaching Hospital, Lagos.

Author: Onyekwere CA, Anomneze EE, and Wali SS
Subjects: Adolescent, Adult, Biomarkers, Case-Control Studies, Diabetes Mellitus blood, Female, Hepatitis B Core Antigens blood, Hepatitis B Surface Antigens blood, Hepatitis B e Antigens blood, Hepatitis B, Chronic epidemiology, Hepatitis C Antibodies blood, Humans, Male, Middle Aged, Nigeria epidemiology, Seroepidemiologic Studies, Diabetes Mellitus virology, Hepatitis B, Chronic blood
Abstract: Hepatitis B virus (HBV) infection, a major world health problem, is hyper endemic in South-East Asia and sub-Saharan Africa including Nigeria. Being a major cause of morbidity and mortality, prophylaxis using the highly efficacious hepatitis B vaccine is recommended for those at risk. The prevalence of serological markers of chronic HBV infection was determined in a population of 100 outpatient diabetics and 80 non-diabetic controls at the Medical Outpatient Department of the Lagos University Teaching Hospital Idi-Araba between January and July 1992. Twenty diabetic patients [20%] and 14 controls [17.5%] had serological markers (HbsAg and antiHBc) indicating ongoing chronic HBV infection. The difference between diabetics and non-diabetic controls was not statistically significant (P>.05). None of the HbsAg and antiHBc positive diabetics [45%] and 8 control patients [57%] were HbeAg positive. The presence of serological markers was not related to the duration, type of diabetic treatment and degree of diabetic control. Our findings suggest that diabetics in Lagos appear not to be more predisposed to chronic HBV infection than the rest of the population, and therefore would require no special antiHBV prophylaxis.
Published: 2002

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