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Alotaibi H, Anis AM, Alloghbi A, Alshammari K. Oncology Early-Phase Clinical Trials in the Middle East and North Africa: A Review of the Current Status, Challenges, Opportunities, and Future Directions. JOURNAL OF IMMUNOTHERAPY AND PRECISION ONCOLOGY 2024; 7:178-189. [PMID: 39219998 PMCID: PMC11361343 DOI: 10.36401/jipo-23-25] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/11/2023] [Revised: 10/14/2023] [Accepted: 10/16/2023] [Indexed: 09/04/2024]
Abstract
Clinical trials, the empirical discipline of medical experimentation conducted on human subjects, have engendered a paradigm shift in medical research. The need for new clinical studies is paramount in the Middle East and North Africa (MENA) region, with its rising cancer incidence and demand for efficient oncology treatments. This paper comprehensively reviews the challenges, opportunities, and future directions of phase I oncology clinical trials in the MENA region. Early-phase trials are vital in determining drug dosage and assessing toxicity, bridging the gap between preclinical research and clinical practice. Considering the unique landscape of MENA, this review explores regulatory aspects, specific hurdles faced, potential advantages, and areas for improvement in conducting these trials. Various future directions can be pursued to maximize the potential of phase I oncology trials in MENA. While regulatory bodies like the Ministry of Health adhere to the International Conference on Harmonization-Good Clinical Practice guidelines, a unified system meeting high standards would yield better results. Strengthening research infrastructure, establishing research centers, incorporating clinical trial education into the curriculum, and improving access to medical facilities are crucial. Enhancing consumer understanding of research would facilitate increased participation and promote sustainability in trial recruitment. Navigating various funding sources would open the door for more funding opportunities. Collaborations between academia, industry, and regulatory bodies, both international and local, should be fostered to promote knowledge sharing, resource pooling, and harmonization of standards. Such collaborations would contribute to the sustainability of clinical trial activities by leveraging collective expertise, sharing research infrastructure, and distributing the burden of regulatory compliance. By adopting these strategies, the MENA region can advance its capacity to conduct early phases of oncology trials and contribute significantly to the global medical research landscape.
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Affiliation(s)
- Hawazin Alotaibi
- College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia
- King Abdullah International Medical Research Center, Jeddah, Saudi Arabia
| | - Amna M. Anis
- Biomedical Engineering Department, Imam Abdulrahman bin Faisal University, Dammam, Saudi Arabia
- College of Medicine, Al Faisal University, Riyadh, Saudi Arabia
| | - Abdurahman Alloghbi
- Medical Oncology Department, College of Medicine, King Khalid University, Abha, Saudi Arabia
| | - Kanan Alshammari
- Department of Oncology, Ministry of National Guard and Health Affairs, Riyadh, Saudi Arabia
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Farhat T, Nahouli H, Hajjar M, Abdul-Sater Z, Kobeissi E, Menassa M, Chaya BF, Elamine A, El Sheikh WG, Tamim H, Hettiaratchy S, Abu-Sittah G. Characteristics of injuries during the 2006 Lebanon conflict: a three-center retrospective study of survivors, 16 years after the conflict. Front Public Health 2024; 12:1382514. [PMID: 38864014 PMCID: PMC11165059 DOI: 10.3389/fpubh.2024.1382514] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2024] [Accepted: 05/03/2024] [Indexed: 06/13/2024] Open
Abstract
Background Armed conflict injury is a growing public health concern, particularly in regions like the Middle East and North Africa (MENA). The protracted conflicts and political unrest in this region have led to a substantial number of injuries. Despite this, there is still limited understanding of the specific injury patterns stemming from conflicts, such as the 2006 Lebanon conflict. This study aimed to assess the characteristics and burdens of injuries resulting from this conflict, which occurred 16 years prior to this research. Methods This retrospective study analyzed data of individuals affected by the 2006 Lebanon conflict, across three tertiary care centers. Demographics, injuries, complications, injury management, and hospitalization expenses were extracted from medical records and analyzed using SPSS version 29.0. Categorical variables were presented as counts and proportions, and continuous variables as mean ± standard deviation (SD). Hospital comparisons utilized chi-square or Fisher's exact tests for categorical variables, and one-way ANOVAs for continuous variables. Analysis was conducted from September to November 2023. Results Across three hospitals, 341 patients were studied, comprising 73.6% males and 26.4% females. Among them, a notable proportion (57.3% males and 34.1% females) fell within the 18-39 age range. Children and adolescents under 18 years accounted for 15.9% of males and 25.9% of females. Blast-related injuries predominated, with 24.5% resulting from direct damage caused by explosive parts and 33.3% from blast wave forces. Extremity trauma occurred in 49.0% of patients, and head/neck trauma in 24.9%. Common injuries, including penetrating, musculoskeletal, and traumatic brain injuries affected 34.9%, 31.1, and 10.0% of patients, respectively. Wound repair, fracture treatment, and debridement were the most performed procedures on 15.5, 13.5 and 9.7% of the patients, respectively. The total cost of care was USD 692,711, largely covered by the Ministry of Public Health (95.9%). Conclusion Conflict-related injuries significantly contribute to the global burden of disease. Therefore, there is a pressing need to improve national guidelines to prioritize life-threatening cases and potential long-term disabilities. Furthermore, enhancing electronic registry systems to collect clinical data on injured patients is essential for conducting research and better understanding the needs of conflict casualties.
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Affiliation(s)
- Theresa Farhat
- Global Health Institute, American University of Beirut, Beirut, Lebanon
| | - Hasan Nahouli
- Division of Orthopedic Surgery, Department of Surgery, American University of Beirut Medical Center, Beirut, Lebanon
| | - Marwan Hajjar
- Division of Plastic Surgery, Department of Surgery, American University of Beirut Medical Center, Beirut, Lebanon
| | - Zahi Abdul-Sater
- Global Health Institute, American University of Beirut, Beirut, Lebanon
| | - Elsa Kobeissi
- Global Health Institute, American University of Beirut, Beirut, Lebanon
| | - Marilyne Menassa
- Global Health Institute, American University of Beirut, Beirut, Lebanon
| | - Bachar F. Chaya
- Division of Plastic Surgery, Department of Surgery, American University of Beirut Medical Center, Beirut, Lebanon
| | - Ahmad Elamine
- Division of Plastic Surgery, Department of Surgery, American University of Beirut Medical Center, Beirut, Lebanon
| | - Walaa G. El Sheikh
- Clinical Research Institute, American University of Beirut Medical Center, Beirut, Lebanon
| | - Hani Tamim
- Clinical Research Institute, American University of Beirut Medical Center, Beirut, Lebanon
- College of Medicine, Alfaisal University, Riyadh, Saudi Arabia
| | - Shehan Hettiaratchy
- Centre for Blast Injury Studies, Imperial College London, London, United Kingdom
- Department of Surgery and Cancer, Imperial College London, London, United Kingdom
- Imperial College Healthcare NHS Trust, London, United Kingdom
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Tolba M, Skelton M, Abdul Sater Z, Fadhil I, Al-Zahrani A, Kutluk T, Akbarov K, Taher A, Sullivan R, Mula-Hussain L. Cancer Research in Vulnerable Populations: A Call for Collaboration and Sustainability From MENAT Countries. JCO Glob Oncol 2023; 9:e2300201. [PMID: 38096463 PMCID: PMC10730041 DOI: 10.1200/go.23.00201] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2023] [Revised: 09/23/2023] [Accepted: 10/24/2023] [Indexed: 12/18/2023] Open
Abstract
PURPOSE Cancer is a major burden across Middle East, North Africa, Türkiye (MENAT). Many MENAT countries experience multiple conflicts that compound vulnerabilities, but little research investigates the linkages between vulnerability and cancer research. This study examines the current level and the potential for cancer research among vulnerable populations in the MENAT region, aiming to provide direction toward developing a research agenda on the region's vulnerable populations. METHODS Expert-driven meetings were arranged among the 10 authors. After obtaining institutional review board approval, a self-administered online survey questionnaire was circulated to more than 500 cancer practitioners working in 22 MENAT countries. RESULTS Two hundred sixteen cancer practitioners across the MENAT region responded. Fifty percent of the respondents identified clinical research in vulnerable patients with cancer as a significant issue; 21.8% reported previous research experience that included vulnerable populations, and 60% reported encountering vulnerable populations in their daily clinical practice. The main barriers to conducting research were lack of funding (60%), protected time (42%), and research training (35%). More than half of the respondents believed that wars/conflicts constituted an important source of vulnerability. The most vulnerable cancer populations were the elderly, palliative/terminally ill, those with concomitant mental health-related issues, those with other chronic illnesses, and socioeconomically deprived patients. CONCLUSION Results support that a major effort is needed to improve cancer research among vulnerable cancer populations in the MENAT region. We call for interdisciplinary research that accounts for the region's unique, compounding, and cumulative forms of vulnerability. This cancer research agenda on different vulnerable populations must balance sociobehavioral studies that explore sociopolitical barriers to quality care and clinical studies that gauge and refine treatment protocols. Building a research agenda through collaboration and solidarity with international partners is prime time.
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Affiliation(s)
- Marwan Tolba
- Department of Radiation Oncology, Dalhousie University, and Cape Breton Cancer Center, Sydney, Nova Scotia, Canada
| | - Mac Skelton
- Institute of Regional and International Studies, American University of Iraq, Sulaimani, Iraq
- Global Oncology Group, King's College London, London, United Kingdom
| | - Zahi Abdul Sater
- College of Public Health, Phoenicia University, Mazraat El Daoudiyeh, Lebanon
- Global Health Institute, American University of Beirut, Beirut, Lebanon
| | - Ibtihal Fadhil
- Eastern Mediterranean NCD Alliance, Dubai, United Arab Emirates
| | - Ali Al-Zahrani
- King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia
- Gulf Center for Cancer Control & Prevention, Riyadh, Saudi Arabia
| | - Tezer Kutluk
- Department of Pediatrics, Division of Pediatric Oncology, Hacettepe University Faculty of Medicine & Cancer Institute, Ankara, Turkey
| | - Kamal Akbarov
- Division of Human Health, International Atomic Energy Agency, Vienna, Austria
| | - Ali Taher
- Hematology & Oncology, Naef K. Basile Cancer Institute, American University of Beirut Medical Center, Beirut, Lebanon
| | - Richard Sullivan
- King's College London & Guy's Comprehensive Cancer Centre, Global Oncology Group & Institute of Cancer Policy, Centre for Conflict & Health Research, London, United Kingdom
| | - Layth Mula-Hussain
- Department of Radiation Oncology, Dalhousie University, and Cape Breton Cancer Center, Sydney, Nova Scotia, Canada
- College of Medicine—Ninevah University, Mosul, Iraq
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Obeidat M, Nazzal J, Al Sharie S, Al-Azzam AM, Maswadeh A, Al-Abdallat H, Ismail L, Alkderat M, Hzayen R, Al-Sheble Y, Mansour A, Al-Hussaini M. Central nervous system tumors in patients coming from areas of conflict in the Middle East/North Africa region: an experience from King Hussein Cancer Center. Front Oncol 2023; 13:1087987. [PMID: 37265794 PMCID: PMC10231637 DOI: 10.3389/fonc.2023.1087987] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Accepted: 04/11/2023] [Indexed: 06/03/2023] Open
Abstract
Introduction The global cancer burden has been disproportionately shifting towards low- and middle-income countries (LMICs). Limited availability and accessibility to screening, treatment and surveillance, increase in the prevalence and lack of control of risk factors, and underdeveloped healthcare infrastructures have greatly contributed to the disparity in the global cancer burden. Methods A retrospective cohort study was conducted that included adult and pediatric patients with an established diagnosis of Central Nervous System (CNS) tumors including brain or spinal tumors of which different demographic, clinical characteristics, and financial burden were presented. Results 749 patients were included stemming from various countries in the Middle East/North Africa (MENA) region including Libya (34.2%), Palestine (19.8%), Iraq (15.4%), Syria (14.6%) Yemen (14.5%), and Sudan (1.5%). Most patients were adults (66%) with a median age of 34-year-old. 104 patients had died (13.9%), 80 patients were still alive (10.7%) and most of the patients (n= 565, 75.5%) were lost to follow-up. The added cost of managing these patients is 10,172,935 Jordanian Dinars (JOD), with King Hussein Cancer Foundation (KHCF) covering around 34.3% of the total cost. Conclusion Our study aimed at taking a closer look at patients coming from areas of conflict in the MENA region diagnosed and treated for CNS tumors at King Hussein Cancer Center (KHCC) over a 12-year period. It was found that even with the contributions of the Jordanian sources almost half of the patients were faced with the entire financial burden of treatment alone.
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Affiliation(s)
- Mouness Obeidat
- Department of Neurosurgery, King Hussein Cancer Center, Amman, Jordan
| | - Jamil Nazzal
- Office of Scientific Affairs and Research, King Hussein Cancer Center, Amman, Jordan
| | | | | | - Ahmad Maswadeh
- Office of Scientific Affairs and Research, King Hussein Cancer Center, Amman, Jordan
| | | | - Layan Ismail
- School of Medicine, The University of Jordan, Amman, Jordan
| | - Marah Alkderat
- School of Medicine, The University of Jordan, Amman, Jordan
| | - Ro’ya Hzayen
- School of Medicine, The University of Jordan, Amman, Jordan
| | | | - Asem Mansour
- Department of Radiology, King Hussein Cancer Center, Amman, Jordan
| | - Maysa Al-Hussaini
- Department of Pathology and Laboratory Medicine, King Hussein Cancer Center, Amman, Jordan
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Skelton M, Al-Mash'hadani AK, Abdul-Sater Z, Saleem M, Alsaad S, Kahtan M, Al-Samarai AH, Al-Bakir AM, Mula-Hussain L. War and oncology: cancer care in five Iraqi provinces impacted by the ISIL conflict. Front Oncol 2023; 13:1151242. [PMID: 37213303 PMCID: PMC10196689 DOI: 10.3389/fonc.2023.1151242] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2023] [Accepted: 04/06/2023] [Indexed: 05/23/2023] Open
Abstract
War and cancer have been intertwined in Iraq for over three decades, a country where the legacies and ongoing impacts of conflict have been commonly associated with both increased cancer rates as well as the deterioration of cancer care. Most recently, the Islamic State of Iraq and the Levant (ISIL) violently occupied large portions of the country's central and northern provinces between 2014 and 2017, causing devastating impacts on public cancer centers across central and northern Iraq. Focusing on the five Iraqi provinces previously under full or partial ISIL occupation, this article examines the immediate and long-term impacts of war on cancer care across three periods (before, during, and after the ISIL conflict). As there is little published data on oncology in these local contexts, the paper relies primarily upon the qualitative interviews and lived experience of oncologists serving in the five provinces studied. A political economy lens is applied to interpret the results, particularly the data related to progress in oncology reconstruction. It is argued that conflict generates immediate and long-term shifts in political and economic conditions that, in turn, shape the rebuilding of oncology infrastructure. The documentation of the destruction and reconstruction of local oncology systems is intended to benefit the next generation of cancer care practitioners in the Middle East and other conflict-affected regions areas in their efforts to adapt to conflict and rebuild from the legacies of war.
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Affiliation(s)
- Mac Skelton
- Institute of Regional and International Studies, American University of Iraq-Sulaimani, Sulaymaniyah, Iraq
- Global Oncology Group, King's College London, London, United Kingdom
| | | | - Zahi Abdul-Sater
- Global Health Institute, American University of Beirut, Beirut, Lebanon
- College of Public Health, Phoenicia University, Mazraat El Daoudiyeh, Lebanon
| | - Mohammed Saleem
- Medical Oncology Department, Kirkuk Oncology and Hematology Center, Kirkuk, Iraq
| | - Saad Alsaad
- Medical Oncology Department, Tikrit Oncology Center, Tikrit, Iraq
| | - Marwa Kahtan
- Medical Oncology Department, Diyala Cancer Center, Baqubah, Iraq
| | | | - Ahmed Moyed Al-Bakir
- Medical Oncology Department, Specialized Oncology and Nuclear Medicine Hospital, Mosul, Iraq
| | - Layth Mula-Hussain
- Radiation Oncology Department, Sultan Qaboos Comprehensive Cancer Care and Research Centre, Muscat, Oman
- Oncology Department, College of Medicine, Ninevah University, Mosul, Iraq
- *Correspondence: Layth Mula-Hussain,
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Sater ZA, Farhat T, Elsayed MN, Youssef Y, Husain M, Kaddoura M, Jaber L, Mukherji D, Taher A. The state of cancer research in fragile and conflict-affected settings in the Middle East and North Africa Region: A bibliometric analysis. Front Oncol 2023; 13:1083836. [PMID: 37035214 PMCID: PMC10076849 DOI: 10.3389/fonc.2023.1083836] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2022] [Accepted: 03/06/2023] [Indexed: 04/11/2023] Open
Abstract
Background Cancer represents a disproportionate burden in LMICs, especially conflict-affected countries in the MENA region. Research output on cancer fails to match the growing burden in the region. This bibliometric study aims to examine the status and trends of cancer research in fragile and conflict-affected settings in the MENA region from 2000 to 2021, while also incorporating economic and demographic indicators as additional factors of analysis. Methods The Web of Science databases were searched for publications related to cancer research in Iraq, Lebanon, Libya, Palestine, Syria, and Yemen from January 1, 2000, to December 31, 2021. The retrieved publications were screened based on preset eligibility criteria and the final list was analyzed using the Bibliometrix Package in R to generate the annual scientific production and citations, journals, institutions, authors, collaborations, keywords, and title co-occurrence. Each country's annual scientific production was analyzed against its annual GDP per capita. Results A total of 4,280 documents met the inclusion criteria in this research. The annual number of publications revealed a significant increase over the past 20 years. These publications were mostly published in international journals that had impact factors rated in the 3rd or 4th quartiles. The overall contribution of researchers from Fragile and Conflict-Affected Settings (FCS) to cancer research was 6.5% of the MENA cancer research productivity, despite comprising around 23% of the total MENA region's population. Lebanon had the highest publication productivity at the country level, followed by Iraq and Syria. GDP per capita was not significantly correlated with cancer research across the countries under investigation. At the institutional level, the American University of Beirut was the most prolific institution and had the highest number of collaborations and the widest range of cooperative partners. Most first authors were male researchers. There is an interest in cancer expression, prevalence, diagnosis, and management in terms of commonly researched topics. Conclusion This study underscores the need for a concerted effort to improve cancer research outcomes in FCS, which can be achieved through targeted research, increased investment in research infrastructure and capacity-building initiatives, and greater regional and global collaboration.
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Affiliation(s)
- Zahi Abdul Sater
- Global Health Institute, American University of Beirut, Beirut, Lebanon
| | - Theresa Farhat
- Global Health Institute, American University of Beirut, Beirut, Lebanon
| | | | - Yara Youssef
- College of Public Health, Phoenicia University, Mazraat El Daoudiyeh, Lebanon
| | - Marium Husain
- Department of Internal Medicine, James Comprehensive Cancer Center, Ohio State University, Ohio, United States
| | - Malak Kaddoura
- Global Health Institute, American University of Beirut, Beirut, Lebanon
| | - Lubna Jaber
- Global Health Institute, American University of Beirut, Beirut, Lebanon
| | - Deborah Mukherji
- Department of Internal Medicine, American University of Beirut Medical Center, Beirut, Lebanon
| | - Ali Taher
- Department of Internal Medicine, American University of Beirut Medical Center, Beirut, Lebanon
- *Correspondence: Ali Taher,
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Adejumo PO, Oluwasanu MM, Ntekim A, Awolude OA, Kotila OA, Aniagwu T, Brown BJ, Dzekem BS, Duncan S, Tito-Ilori M, Ajani O, Lee SM, Babalola CP, Ojengbede O, Huo D, Hammad N, Olopade OI. Oncology Training Needs Assessment Among Health Care Professionals in Nigeria. JCO Glob Oncol 2022; 8:e2200017. [PMID: 35594507 PMCID: PMC9173573 DOI: 10.1200/go.22.00017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2022] [Revised: 03/08/2022] [Accepted: 04/06/2022] [Indexed: 11/20/2022] Open
Abstract
PURPOSE This study investigated the status of training and preparedness for oncology practice and research and degree of interprofessional collaboration among health care professionals in the six geopolitical regions of Nigeria. METHODS A convergent parallel mixed methods design was used. Three hundred seventeen respondents completed a three-part, online questionnaire. Self-rated competencies in oncology research (26 items), oncology practice (16 items), and interprofessional collaboration (nine items) were assessed with a one- to five-point Likert scale. Six key informant and 24 in-depth interviews were conducted. Descriptive statistics, analysis of variance, and pairwise t-test were used to analyze the quantitative data, whereas thematic analysis was used for the qualitative data. RESULTS Respondents were mostly female (65.6%) with a mean age of 40.5 ± 8.3 years. Respondents include 178 nurses (56.2%), 93 medical doctors (29.3%), and 46 pharmacists (14.5%). Self-assessed competencies in oncology practice differed significantly across the three groups of health care professionals (F = 4.789, P = .009). However, there was no significant difference across professions for competency in oncology research (F = 1.256, P = .286) and interprofessional collaboration (F = 1.120, P = .327). The majority of respondents (267, 82.4%) felt that educational opportunities in oncology-associated research in the country are inadequate and that this has implications for practice. Key training gaps reported include poor preparedness in data analysis and bioinformatics (138, 43.5%), writing clinical trials (119, 37.5%), and writing grant/research proposals (105, 33.1%). Challenges contributing to gaps in cancer research include few trained oncology specialists, low funding for research, and inadequate interprofessional collaboration. CONCLUSION This study highlights gaps in oncology training and practice and an urgent need for interventions to enhance interprofessional training to improve quality of cancer care in Nigeria. These would accelerate progress toward strengthening the health care system and reducing global disparities in cancer outcomes.
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Affiliation(s)
- Prisca Olabisi Adejumo
- Department of Nursing, Faculty of Clinical Sciences, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - Mojisola Morenike Oluwasanu
- Department of Health Promotion and Education, Faculty of Public Health, African Regional Health Education Center, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - Atara Ntekim
- Department of Radiation Oncology, Faculty of Clinical Sciences, College of Medicine/University College Hospital, University of Ibadan, Ibadan, Nigeria
| | - Olutosin Alaba Awolude
- Department of Obstetrics and Gynecology, Faculty of Clinical Sciences, College of Medicine, University of Ibadan/University College Hospital, Ibadan, Nigeria
| | - Olayinka Adejoke Kotila
- Department of Pharmaceutical Chemistry, Faculty of Pharmacy, University of Ibadan, Ibadan, Nigeria
- Centre for Drug Discovery Development and Production (CDDDP), Faculty of Pharmacy, University of Ibadan, Ibadan, Nigeria
| | - Toyin Aniagwu
- Department of Health Promotion and Education, Faculty of Public Health, African Regional Health Education Center, College of Medicine, University of Ibadan, Ibadan, Nigeria
- School of Occupational Health Nursing, University College Hospital, Ibadan, Nigeria
| | - Biobele Jotham Brown
- Department of Pediatrics, Faculty of Clinical Sciences, College of Medicine, University of Ibadan/University College Hospital, Ibadan, Nigeria
| | - Bonaventure Suiru Dzekem
- Section of Hematology/Oncology, Center for Global Health, University of Chicago Comprehensive Cancer Center, Chicago, IL
| | - Susan Duncan
- Section of Hematology/Oncology, Center for Global Health, University of Chicago Comprehensive Cancer Center, Chicago, IL
| | - Moyinoluwalogo Tito-Ilori
- Center for Population and Reproductive Health, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - Olufadekemi Ajani
- Center for Population and Reproductive Health, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - Sang Mee Lee
- Department of Public Health Sciences, University of Chicago, Chicago, IL
| | - Chinedum Peace Babalola
- Department of Pharmaceutical Chemistry, Faculty of Pharmacy, University of Ibadan, Ibadan, Nigeria
- Centre for Drug Discovery Development and Production (CDDDP), Faculty of Pharmacy, University of Ibadan, Ibadan, Nigeria
- Institute for Advanced Medical Research and Training, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - Oladosu Ojengbede
- Department of Obstetrics and Gynecology, Faculty of Clinical Sciences, College of Medicine, University of Ibadan/University College Hospital, Ibadan, Nigeria
- Center for Population and Reproductive Health, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - Dezheng Huo
- Department of Public Health Sciences, University of Chicago, Chicago, IL
| | - Nazik Hammad
- Department of Oncology, Queen's University, Kingston, Ontario, Canada
| | - Olufunmilayo I. Olopade
- Section of Hematology/Oncology, Center for Global Health, University of Chicago Comprehensive Cancer Center, Chicago, IL
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