1
|
Musa J, Kocherginsky M, Magaji FA, Maryam AJ, Asufi J, Nenrot D, Burdett K, Katam N, Christian EN, Palanisamy N, Odukoya O, Silas OA, Abdulkareem F, Akpa P, Badmos K, Imade GE, Akanmu AS, Gursel DB, Zheng Y, Joyce BT, Achenbach CJ, Sagay AS, Anorlu R, Wei JJ, Ogunsola F, Murphy RL, Hou L, Simon MA. Epidemiology and survival outcomes of HIV-associated cervical cancer in Nigeria. Infect Agent Cancer 2023; 18:68. [PMID: 37915091 PMCID: PMC10619301 DOI: 10.1186/s13027-023-00550-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2023] [Accepted: 10/25/2023] [Indexed: 11/03/2023] Open
Abstract
INTRODUCTION Invasive cervical cancer (ICC) is an HIV-associated cancer that is preventable and precancerous stages including early ICC stages could be detected through screening offering opportunities for treatment and cure. The high incidence in women living with HIV and late presentation often at advanced stages of ICC with limited treatment facilities often result in early mortality. We sought to compare the epidemiologic characteristics and survival differences in HIV status of ICC patients in Nigeria. METHODS We conducted a cohort study at two federal academic hospital-based research sites in Jos University Teaching Hospital, and Lagos University Teaching Hospital Nigeria, between March 2018 and September 2022. We enrolled women with histologically confirmed ICC with known HIV status, and FIGO staging as part of the United States of America's National Institutes of Health/National Cancer Institute funded project titled 'Epigenomic Biomarkers of HIV-Associated Cancers in Nigeria'. The primary outcome was all-cause mortality with assessment of overall survival (OS) and time to death after ICC diagnosis. OS distribution was estimated using the method of Kaplan-Meier and compared between groups using the log-rank test. RESULTS A total of 239 women with confirmed ICC were enrolled and included in this analysis, of whom 192 (80.3%) were HIV-negative (HIV-/ICC +), and 47 (19.7%) were HIV-positive (HIV +/ICC +). The HIV +/ICC + patients were younger with median age 46 (IQR: 40-51) years compared to 57 (IQR: 45-66) among HIV-/ICC + (P < 0.001). Squamous cell carcinoma was the commonest histopathologic variant in 80.4% of ICC diagnosis, moderately differentiated tumor grade in 68.1% in both groups. HIV +/ICC + diagnosis was at FIGO advanced stages in 64.9% compared to 47.9% in HIV-/ICC +. The HIV-/ICC + women had better OS compared to HIV +/ICC + participants (p = 0.018), with 12-month OS 84.1% (95%CI 75-90%) and 67.6% (95%CI 42-84%) respectively. CONCLUSION ICC is diagnosed at a relatively young age in women living with HIV, with a significantly lower overall survival probability compared to women without HIV. The trend of presentation and diagnosis at advanced stages in women living with HIV could partly explain the differences in overall survival.
Collapse
Affiliation(s)
- Jonah Musa
- Department of Obstetrics and Gynecology, College of Health Sciences, University of Jos, Jos, Plateau State, Nigeria.
- Department of Preventive Medicine, Division of Cancer Epidemiology and Prevention, Feinberg School of Medicine, Northwestern University, Chicago, USA.
- Center for Global Oncology, Institute for Global Health, Feinberg School of Medicine, Northwestern University, Chicago, USA.
| | - Masha Kocherginsky
- Division of Biostatistics, Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, USA
| | - Francis A Magaji
- Department of Obstetrics and Gynecology, College of Health Sciences, University of Jos, Jos, Plateau State, Nigeria
| | - Ali J Maryam
- Department of Obstetrics and Gynecology, College of Health Sciences, University of Jos, Jos, Plateau State, Nigeria
| | - Joyce Asufi
- Department of Nursing, Oncology Unit and Nursing Education, Jos University Teaching Hospital, Jos, Nigeria
| | - Danjuma Nenrot
- Information Technology and Data Management Unit, Adult HIV Clinic, Jos University Teaching Hospital, Jos, Nigeria
| | - Kirsten Burdett
- Division of Biostatistics, Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, USA
| | - Neelima Katam
- Robert H. Lurie Comprehensive Cancer Center and Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, 60611, USA
| | - Elizabeth N Christian
- Robert J. Havey MD Institute for Global Health, Northwestern University, Chicago, IL, USA
| | - Nisha Palanisamy
- Robert J. Havey MD Institute for Global Health, Northwestern University, Chicago, IL, USA
| | - Olukemi Odukoya
- Department of Community Medicine, College of Medicine, University of Lagos, Lagos, Nigeria
| | - Olugbenga A Silas
- Department of Anatomic and Forensic Pathology, College of Health Sciences, University of Jos, Jos, Nigeria
| | - Fatimah Abdulkareem
- Department of Anatomic and Forensic Pathology, College of Medicine, University of Lagos, Lagos, Nigeria
| | - Philip Akpa
- Department of Anatomic and Forensic Pathology, College of Health Sciences, University of Jos, Jos, Nigeria
| | - Kabir Badmos
- Department of Anatomic and Forensic Pathology, College of Medicine, University of Lagos, Lagos, Nigeria
| | - Godwin E Imade
- Department of Obstetrics and Gynecology, College of Health Sciences, University of Jos, Jos, Plateau State, Nigeria
- Genomics and Postgraduate Core Facility, College of Health Sciences, University of Jos, Jos, Nigeria
| | - Alani S Akanmu
- Department of Haematology and Blood Transfusion, College of Health Sciences, University of Jos, Jos, Nigeria
| | - Demirkan B Gursel
- Robert H. Lurie Comprehensive Cancer Center and Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, 60611, USA
| | - Yinan Zheng
- Department of Preventive Medicine, Division of Cancer Epidemiology and Prevention, Feinberg School of Medicine, Northwestern University, Chicago, USA
| | - Brian T Joyce
- Department of Preventive Medicine, Division of Cancer Epidemiology and Prevention, Feinberg School of Medicine, Northwestern University, Chicago, USA
| | - Chad J Achenbach
- Robert J. Havey MD Institute for Global Health, Northwestern University, Chicago, IL, USA
- Division of Infectious Diseases, Department of Medicine, Feinberg School of Medicine, Northwestern University, Chicago, USA
| | - Atiene S Sagay
- Department of Obstetrics and Gynecology, College of Health Sciences, University of Jos, Jos, Plateau State, Nigeria
| | - Rose Anorlu
- Department of Obstetrics and Gynecology, College of Medicine, University of Lagos, Lagos, Nigeria
| | - Jian-Jun Wei
- Department of Pathology, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Folasade Ogunsola
- Department of Medical Microbiology, College of Medicine, University of Lagos, Lagos, Nigeria
| | - Robert L Murphy
- Robert J. Havey MD Institute for Global Health, Northwestern University, Chicago, IL, USA
- Division of Infectious Diseases, Department of Medicine, Feinberg School of Medicine, Northwestern University, Chicago, USA
| | - Lifang Hou
- Department of Preventive Medicine, Division of Cancer Epidemiology and Prevention, Feinberg School of Medicine, Northwestern University, Chicago, USA
- Center for Global Oncology, Institute for Global Health, Feinberg School of Medicine, Northwestern University, Chicago, USA
- Robert H. Lurie Comprehensive Cancer Center and Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, 60611, USA
| | - Melissa A Simon
- Robert H. Lurie Comprehensive Cancer Center and Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, 60611, USA
- Department of Obstetrics and Gynecology, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| |
Collapse
|
2
|
Akanbi MO, Bilaver LA, Achenbach C, Hirschhorn LR, Rivera AS, Adekolujo OS, Adekola KUA, Silas OA, Agaba PA, Agbaji O, Shehu NY, Sagay SA, Hou L, Murphy RL. Incident Kaposi sarcoma during the expansion of antiretroviral therapy eligibility in Nigeria: a retrospective cohort study. BMC Cancer 2023; 23:890. [PMID: 37735371 PMCID: PMC10512500 DOI: 10.1186/s12885-023-11402-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2023] [Accepted: 09/13/2023] [Indexed: 09/23/2023] Open
Abstract
INTRODUCTION The expansion of antiretroviral therapy (ART) eligibility could lead to earlier initiation of Human Immunodeficiency Virus (HIV) treatment and consequently reduce the risk of HIV-associated Kaposi Sarcoma (KS). We investigated the impact of changes in the Nigerian HIV treatment guidelines on KS incidence among adults enrolled in HIV care in Nigeria. METHODS We analyzed data of adults who enrolled for HIV care from January 2006 to December 2016 at one of Nigeria's largest HIV treatment centers. Based on changes in HIV treatment guidelines, we classified 2006-2009 as the pre-expansion period and 2010-2016 as the post-expansion period. We used Kaplan Meier curves to compare the incidence of KS in the pre-expansion to the post-expansion period. We used Cox regression models to assess the hazard for incident KS between the two periods after adjusting for potential confounders. RESULTS Among 14,479 patients with HIV, the overall KS incidence was 2.35; 95% CI 2.01-2.74/1,000 person-years. The incidence of KS decreased from 2.53 to 1.58 per 1,000 person-years from 2006 to 2009 to 2010-2016. In models adjusting for age, sex, CD4-T cell count, and ART use, the risk for KS remained lower in 2010-2016 compared to 2006-2009. In analyses restricted to time on ART, there was no significant difference in KS incidence between HIV patients who enrolled in 2006-2009 and 2010-2016 after adjusting for age, sex, and CD4 T-cell count. CONCLUSION The expansion of ART eligibility was associated with a reduced incidence of HIV-associated KS among adults initiating HIV care in Jos, Nigeria. The reduction was likely driven by earlier enrollment for HIV care and ART initiation.
Collapse
Affiliation(s)
- Maxwell O Akanbi
- Department of Hematology & Clinical Oncology, Michigan State University/ McLaren Greater Lansing, 2900 Collins Road, Michigan, 48910, USA.
- Feinberg School of Medicine, Northwestern University, Chicago, IL, USA.
- Department of Medicine, McLaren Hospital, Flint, MI, USA.
- College of Medicine, University of Jos, Jos, Plateau State, Nigeria.
| | - Lucy A Bilaver
- Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Chad Achenbach
- Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Lisa R Hirschhorn
- Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Adovich S Rivera
- Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | | | | | | | - Patricia A Agaba
- College of Medicine, University of Jos, Jos, Plateau State, Nigeria
| | - Oche Agbaji
- College of Medicine, University of Jos, Jos, Plateau State, Nigeria
| | - Nathan Y Shehu
- College of Medicine, University of Jos, Jos, Plateau State, Nigeria
| | - Solomon A Sagay
- College of Medicine, University of Jos, Jos, Plateau State, Nigeria
| | - Lifang Hou
- Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Robert L Murphy
- Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| |
Collapse
|
3
|
Musa J, Kocherginsky M, Magaji FA, Maryam AJ, Asufi J, Nenrot D, Burdett K, Katam N, Christian EN, Palanisamy N, Odukoya O, Silas OA, Abdulkareem F, Akpa P, Badmos K, Imade GE, Akanmu AS, Gursel DB, Zheng Y, Joyce BT, Achenbach CJ, Sagay AS, Anorlu R, Wei JJ, Ogunsola F, Murphy RL, Hou L, Simon MA. Epidemiology and Survival outcomes of HIV-associated cervical cancer in Nigeria. medRxiv 2023:2023.08.08.23293820. [PMID: 37609183 PMCID: PMC10441483 DOI: 10.1101/2023.08.08.23293820] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/24/2023]
Abstract
Introduction Invasive cervical cancer (ICC) is an HIV-associated cancer that is preventable and precancerous stages including early ICC stages could be detected through screening offering opportunities for treatment and cure. The high incidence in women living with HIV and late presentation often at advanced stages of ICC with limited treatment facilities often result in early mortality. We sought to compare the epidemiologic characteristics and survival differences in HIV status of ICC patients in Nigeria. Methods We conducted a cohort study at two federal academic hospital-based research sites in Jos University Teaching Hospital, and Lagos University Teaching Hospital Nigeria, between March 2018 and September 2022. We enrolled women with histologically confirmed ICC with known HIV status, and FIGO staging as part of the United States of America's National Institutes of Health/National Cancer Institute funded project titled 'Epigenomic Biomarkers of HIV-Associated Cancers in Nigeria'. The primary outcome was all-cause mortality with assessment of overall survival (OS) and time to death after ICC diagnosis. OS distribution was estimated using the method of Kaplan-Meier and compared between groups using the log-rank test. Results A total of 239 women with confirmed ICC were enrolled and included in this analysis, of whom 192 (80.3%) were HIV-negative (HIV-/ICC+), and 47 (19.7%) were HIV-positive (HIV+/ICC+). The HIV+/ICC) patients were younger with median age 46 (IQR: 40-51) years compared to 57 (IQR: 45-66) among HIV-/ICC+) (P<0.001. Squamous cell carcinoma was the commonest histopathologic variant in 80.4% of ICC diagnosis, moderately differentiated tumor grade in 68.1% in both groups. HIV+/ICC+ diagnosis was at FIGO advanced stages in 64.9% compared to 47.9% in HIV-/ICC+. The HIV-/ICC+ women had better OS compared to HIV+/ICC+ participants (p=0.018), with 12-month OS 84.1% (95%CI: 75% - 90%) and 67.6% (95%CI: 42%-84%) respectively. Conclusion ICC is diagnosed at a relatively young age in women living with HIV, with a significantly lower overall survival probability compared to women without HIV. The trend of presentation and diagnosis at advanced stages in women living with HIV could partly explain the differences in overall survival.
Collapse
Affiliation(s)
- Jonah Musa
- Department of Obstetrics and Gynecology, College of Health Sciences, University of Jos, Plateau State, Nigeria
- Department of Preventive Medicine, Division of Cancer Epidemiology and Prevention, Feinberg School of Medicine, Northwestern University, USA
- Center for Global Oncology, Institute for Global Health, Feinberg School of Medicine, Northwestern University, Chicago, USA
| | - Masha Kocherginsky
- Division of Biostatistics, Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University
| | - Francis A. Magaji
- Department of Obstetrics and Gynecology, College of Health Sciences, University of Jos, Plateau State, Nigeria
| | - Ali J. Maryam
- Department of Obstetrics and Gynecology, College of Health Sciences, University of Jos, Plateau State, Nigeria
| | - Joyce Asufi
- Department of Nursing, Oncology Unit and Nursing Education, Jos University Teaching Hospital, Jos, Nigeria
| | - Danjuma Nenrot
- Information Technology and Data Management Unit, Adult HIV clinic, Jos University Teaching Hospital, Jos, Nigeria
| | - Kristen Burdett
- Division of Biostatistics, Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University
| | - Neelima Katam
- Robert H. Lurie Comprehensive Cancer Center and Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, 60611, USA
| | - Elizabeth N. Christian
- Robert J. Havey MD, Institute for Global Health, Northwestern University, Chicago, IL, USA
| | - Nisha Palanisamy
- Robert J. Havey MD, Institute for Global Health, Northwestern University, Chicago, IL, USA
| | - Olukemi Odukoya
- Department of Community Medicine, College of Medicine, University of Lagos, Nigeria
| | - Olugbenga A. Silas
- Department of Anatomic and Forensic Pathology, College of Health Sciences, University of Jos, Nigeria
| | - Fatimah Abdulkareem
- Department of Anatomic and Forensic Pathology, College of Medicine, University of Lagos, Nigeria
| | - Philip Akpa
- Department of Anatomic and Forensic Pathology, College of Health Sciences, University of Jos, Nigeria
| | - Kabir Badmos
- Department of Anatomic and Forensic Pathology, College of Medicine, University of Lagos, Nigeria
| | - Godwin E. Imade
- Department of Obstetrics and Gynecology, College of Health Sciences, University of Jos, Plateau State, Nigeria
- Genomics and Postgraduate Core Facility, College of Health Sciences, University of Jos, Nigeria
| | - Alani S. Akanmu
- Department of Haematology and Blood Transfusion, College of Health Sciences, University of Jos, Nigeria
| | - Demirkan B. Gursel
- Robert H. Lurie Comprehensive Cancer Center and Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, 60611, USA
| | - Yinan Zheng
- Department of Preventive Medicine, Division of Cancer Epidemiology and Prevention, Feinberg School of Medicine, Northwestern University, USA
| | - Brian T. Joyce
- Department of Preventive Medicine, Division of Cancer Epidemiology and Prevention, Feinberg School of Medicine, Northwestern University, USA
| | - Chad J. Achenbach
- Robert J. Havey MD, Institute for Global Health, Northwestern University, Chicago, IL, USA
- Division of Infectious Diseases, Department of Medicine, Feinberg School of Medicine, Northwestern University, Chicago, USA
| | - Atiene S. Sagay
- Department of Obstetrics and Gynecology, College of Health Sciences, University of Jos, Plateau State, Nigeria
| | - Rose Anorlu
- Department of Obstetrics and Gynecology, College of Medicine, University of Lagos, Nigeria
| | - Jian-Jun Wei
- Department of Pathology, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Folasade Ogunsola
- Department of Medical Microbiology, College of Medicine, University of Lagos, Nigeria
| | - Robert L. Murphy
- Robert J. Havey MD, Institute for Global Health, Northwestern University, Chicago, IL, USA
- Division of Infectious Diseases, Department of Medicine, Feinberg School of Medicine, Northwestern University, Chicago, USA
| | - Lifang Hou
- Department of Preventive Medicine, Division of Cancer Epidemiology and Prevention, Feinberg School of Medicine, Northwestern University, USA
- Center for Global Oncology, Institute for Global Health, Feinberg School of Medicine, Northwestern University, Chicago, USA
- Robert H. Lurie Comprehensive Cancer Center and Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, 60611, USA
| | - Melissa A. Simon
- Robert H. Lurie Comprehensive Cancer Center and Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, 60611, USA
- Department of Obstetrics and Gynecology, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| |
Collapse
|
4
|
Musa J, Maiga M, Green SJ, Magaji FA, Maryam AJ, Okolo M, Nyam CJ, Cosmas NT, Silas OA, Imade GE, Zheng Y, Joyce BT, Diakite B, Morhason-Bello I, Achenbach CJ, Sagay AS, Ujah IAO, Murphy RL, Hou L, Mehta SD. Vaginal microbiome community state types and high-risk human papillomaviruses in cervical precancer and cancer in North-central Nigeria. BMC Cancer 2023; 23:683. [PMID: 37474918 PMCID: PMC10360349 DOI: 10.1186/s12885-023-11187-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Accepted: 07/17/2023] [Indexed: 07/22/2023] Open
Abstract
BACKGROUND High risk human papillomaviruses (HR-HPV) have a causal role in cervical oncogenesis, and HIV-mediated immune suppression allows HR-HPV to persist. We studied whether vaginal microbiome community state types (CSTs) are associated with high-grade precancer and/or invasive cervical cancer (HSIL/ICC). METHODS This was a cross-sectional study of adult women with cervical cancer screening (CCS) at the Jos University Teaching Hospital (JUTH) in Jos, Nigeria, between January 2020 and February 2022. Cervical swabs underwent HPV genotyping (Anyplex™ II HPV28). Cervico-vaginal lavage (CVL) sample was collected for 16 S rRNA gene amplicon sequencing. We used multivariable logistic regression modelling to assess associations between CSTs and other factors associated with HSIL/ICC. RESULTS We enrolled 155 eligible participants, 151 with microbiome data for this analysis. Women were median age 52 (IQR:43-58), 47.7% HIV positive, and 58.1% with HSIL/ICC. Of the 138 with HPV data, 40.6% were negative for HPV, 10.1% had low-risk HPV, 26.8% had single HR-HPV, and 22.5% had multiple HR-HPV types. The overall prevalence of any HR-HPV type (single and multiple) was 49.3%, with a higher proportion in women with HSIL/ICC (NILM 31.6%, LSIL 46.5%, HSIL 40.8%, and 81.5% ICC; p = 0.007). Women with HIV were more likely to have HSIL/ICC (70.3% vs. 29.7% among women without HIV). In crude and multivariable analysis CST was not associated with cervical pathology (CST-III aOR = 1.13, CST-IV aOR = 1.31). However, in the presence of HR-HPV CST-III (aOR = 6.7) and CST-IV (aOR = 3.6) showed positive association with HSIL/ICC. CONCLUSION Vaginal microbiome CSTs were not significantly associated with HSIL/ICC. Our findings suggest however, that CST could be helpful in identifying women with HSIL/ICC and particularly those with HR-HPV. Characterization of CSTs using point-of-care molecular testing in women with HR-HPV should be studied as an approach to improve early detection and cervical cancer prevention. Future longitudinal research will improve our understanding of the temporal effect of non-optimal CST, HR-HPV, and other factors in cervical cancer development, prevention, and control.
Collapse
Affiliation(s)
- Jonah Musa
- Department of Obstetrics and Gynecology, College of Health Sciences, University of Jos, Jos, Plateau State, Nigeria.
- Department of Preventive Medicine, Division of Cancer Epidemiology and Prevention, Feinberg School of Medicine, Northwestern University, Chicago, USA.
- Center for Global Oncology, Institute for Global Health, Feinberg School of Medicine, Northwestern University, Chicago, USA.
| | - Mamoudou Maiga
- Department of Preventive Medicine, Division of Cancer Epidemiology and Prevention, Feinberg School of Medicine, Northwestern University, Chicago, USA
- Center for Global Oncology, Institute for Global Health, Feinberg School of Medicine, Northwestern University, Chicago, USA
- Center for innovations in Healthcare Technologies, McCormick's School of Biomedical Engineering, Northwestern University, Chicago, IL, USA
| | - Stefan J Green
- Genomics and Microbiome Core Facility, Rush University, Chicago, IL, USA
| | - Francis A Magaji
- Department of Obstetrics and Gynecology, College of Health Sciences, University of Jos, Jos, Plateau State, Nigeria
| | - Ali J Maryam
- Department of Preventive Medicine, Division of Cancer Epidemiology and Prevention, Feinberg School of Medicine, Northwestern University, Chicago, USA
| | - Mark Okolo
- Department of Medical Microbiology, College of Health Sciences, University of Jos, Jos, Nigeria
| | - Chuwang J Nyam
- Division of Epidemiology and Biostatistics, School of Public Health, University of Illinois at Chicago, Chicago, IL, USA
- Genomics and Postgraduate Core Facility, College of Health Sciences, University of Jos, Jos, Nigeria
| | - Nanma T Cosmas
- Department of Medical Microbiology, College of Health Sciences, University of Jos, Jos, Nigeria
| | - Olugbenga A Silas
- Department of Anatomic Pathology and Forensic Medicine, College of Health Sciences, University of Jos, Jos, Nigeria
| | - Godwin E Imade
- Department of Obstetrics and Gynecology, College of Health Sciences, University of Jos, Jos, Plateau State, Nigeria
- Genomics and Postgraduate Core Facility, College of Health Sciences, University of Jos, Jos, Nigeria
| | - Yinan Zheng
- Department of Preventive Medicine, Division of Cancer Epidemiology and Prevention, Feinberg School of Medicine, Northwestern University, Chicago, USA
| | - Brian T Joyce
- Department of Preventive Medicine, Division of Cancer Epidemiology and Prevention, Feinberg School of Medicine, Northwestern University, Chicago, USA
| | - Brehima Diakite
- University of Sciences, Technique and Technologies of Bamako, Bamako, Mali
| | - Imran Morhason-Bello
- Department of Obstetrics and Gynecology, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - Chad J Achenbach
- Division of Infectious Diseases, Department of Medicine, Feinberg School of Medicine, Northwestern University, Chicago, USA
- Robert J. Havey MD, Institute for Global Health, Northwestern University, Chicago, IL, USA
| | - Atiene S Sagay
- Department of Obstetrics and Gynecology, College of Health Sciences, University of Jos, Jos, Plateau State, Nigeria
| | - Innocent A O Ujah
- Department of Obstetrics and Gynecology, College of Health Sciences, University of Jos, Jos, Plateau State, Nigeria
- Federal University of Health Sciences, Otukpo, Benue State, Nigeria
| | - Robert L Murphy
- Department of Obstetrics and Gynecology, College of Medicine, University of Ibadan, Ibadan, Nigeria
- Robert J. Havey MD, Institute for Global Health, Northwestern University, Chicago, IL, USA
| | - Lifang Hou
- Department of Preventive Medicine, Division of Cancer Epidemiology and Prevention, Feinberg School of Medicine, Northwestern University, Chicago, USA
- Center for Global Oncology, Institute for Global Health, Feinberg School of Medicine, Northwestern University, Chicago, USA
- Robert H. Lurie Comprehensive Cancer Center, Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, 60611, USA
| | - Supriya Dinesh Mehta
- Division of Epidemiology and Biostatistics, School of Public Health, University of Illinois at Chicago, Chicago, IL, USA
- Department of Epidemiology and Biostatistics, Rush University, Chicago, IL, USA
| |
Collapse
|
5
|
Musa J, Magaji FA, Ali MJ, Okolo M, Silas OA, Imade GE, Green SJ, Mehta SD, Hou L, Murphy RL. Sustaining the momentum for global cancer research and career development in the COVID-19 era: Lessons and challenges. J Glob Health 2023; 13:03010. [PMID: 37052209 PMCID: PMC10099405 DOI: 10.7189/jogh.13.03010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/14/2023] Open
Affiliation(s)
- Jonah Musa
- Department of Obstetrics and Gynecology, College of Health Sciences, University of Jos, Jos, Plateau State, Nigeria
- Department of Preventive Medicine, Division of Cancer Epidemiology and Prevention, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA
- Center for Global Oncology, Institute for Global Health, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA
| | - Francis A Magaji
- Department of Obstetrics and Gynecology, College of Health Sciences, University of Jos, Jos, Plateau State, Nigeria
| | - Maryam J Ali
- Department of Obstetrics and Gynecology, College of Health Sciences, University of Jos, Jos, Plateau State, Nigeria
| | - Mark Okolo
- Department of Medical Microbiology, College of Health Sciences, University of Jos, Jos, Plateau State, Nigeria
| | - Olugbenga A Silas
- Department of Anatomic Pathology and Forensic Medicine, College of Health Sciences, University of Jos, Jos, Plateau State, Nigeria
| | - Godwin E Imade
- Department of Obstetrics and Gynecology, College of Health Sciences, University of Jos, Jos, Plateau State, Nigeria
- Genomics and Postgraduate Core Facility, College of Health Sciences, University of Jos, Jos, Plateau State, Nigeria
| | - Stefan J Green
- Genomics and Microbiome Core Facility, Rush University, Chicago, Illinois, USA
| | - Supriya D Mehta
- Division of Epidemiology and Biostatistics, School of Public Health, University of Illinois at Chicago, Chicago, Illinois, USA
- Department of Epidemiology and Biostatistics, RUSH University, Chicago, Illinois, USA
| | - Lifang Hou
- Department of Preventive Medicine, Division of Cancer Epidemiology and Prevention, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA
- Center for Global Oncology, Institute for Global Health, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA
- Robert H. Lurie Comprehensive Cancer Center and Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA
| | - Robert L Murphy
- Division of Infectious Diseases, Department of Medicine, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA
- Robert J. Havey MD, Institute for Global Health, Northwestern University, Chicago, Illinois, USA
| |
Collapse
|
6
|
Akanbi MO, Bilaver LA, Achenbach C, Hirschhorn LR, Rivera AS, Silas OA, Agaba PA, Agbaji O, Shehu NY, Sagay SA, Hou L, Murphy RL. Analyses of Kaposi Sarcoma trends among adults establishing initial outpatient HIV care in Nigeria: 2006-2017. Infect Agent Cancer 2022; 17:10. [PMID: 35313941 PMCID: PMC8935748 DOI: 10.1186/s13027-022-00424-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2021] [Accepted: 03/11/2022] [Indexed: 12/24/2022] Open
Abstract
Background The incidence of Human Immunodeficiency Virus (HIV)-associated Kaposi Sarcoma (KS) in the pre-antiretroviral therapy (ART) population remains high in several countries in sub-Saharan Africa. We examined trends of KS prevalence in adults, establishing initial outpatient HIV care from 2006 to 2017 in Nigeria. Methods We analyzed data of 16,431 adults (age ≥ 18 years) enrolled for HIV care from January 1, 2006, to December 31, 2017, in a large clinic in Jos, Nigeria. KS at enrollment was defined as KS recorded in the electronic health record within 30 days of clinic enrollment. Time trends were compared among four periods: 2006–2008, 2009–2011, 2012–2014, and 2015–2017 using logistic regression models. Annual trends were analyzed using join point regression and restricted splines. Results The study population had a mean age 35.1 (standard deviation, SD 9.5) years, and were 65.7% female (n = 10,788). The mean CD4 cell count was 220 (95% CI 117–223). The overall KS prevalence at entry was 0.59% (95% CI 0.48–0.72). Compared to 2006–2008, KS prevalence was significantly higher in 2009–2011 (adjusted odds ratio 5.07 (95% CI 3.12–8.24), p < 0.001), but remained unchanged in subsequent periods. Male sex and low CD4 T-cell count independently increased odds for KS. Conclusions Despite ART expansion, KS at enrollment showed no significant decline. The low CD4 cell count, across all periods, indicates delay in enrollment for HIV care, which increases KS risk. Interventions aimed at early HIV diagnosis and linkage to ART is critical to KS risk reduction in this population. Supplementary Information The online version contains supplementary material available at 10.1186/s13027-022-00424-4.
Collapse
Affiliation(s)
- Maxwell O Akanbi
- Department of Internal Medicine, McLaren Hospital, 401 S Ballenger Hwy, Flint, MI, 48532, USA. .,Health Sciences Integrated Ph.D. Program, Center for Education in Health Sciences, Institute for Public Health and Medicine, Feinberg School of Medicine, Northwestern University, Chicago, USA. .,Robert J Havey Institute for Global Health, Center for Global Communicable Diseases, Feinberg School of Medicine, Northwestern University, Chicago, USA. .,Department of Medicine, College of Health Sciences, University of Jos, Jos, Nigeria.
| | - Lucy A Bilaver
- Health Sciences Integrated Ph.D. Program, Center for Education in Health Sciences, Institute for Public Health and Medicine, Feinberg School of Medicine, Northwestern University, Chicago, USA
| | - Chad Achenbach
- Robert J Havey Institute for Global Health, Center for Global Communicable Diseases, Feinberg School of Medicine, Northwestern University, Chicago, USA.,Department of Infectious Diseases, Northwestern University Feinberg School of Medicine, Chicago, USA
| | - Lisa R Hirschhorn
- Robert J Havey Institute for Global Health, Center for Global Communicable Diseases, Feinberg School of Medicine, Northwestern University, Chicago, USA.,Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, USA
| | - Adovich S Rivera
- Health Sciences Integrated Ph.D. Program, Center for Education in Health Sciences, Institute for Public Health and Medicine, Feinberg School of Medicine, Northwestern University, Chicago, USA
| | - Olugbenga A Silas
- Department of Pathology, College of Human Sciences, University of Jos, Jos, Nigeria
| | - Patricia A Agaba
- Department of Family Medicine, College of Human Sciences, University of Jos, Jos, Nigeria
| | - Oche Agbaji
- Department of Medicine, College of Health Sciences, University of Jos, Jos, Nigeria
| | - Nathan Y Shehu
- Department of Medicine, College of Health Sciences, University of Jos, Jos, Nigeria
| | - Solomon A Sagay
- Department of Obstetrics and Gynecology, College of Human Sciences, University of Jos, Jos, Nigeria
| | - Lifang Hou
- Health Sciences Integrated Ph.D. Program, Center for Education in Health Sciences, Institute for Public Health and Medicine, Feinberg School of Medicine, Northwestern University, Chicago, USA.,Department of Prevention Diseases (Cancer Epidemiology and Prevention), Northwestern University Feinberg School of Medicine, Chicago, USA.,Institute for Global Health, Center for Global Oncology, Feinberg School of Medicine, Northwestern University, Chicago, USA
| | - Robert L Murphy
- Robert J Havey Institute for Global Health, Center for Global Communicable Diseases, Feinberg School of Medicine, Northwestern University, Chicago, USA.,Department of Infectious Diseases, Northwestern University Feinberg School of Medicine, Chicago, USA
| |
Collapse
|
7
|
Musa J, Kim K, Zheng Y, Travis LB, Gursel D, Silas OA, Abdulkareem FB, Imade G, Akanmu A, Wei JJ, Kocherginsky M, Kim KY, Wehbe FH, Achenbach C, Anorlu R, Simon MA, Sagay A, Ogunsola F, Murphy R, Hou L. Accelerated epigenetic age among HIV-infected Nigerian women with invasive cervical cancer. J Clin Oncol 2021. [DOI: 10.1200/jco.2021.39.15_suppl.e17504] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
e17504 Background: Invasive cervical cancer (ICC) is one of the HIV-associated cancers with a high burden in Nigeria. ICC occurs at relatively younger age in HIV infected women, with HIV known to promote aging and related diseases, including cancer. DNA methylation changes with increasing age, various health-related exposures, and age-related health outcomes, suggesting a role of DNA methylation in biological aging and disease. We sought to understand the effect of HIV infection on epigenetic age acceleration (EpiAgeAccel) in Nigerian women with ICC. Methods: Epigenetic age (EpiAge) was estimated by Horvath’s calculator using genome-wide methylation data in 116 cervical tissue samples from three groups of women: a) HIV positive with ICC (n=39); b) HIV positive and cancer-free (n=53); and c) HIV negative with ICC (n=24). EpiAgeAccel was computed as the regression residuals of EpiAge against chronological age (ChronAge), representing the independent deviation of EpiAge from ChronAge. We compared EpiAgeAccel across the 3 HIV/ICC groups using multiple linear regressions adjusting for ChronAge, education, parity, employment, cancer stage, body mass index, and study site. Among the ICC women, we compared EpiAgeAccel between 26 tumor tissues and their surrounding normal tissues using paired t-tests, stratified by HIV status. Results: EpiAgeAccel among HIV positive women with ICC was 4.5 years higher than HIV positive and cancer-free women (p=0.019). We did not find substantial differences in EpiAgeAccel between HIV-positive women with ICC and HIV-negative women with ICC. EpiAgeAccel was 7.9 and 2.9 years higher in tumor tissues compared to the surrounding normal tissues among HIV positive women (p=0.021) and negative women (p=0.295), respectively. Conclusions: EpiAge is accelerated in cervical tissue of HIV-infected women with ICC. EpiAgeAccel may be a potential biomarker for ICC screening and early detection for women living with HIV in low- and middle-income countries.
Collapse
Affiliation(s)
- Jonah Musa
- University of Jos, Jos, Plateau, Nigeria
| | | | | | | | - Demirkan Gursel
- Northwestern University, Feinberg School of Medicine, Chicago, IL
| | | | | | | | | | - Jian-Jun Wei
- Department of Pathology, Northwestern University, Feinberg Medical School, Chicago, IL
| | | | | | | | - Chad Achenbach
- Feinberg School of Medicine, Northwestern University, Chicago, IL
| | | | - Melissa A. Simon
- Feinberg School of Medicine, Northwestern University, Chicago, IL
| | | | | | | | - Lifang Hou
- Feinberg School of Medicine, Northwestern University, Chicago, IL
| |
Collapse
|
8
|
Zheng Y, Musa J, Joyce BT, Wang J, Gursel D, Silas OA, Abdulkareem FB, Imade G, Akanmu A, Wei JJ, Kocherginsky M, Kim KY, Wehbe FH, Achenbach C, Anorlu R, Simon MA, Sagay A, Ogunsola F, Murphy R, Hou L. Global line-1 hypomethylation as novel biomarker for cervical cancer in Nigerian women living with HIV. J Clin Oncol 2021. [DOI: 10.1200/jco.2021.39.15_suppl.e17513] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
e17513 Background: Nigeria faces a high health burden of cervical cancer (CC), which is worsened by high prevalence of human immunodeficiency virus (HIV) infection. Repetitive elements (RE) are DNA sequences that occur in multiple copies throughout the human genome. HIV infection can lead to RE hypomethylation that causes genome instability, an event often seen in the early phase of tumorigenesis. We aim to examine global RE hypomethylation as a novel epigenetic biomarker for CC among HIV-positive women in Nigeria. Methods: This study involved three groups of women: a) HIV-positive with CC (n=39); b) HIV-positive and cancer-free (n=52); and c) HIV-negative with CC (n=23). We estimated three types of global RE methylation in cervical tissue using genome-wide methylation data: long interspersed nuclear elements (LINE-1), Alu, and human endogenous retrovirus (HERV). We used multiple linear regression adjusting for age, education, parity, employment, cancer stage, body mass index, and sample batch to compare the biomarkers across the HIV/ICC groups and paired t-test to compare 26 pairs of tumor vs. surrounding normal tissues, stratified by HIV status. Receiver operating characteristic curve (ROC) and area under the ROC (AUC) were used to examine the diagnostic value. Results: Among HIV-positive women, all 3 global RE methylation biomarkers were hypomethylated in CC compared to cancer-free (LINE-1: mean difference [MD]=-0.049, p-value=2.9e-8; Alu: MD=-0.011, p-value=2.0e-4; HERV: MD=-0.013, p-value=1.7e-6). Paired analyses showed a larger, more significant MD in HIV-positive stratum than HIV-negative, especially LINE-1 (MD=-0.048 vs. -0.020, p-value=0.004 vs. 0.254). LINE-1 achieved the highest AUC (0.85, 95% CI: 0.76-0.95) in distinguishing tumor tissue from normal tissue among HIV-positive women, followed by HERV (0.82, 95% CI: 0.73-0.92) and Alu (0.60, 95% CI: 0.47-0.72). Conclusions: Global LINE-1 hypomethylation may serve as a novel biomarker for CC screening and early detection for women living with HIV in low- and middle-income countries.
Collapse
Affiliation(s)
| | - Jonah Musa
- University of Jos, Jos, Plateau, Nigeria
| | | | - Jun Wang
- Northwestern University, Chicago, IL
| | - Demirkan Gursel
- Northwestern University, Feinberg School of Medicine, Chicago, IL
| | | | | | | | | | - Jian-Jun Wei
- Department of Pathology, Northwestern University, Feinberg Medical School, Chicago, IL
| | | | | | | | - Chad Achenbach
- Feinberg School of Medicine, Northwestern University, Chicago, IL
| | | | - Melissa A. Simon
- Feinberg School of Medicine, Northwestern University, Chicago, IL
| | | | | | | | - Lifang Hou
- Feinberg School of Medicine, Northwestern University, Chicago, IL
| |
Collapse
|
9
|
Adoga AA, Kokong DD, Ma'an ND, Silas OA, Dauda AM, Yaro JP, Mugu JG, Mgbachi CJ, Yabak CJ. The epidemiology, treatment, and determinants of outcome of primary head and neck cancers at the Jos University Teaching Hospital. South Asian J Cancer 2020; 7:183-187. [PMID: 30112335 PMCID: PMC6069340 DOI: 10.4103/sajc.sajc_15_18] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
Introduction: This study aims to evaluate the epidemiology, treatment, and factors that determine the outcomes of head and neck cancers (HNC). Patients and Methods: Retrospective analytical review of HNC managed at the Jos University Teaching Hospital between May 2007 and April 2017 using the International Classification of Diseases version 10. Results: Of 487 head and neck neoplasms, 129 (26.5%) were malignant and 122 health records met the criteria for analysis consisting of 83 (68.0%) males and 39 (32.0%) females aged 13 years to 85 years (mean = 51 years; standard deviation = ±16.0 years). The most common presenting feature was nasal obstruction (n = 47; 38.5%). The most common tumor site was the nasopharynx (n = 34; 27.9%). Mean duration of symptoms was 13.3 months. Alcohol (P = 0.02), cigarette smoking (P = 0.01), and cooking wood smoke (P = 0.01) were associated with advanced tumor stage. Squamous cell carcinoma was the most common histological type. Posttreatment complication rate was 47.5%. Lost to follow-up rate was 55.7%. The lungs were the most common distant metastatic site. The case fatality rate was 18.0%. Conclusion: HNC constitutes almost a quarter of head and neck tumors affecting twice the number of males in their sixth decade with nasopharyngeal cancers being the most common in both genders. Several modifiable variables are noted to target appropriate future cancer education for lifestyle modification, screening for early detection and treatment.
Collapse
Affiliation(s)
- Adeyi A Adoga
- Department of Otorhinolaryngology, Head and Neck Surgery, Jos University Teaching Hospital, Jos, Nigeria
| | - Daniel D Kokong
- Department of Otorhinolaryngology, Head and Neck Surgery, Jos University Teaching Hospital, Jos, Nigeria
| | - Nuhu D Ma'an
- Department of Otorhinolaryngology, Head and Neck Surgery, Jos University Teaching Hospital, Jos, Nigeria
| | - Olugbenga A Silas
- Department of Pathology, Jos University Teaching Hospital, Jos, Nigeria
| | - Ayuba M Dauda
- Department of Pathology, Jos University Teaching Hospital, Jos, Nigeria
| | - John P Yaro
- Department of Otorhinolaryngology, Head and Neck Surgery, Jos University Teaching Hospital, Jos, Nigeria
| | - Joyce G Mugu
- Department of Otorhinolaryngology, Head and Neck Surgery, Jos University Teaching Hospital, Jos, Nigeria
| | - Chukwunonso J Mgbachi
- Department of Otorhinolaryngology, Head and Neck Surgery, Jos University Teaching Hospital, Jos, Nigeria
| | - Caleb J Yabak
- Department of Otorhinolaryngology, Head and Neck Surgery, Jos University Teaching Hospital, Jos, Nigeria
| |
Collapse
|
10
|
Adoga AA, Silas OA, Yaro JP. Extramedullary plasmacytoma of the nasal cavity and ethmoidal sinus in human immunodeficiency virus-positive patient. J Cancer Res Ther 2020; 16:157-160. [PMID: 32362627 DOI: 10.4103/jcrt.jcrt_102_18] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Extramedullary plasmacytoma (EMP) occurring in the nose and paranasal sinus regions are rare with a male preponderance in the fifth and seventh decades of life. We report a case of EMP of the nasal cavity and ethmoid sinus in a 28-year-old female with human immunodeficiency virus infection.
Collapse
Affiliation(s)
- Adeyi A Adoga
- Department of Otorhinolaryngology, Head and Neck Surgery, Jos University Teaching Hospital, Jos, Plateau State, Nigeria
| | - Olugbenga A Silas
- Department of Pathology, Head and Neck Surgery, Jos University Teaching Hospital, Jos, Plateau State, Nigeria
| | - John P Yaro
- Department of Otorhinolaryngology, Head and Neck Surgery, Jos University Teaching Hospital, Jos, Plateau State, Nigeria
| |
Collapse
|
11
|
Musa J, Mehta SD, Achenbach CJ, Evans CT, Jordan N, Magaji FA, Pam VC, Daru PH, Silas OA, Sagay AS, Anorlu R, Zheng Y, Maiga M, Adewole IF, Murphy RL, Hou L, Simon MA. HIV and development of epithelial cell abnormalities in women with prior normal cervical cytology in Nigeria. Infect Agent Cancer 2020; 15:50. [PMID: 32760435 PMCID: PMC7392708 DOI: 10.1186/s13027-020-00316-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2020] [Accepted: 07/21/2020] [Indexed: 12/28/2022] Open
Abstract
Background HIV-associated cellular immune dysfunction has been linked to higher risk of cervical dysplasia and cancer in HIV infected women. We sought to understand the relationship between HIV and development of epithelial cell abnormalities (ECA) at follow-up in women with prior normal cervical cytology (NCC). Methods Retrospective cohort analysis of women who received a Pap test at the Operation Stop Cervical Cancer Unit in Jos, Nigeria over a 10-year period (2006-2016). We analyzed the data of women with NCC at first Pap who had at least one follow-up cytology result for time-to-detection of ECA. We determined follow-up time in years from date of first NCC to date of first ECA report or date of last NCC follow up report with censoring at last follow-up date or December 31st, 2016 whichever came first. The primary outcome was development of any ECA as defined by the Bethesda 2001 reporting system. We identified demographic and clinical factors associated with incident ECA using multivariable Cox regression. Results A total of 1599 women were eligible for this analysis. Overall, 3.7% (57/1556) of women reported being HIV infected. The median age at first Pap was 39 years (IQR; 33-45). The HIV infected women were younger (36.3 ± 8.1) compared to those uninfected (39.3 ± 6.6), p = 0.005. After an accrued follow-up time of 3809 person-years (PYs), 243 women (15%) had an ECA with an event rate of 6.38 per 100 PYs. Women ≥35 years at first Pap were more likely to have an ECA compared to those < 35 years (7.5 per 100 PYs vs 3.8 per 100 PYs, HR = 1.96; 95% CI: 1.4, 2.8). HIV status was not significantly associated with developing ECA in either unadjusted (7.4 per 100 PYs vs 6.4 per 100 PYs, HR = 1.17; 95% CI: 0.53, 2.3) or adjusted analyses (aHR = 1.78; 95% CI: 0.87, 3.65). Conclusion Women living with HIV and on successful antiretroviral treatment may not have a differential hazard in the development of ECA during follow up after a prior normal Pap. Offering a repeat CCS to women who are 35 years or older irrespective of HIV status is likely an effective strategy in resource limited settings.
Collapse
Affiliation(s)
- Jonah Musa
- Department of Obstetrics and Gynecology, College of Medical Sciences, University of Jos, Jos, Plateau State Nigeria.,Department of Preventive Medicine, Division of Cancer Epidemiology and Prevention, Feinberg School of Medicine, Northwestern University, Chicago, USA.,Center for Global Oncology, Institute for Global Health, Feinberg School of Medicine, Northwestern University, Chicago, USA
| | - Supriya D Mehta
- Division of Epidemiology and Biostatistics, School of Public Health, University of Illinois at Chicago, Chicago, IL USA
| | - Chad J Achenbach
- Center for Global Oncology, Institute for Global Health, Feinberg School of Medicine, Northwestern University, Chicago, USA.,Division of Infectious Diseases, Department of Medicine, Feinberg School of Medicine, Northwestern University, Chicago, USA
| | - Charlesnika T Evans
- Department of Preventive Medicine, Center for Health Services and Outcomes Research, Global Health, Institute for Public Health and Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL USA.,Center of Innovation for Complex Chronic Healthcare (CINCCH), Department of Veterans Affairs, Edward Hines Jr. VA Hospital, Hines, IL USA
| | - Neil Jordan
- Center of Innovation for Complex Chronic Healthcare (CINCCH), Department of Veterans Affairs, Edward Hines Jr. VA Hospital, Hines, IL USA.,Department of Psychiatry & Behavioral Sciences, Feinberg School of Medicine, Northwestern University, Chicago, USA
| | - Francis A Magaji
- Department of Obstetrics and Gynecology, College of Medical Sciences, University of Jos, Jos, Plateau State Nigeria
| | - Victor C Pam
- Department of Obstetrics and Gynecology, College of Medical Sciences, University of Jos, Jos, Plateau State Nigeria
| | - Patrick H Daru
- Department of Obstetrics and Gynecology, College of Medical Sciences, University of Jos, Jos, Plateau State Nigeria
| | - Olugbenga A Silas
- Department of Pathology, Faculty of Medical Sciences, University of Jos, Jos, Plateau State Nigeria
| | - Atiene S Sagay
- Department of Obstetrics and Gynecology, College of Medical Sciences, University of Jos, Jos, Plateau State Nigeria
| | - Rose Anorlu
- Department of Obstetrics and Gynecology, College of Medicine, University of Lagos, Jos, Nigeria
| | - Yinan Zheng
- Center for Population Epigenetics, Robert H. Lurie Comprehensive Cancer Center and Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL 60611 USA
| | - Mamoudou Maiga
- Center for Global Oncology, Institute for Global Health, Feinberg School of Medicine, Northwestern University, Chicago, USA.,Techniques and Technologies of Bamako, University of Sciences, Bamako, Mali
| | - Isaac F Adewole
- Department of Obstetrics and Gynecology, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - Robert L Murphy
- Center for Global Oncology, Institute for Global Health, Feinberg School of Medicine, Northwestern University, Chicago, USA.,Division of Infectious Diseases, Department of Medicine, Feinberg School of Medicine, Northwestern University, Chicago, USA
| | - Lifang Hou
- Center for Global Oncology, Institute for Global Health, Feinberg School of Medicine, Northwestern University, Chicago, USA.,Center for Population Epigenetics, Robert H. Lurie Comprehensive Cancer Center and Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL 60611 USA
| | - Melissa A Simon
- Department of Obstetrics and Gynecology, Preventive Medicine and Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, USA
| |
Collapse
|
12
|
Ocheke AN, Agaba PA, Imade GE, Silas OA, Ajetunmobi OI, Echejoh G, Ekere C, Sendht A, Bitrus J, Agaba EI, Sagay AS. Re: Chorioamnionitis in pregnancy: a comparative study of HIV-positive and HIV-negative parturients. Int J STD AIDS 2019; 30:101-102. [PMID: 30803410 DOI: 10.1177/0956462418803820] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
- Amaka N Ocheke
- 1 Department of Obstetrics and Gynaecology, University of Jos/Jos University Teaching Hospital, Jos, Nigeria
| | - Patricia A Agaba
- 2 Department of Family Medicine, University of Jos/Jos University Teaching Hospital, Jos, Nigeria
| | - Godwin E Imade
- 1 Department of Obstetrics and Gynaecology, University of Jos/Jos University Teaching Hospital, Jos, Nigeria
| | - Olugbenga A Silas
- 3 Department of Histopathology, University of Jos/Jos University Teaching Hospital, Jos, Nigeria
| | - Olanrewaju I Ajetunmobi
- 3 Department of Histopathology, University of Jos/Jos University Teaching Hospital, Jos, Nigeria
| | - Godwins Echejoh
- 3 Department of Histopathology, University of Jos/Jos University Teaching Hospital, Jos, Nigeria
| | - Clement Ekere
- 1 Department of Obstetrics and Gynaecology, University of Jos/Jos University Teaching Hospital, Jos, Nigeria
| | - Ayuba Sendht
- 1 Department of Obstetrics and Gynaecology, University of Jos/Jos University Teaching Hospital, Jos, Nigeria
| | - James Bitrus
- 1 Department of Obstetrics and Gynaecology, University of Jos/Jos University Teaching Hospital, Jos, Nigeria
| | - Emmanuel I Agaba
- 4 Department of Medicine, University of Jos/Jos University Teaching Hospital, Jos, Nigeria
| | - Atiene S Sagay
- 1 Department of Obstetrics and Gynaecology, University of Jos/Jos University Teaching Hospital, Jos, Nigeria
| |
Collapse
|
13
|
Egesie OJ, Agaba PA, Silas OA, Achenbach C, Zoakah A, Agbaji OO, Madaki JA, Okeke EN, Hou L, Sagay AS, Murphy R. Presentation and survival in patients with hematologic malignancies in Jos, Nigeria: A retrospective cohort analysis. ACTA ACUST UNITED AC 2018; 20:49-56. [PMID: 29963503 DOI: 10.4103/jomt.jomt_8_18] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Background Haematologic malignancies cause significant morbidity and mortality and are not uncommon in resource-limited-low income countries. However, the types, pattern of presentation and treatment outcomes vary across regions. We assessed the presentation and overall survival over an 11-year period in adult patients presenting with haematologic cancers in Jos, North Central Nigeria. Materials and Methods This retrospective outcome study evaluated patients who presented with haematologic malignancies between 2005-2015 at the Jos University Teaching Hospital (JUTH), Jos. Variables of interest were abstracted through chart reviews. Descriptive statistics were used to evaluate baseline and follow-up parameters. Overall survival (OS) was assessed using Kaplan-Meier method. Results Sixty patients, contributing 25,994 person-days of follow-up were evaluated. The mean age was 43+17 years and 61.7% were males. Thirty-one patients (51.7%) presented with leukemia, 45.0% with lymphoma, and 3.3% with multiple myeloma. Forty-two (70.0%) presented with advanced disease, 5 (5.2%) were HIV positive and 4 (6.7%) had died at the end of follow-up. OS was 84.3% (95% CI: 58.1-94.7). Survival differed by disease group (p=0.01) and having fever at presentation (p=0.02). Conclusion We found long-term OS to be impacted by disease type and status of fever at presentation. Disease-specific Strategies to improve early diagnosis and therapies are needed to ensure optimal outcomes in Nigerian patients.
Collapse
Affiliation(s)
- Ochaka J Egesie
- Department of Haematology and Blood Transfusion, Jos University Teaching Hospital, Jos, Nigeria
| | - Patricia A Agaba
- Department of Family Medicine, University of Jos/Jos University Teaching Hospital, Nigeria
| | - Olugbenga A Silas
- Department of Histopathology, Jos University Teaching Hospital, Jos, Nigeria
| | - Chad Achenbach
- Department of Medicine and Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago IL, USA
| | - Ayuba Zoakah
- Department of Community Medicine, Jos University Teaching Hospital, Jos, Nigeria
| | - Oche O Agbaji
- Department of Internal Medicine, Jos University Teaching Hospital, Jos, Nigeria
| | - Jeremiah A Madaki
- Department of Family Medicine, University of Jos/Jos University Teaching Hospital, Nigeria
| | - Edith N Okeke
- Department of Internal Medicine, Jos University Teaching Hospital, Jos, Nigeria
| | - Lifang Hou
- Department of Medicine and Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago IL, USA.,Center for Population Epigenetics, Robert H. Lurie Comprehensive Cancer Center and Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago IL, USA
| | - Atiene S Sagay
- Department of Obstetrics and Gynaecology, Jos University Teaching Hospital, Jos, Nigeria
| | - Robert Murphy
- Department of Medicine and Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago IL, USA
| |
Collapse
|
14
|
Adoga AA, Silas OA, Yaro JP, Okwori ET, Iduh AA, Mgbachi CJ. Assessment of the sociodemographic characteristics and efficacy of screening for oral, head and neck potential malignant lesions in apparently healthy adults in Jos Nigeria. Indian J Cancer 2017; 53:252-255. [PMID: 28071621 DOI: 10.4103/0019-509x.197713] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BACKGROUND The efficacy of screening for oral, head and neck cancers (HNCs) in adequately identifying high-risk groups is controversial. OBJECTIVES This study aims to review our experience with a free oral, HNC-screening program to determine the sociodemographic characteristics of the participants and the effectiveness of this program to improve future programs. MATERIALS AND METHODS A prospective cross-sectional survey of participants in a free oral, HNC screening exercise was performed in the years 2009, 2012, and 2013. RESULTS In the years of screening, 135 participants presented aged between 21 and 83 years (mean = 47.0; ±15.6) with a male to female ratio of 1.2:1. 32.6% consumed alcohol, and 17.8% were smokers. Smoking (P = 0.04) and alcohol use (P = 0.05) were associated with higher rates of suspicious malignant symptoms. There was no statistical correlation between symptom prevalence and the number of participants requiring immediate consultation for oral, HNC (r = 0.47), and those referred for routine follow-up (r = 0.34). Premalignant and malignant lesions were diagnosed in 5 males aged 44-72 years. 83.7% found the screening program beneficial in increasing their awareness of the disease. CONCLUSIONS This hospital-based screening demonstrates improved awareness among people about oral, HNCs, and survival outcomes on a small scale. A community-based screening with health education to target a larger high-risk population is recommended to encourage individuals to modify high-risk factors and improve outcomes.
Collapse
Affiliation(s)
- A A Adoga
- Department of Otorhinolaryngology, Head and Neck Surgery, Jos University Teaching Hospital, Jos, Plateau State, Nigeria
| | - O A Silas
- Department of Pathology, Jos University Teaching Hospital, Jos, Plateau State, Nigeria
| | - J P Yaro
- Department of Otorhinolaryngology, Head and Neck Surgery, Jos University Teaching Hospital, Jos, Plateau State, Nigeria
| | - E T Okwori
- Department of Otorhinolaryngology, Head and Neck Surgery, Jos University Teaching Hospital, Jos, Plateau State, Nigeria
| | - A A Iduh
- Department of Otorhinolaryngology, Head and Neck Surgery, Jos University Teaching Hospital, Jos, Plateau State, Nigeria
| | - C J Mgbachi
- Department of Otorhinolaryngology, Head and Neck Surgery, Jos University Teaching Hospital, Jos, Plateau State, Nigeria
| |
Collapse
|
15
|
Ocheke AN, Ocheke IE, Agaba PA, Imadde GE, Silas OA, Ajetunmobi OI, Godwins EJ, Ekere C, Sendeht A, Bitrus J, Agaba EI, Sagay AS. MATERNAL AND NEONATAL OUTCOMES OF HISTOLOGICAL CHORIOAMNIONITIS. J West Afr Coll Surg 2016; 6:1-14. [PMID: 28856121 PMCID: PMC5555724] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
BACKGROUND Clinical Chorioamnionitis contributes to maternal and neonatal morbidity and mortality but the effect of histological chorioamnionitis is sparse in our environment. AIM To determine the maternal and neonatal outcomes of histological chorioamnionitis amongst pregnant women and their babies. DESIGN OF THE STUDY Cross sectional longitudinal study. SETTING Jos University Teaching Hospital (JUTH), Jos, Nigeria. METHODOLOGY Parturients were interviewed and examined as well as had their placenta examined histologically for chorioamnionitis. They and their babies were followed up for 6 weeks after delivery to monitor for any complications that may arise. RESULTS A total of 148 parturients were enrolled from the labour ward of Jos University Teaching Hospital and of these 90 (60.8%) had histologic chorioamnionitis (HCA). As regards outcome, 9(10%) with histologic chorioamnionitis as well as 5(8.62%) of those without HCA had premature delivery. Low birth weight occurred in 12(13.33%) and 6(10.34 %) of those with HCA and without HCA respectively. In all, 1(1.47%) and 1(2.56%) of women with HCA and without HCA correspondingly had neonatal sepsis. Puerperal sepsis occurred in 2(2.94%) of those with HCA and 2(5.13%) of those without HCA. CONCLUSION Our study has demonstrated that histological chorioamnionitis had no adverse maternal or neonatal effect. There is the need for more studies investigating the cause and the implication of histological chorioamnionitis.
Collapse
Affiliation(s)
- A N Ocheke
- Department of Obstetrics and Gynaecology,Faculty of Medical Sciences, University of Jos, Jos, Nigeria
| | - I E Ocheke
- Department of Paediatrics,Faculty of Medical Sciences, University of Jos, Jos, Nigeria
| | - P A Agaba
- Department of Family medicine, Faculty of Medical Sciences, University of Jos, Jos, Nigeria
| | - G E Imadde
- Department of Obstetrics and Gynaecology,Faculty of Medical Sciences, University of Jos, Jos, Nigeria
| | - O A Silas
- Department of Histopathology, Faculty of Medical Sciences, University of Jos, Jos, Nigeria
| | - O I Ajetunmobi
- Department of Histopathology, Faculty of Medical Sciences, University of Jos, Jos, Nigeria
| | - Eche John Godwins
- Department of Histopathology, Faculty of Medical Sciences, University of Jos, Jos, Nigeria
| | - C Ekere
- Department of Obstetrics and Gynaecology,Faculty of Medical Sciences, University of Jos, Jos, Nigeria
| | - A Sendeht
- Department of Obstetrics and Gynaecology,Faculty of Medical Sciences, University of Jos, Jos, Nigeria
| | - J Bitrus
- Department of Obstetrics and Gynaecology,Faculty of Medical Sciences, University of Jos, Jos, Nigeria
| | - E I Agaba
- Department of Medicine, Faculty of Medical Sciences, University of Jos, Jos, Nigeria
| | - A S Sagay
- Department of Obstetrics and Gynaecology,Faculty of Medical Sciences, University of Jos, Jos, Nigeria
| |
Collapse
|
16
|
Ocheke AN, Agaba PA, Imade GE, Silas OA, Ajetunmobi OI, Echejoh G, Ekere C, Sendht A, Bitrus J, Agaba EI, Sagay AS. Chorioamnionitis in pregnancy: a comparative study of HIV-positive and HIV-negative parturients. Int J STD AIDS 2015; 27:296-304. [PMID: 25887063 DOI: 10.1177/0956462415580887] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2014] [Accepted: 03/16/2015] [Indexed: 11/15/2022]
Abstract
Chorioamnionitis is an important risk factor for vertical transmission of HIV/AIDS. We compared the prevalence and correlates of histologic chorioamnionitis (HCA) in HIV-positive and HIV-negative pregnant women. HIV-positive and -negative parturients were interviewed, examined and had their placentas examined histologically for chorioamnionitis. Data regarding HIV were also retrieved from their hospital records. A total of 298 parturients (150 HIV positive and 148 HIV negative) were enrolled. The two groups were similar in socio-demographic and obstetric parameters except for age. The prevalence of HCA was 57.1% in HIV-positive women and 61.6% in HIV-negative women (p = 0.43). HCA staging was associated with the number of intrapartum vaginal examinations in HIV-positive subjects and nulliparity in HIV-negative subjects. The number of intrapartum vaginal examinations and coitus in the week prior to delivery significantly affected the grade of HCA in HIV-negative subjects. The prevalence of HCA in both HIV-positive and HIV-negative is high. Most variables did not affect the occurrence of HCA in both groups studied except number of intrapartum examinations, coitus in the preceding one week and nulliparity, which were related to severity of the disease.
Collapse
Affiliation(s)
- Amaka N Ocheke
- Department of Obstetrics and Gynaecology, University of Jos/Jos University Teaching Hospital, Jos, Nigeria
| | - Patricia A Agaba
- Department of Family Medicine, University of Jos/Jos University Teaching Hospital, Jos, Nigeria
| | - Godwin E Imade
- Department of Obstetrics and Gynaecology, University of Jos/Jos University Teaching Hospital, Jos, Nigeria
| | - Olugbenga A Silas
- Department of Histopathology, University of Jos/Jos University Teaching Hospital, Jos, Nigeria
| | - Olanrewaju I Ajetunmobi
- Department of Histopathology, University of Jos/Jos University Teaching Hospital, Jos, Nigeria
| | - Godwins Echejoh
- Department of Histopathology, University of Jos/Jos University Teaching Hospital, Jos, Nigeria
| | - Clement Ekere
- Department of Obstetrics and Gynaecology, University of Jos/Jos University Teaching Hospital, Jos, Nigeria
| | - Ayuba Sendht
- Department of Obstetrics and Gynaecology, University of Jos/Jos University Teaching Hospital, Jos, Nigeria
| | - James Bitrus
- Department of Obstetrics and Gynaecology, University of Jos/Jos University Teaching Hospital, Jos, Nigeria
| | - Emmanuel I Agaba
- Department of Medicine, University of Jos/Jos University Teaching Hospital, Jos, Nigeria
| | - Atiene S Sagay
- Department of Obstetrics and Gynaecology, University of Jos/Jos University Teaching Hospital, Jos, Nigeria
| |
Collapse
|
17
|
Silas OA, Ige OO, Adoga AA, Nimkur LT, Ajetunmobi OI. Role of Fine Needle Aspiration Cytology (FNAC) as a Diagnostic Tool in Paediatric Head and Neck Lymphodenopathy. ACTA ACUST UNITED AC 2014; 4. [PMID: 26306308 DOI: 10.4172/2324-8785.1000211] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
A neck mass that is present for longer than a week might be pathological requiring rapid and thorough evaluation. This study aims to evaluate the positive role Fine needle aspiration cytology plays in the diagnosis of pediatric patients with lymphadenopathy in the head and neck region. Fine needle aspiration of lymph nodes was carried out, fixed and stained by cytopathologists for 56 patients at the Jos University Teaching Hospital, 43 (76.8%) were inflammatory and 13 (23.2%) malignant. Reactive hyperplasia (72.1%), acute suppurative (18.6%) and tuberculosis (9.3%) constituted the inflammatory lesions. Non Hodgkins lymphoma was the commonest malignant lesion (76.9%) followed by Hodgkins lymphoma (15.4%), the least being Rhabdomyosarcoma (7.7%). Age range 10-14 years had the highest number of cases (46.4%). Males were 36 (64.3%) while females were 20 (35.7%). All malignant cases diagnosed by FNAC had to undergo confirmation/characterization by histology and had 100% concordance. Thus there were no false positives and specificity was 100%, sensitivity 100%. Of the 43 diagnosed as inflammatory by FNAC, 12 cases which did not resolve after treatment or where patients condition worsened had to undergo surgical biopsy. Out of these only 1 (8.3%) case of fungal infection was misdiagnosed by FNAC. The lymph nodes were generalized 4 (7.1%) and localized in 52 (92.9%). Maximum number of cases 53 (94.6%) had Cervical Lymphadenopathy followed by axillary 2 (3.6%) and inguinal 1 (1.8%). Out of the cervical group of nodes, the upper anterior and upper posterior deep cervical nodes were involved in majority of cases (95%).
Collapse
Affiliation(s)
- O A Silas
- Pathology department Jos University Teaching Hospital, Jos, Nigeria
| | - O O Ige
- Pediatrics departments Jos University Teaching Hospital, Jos, Nigeria
| | - A A Adoga
- Ear, Nose and Throat department Jos Teaching Hospital, Jos, Nigeria
| | - L T Nimkur
- Ear, Nose and Throat department Jos Teaching Hospital, Jos, Nigeria
| | - O I Ajetunmobi
- Pathology department Jos University Teaching Hospital, Jos, Nigeria
| |
Collapse
|
18
|
Daru PH, Osagie EO, Pam IC, Mutihir JT, Silas OA, Ekwempu CC. Analysis of cases of rape as seen at the Jos University Teaching Hospital, Jos, North Central Nigeria. Niger J Clin Pract 2011; 14:47-51. [PMID: 21493992 DOI: 10.4103/1119-3077.79240] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVE Women are at a higher risk of being sexually harassed. There is a need to document the clinical findings of this crime and its outcome in order to improve the quality of care the victims receive. MATERIALS AND METHODS Case notes of patients who presented with alleged rape at Jos University Teaching Hospital between January 2001 and December 2003 were retrieved and analyzed. RESULTS During the study period, 2,135 patients were seen in the Gynaecological Emergency Unit. A total of 120 were for alleged rape, representing 5.6% of the total cases seen. However, only 105 case notes were available for analysis. Of these, 63.8% of the alleged rapes were in children, with the infantile age group accounting for 26.7%. 36.2% of the victims had experienced some form of sexual exposure prior to the rape. A previous relationship with the rapist was established in 77.4% of the cases. Most cases delayed in presenting to hospital. Thirty six percent of the cases did not have a human immunodeficiency virus screening test done. Candida albicans (13.3%) accounted for most of the infectious agents. Emergency contraception was administered to the victims when indicated. CONCLUSION Women under 16 years of age were at an increased risk of being raped, possibly because they are defenseless and vulnerable. Three quarters (3/4) of the assailants had some form of relationship with the victims, which may account for the delays in reporting. Children and young adolescents were more at risk than adults to be raped.
Collapse
Affiliation(s)
- P H Daru
- Department of Obstetrics and Gynaecology, Faculty of Medical Sciences, University of Jos and Jos University Teaching Hospital, Jos, Plateau State, Nigeria.
| | | | | | | | | | | |
Collapse
|
19
|
Adoga AA, Silas OA, Nimkur LT. Clinicopathological profile of malignant tumors of the oropharynx: a case series. ACTA ACUST UNITED AC 2011; 7:206-9. [PMID: 21516955 DOI: 10.4314/eajph.v7i3.64728] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND Due to recent lifestyle changes, the worldwide incidence of malignant oropharyngeal tumors is on the increase. This study focuses on the clinical and pathological profile of malignant tumors of the oropharynx as seen in a north-central Nigerian teaching hospital. METHODS This is a descriptive retrospective analysis of the clinical and pathological profile of this disease. RESULTS Six patients aged between 37 years and 78 years had malignant oropharyngeal tumors. There were 5 (83.3%) males and 1 (16.7%) female. All patients presented with cervical swelling, dysphagia, odynophagia and muffled voice with dental caries and visible masses filling up the oral cavity and oropharynx. Four (66.7%) patients presented with dyspnea and 3 (50%) with otalgia and deafness. Three (50%) patients had histologic diagnosis of non-Hodgkin's lymphoma (centroblastic), 1 had lymphoepithelioma and 2 had squamous cell carcinoma. Two (33.3%) patients died during treatment, 2 (33.30%) defaulted and 1 (16.7%) is being followed up for 5 years and is tumor free. CONCLUSION Oropharyngeal cancer has a poor prognosis in the tropics due to late presentation. Proper health education aimed at early detection and treatment in our environment is required.
Collapse
Affiliation(s)
- A A Adoga
- Otorhinolaryngolog Unit, Department of Surgery, Jos University Teaching Hospital, PMB 2076, Jos, Plateau State, Nigeria
| | | | | |
Collapse
|
20
|
Abstract
Embryonal rhabdomyosarcoma (sarcoma botyroides) of the cervix, which is rare, is described in a 16-year-old. The combined use of chemotherapy, radiotherapy and surgery has markedly improved survival in those with this condition. However, our patient did not benefit from this treatment modality due to late presentation and loss to follow-up.
Collapse
Affiliation(s)
- A N Ocheke
- Department of Obstetrics and Gynaecology, Jos University Teaching Hospital, Jos, Nigeria.
| | | | | | | | | |
Collapse
|
21
|
Dauda AM, Mandong BM, Manasseh AN, Malami AS, Echejoh GO, Silas OA. Histopathological analysis of endometrial biopsies in Jos University Teaching Hospital (JUTH), Nigeria. A 5-year critical review. Niger J Med 2011; 20:151-154. [PMID: 21970278] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/31/2023] Open
Abstract
AIMS This study is aimed at giving an insight into the pattern and age distribution of endometrial analysis as seen at Jos University Teaching Hospital. METHODS This is a retrospective reviewed cases of endometrial biopsies diagnosed between January 1998 to December 2002 in the Histopathological Department ofJos University Teaching Hospital RESULTS A review of endometrial biopsies slides from 556 patients revealed that pregnancy related diagnosis was the commonest, representing 302 (54.3%) of histopathological diagnosis, followed by endometrial hyperplasia, accounting for 97 cases (17.5%) and majority of which was categorised as mild hyperplasias. Hydatidiform mole, which ranked third, constituted 58 (10.4%) of the cases studied. Choriocarcinoma was the leading malignancy representing 10 cases (45%) of the malignant tumours and 1.8% of all the endometrial biopsies. Endometrial adenocarcinoma, stromal sarcoma and metastatic cancer constituted 6 (1.0%), 3 (0.5%) and 3 (0.5%), respectively. CONCLUSION The commonest endometrial pattern seen in JUTH over the study period was products of conception which peak in the third decade of life; primary malignancies of the endometrium are uncommon in JUTH and they represented just about 2%.
Collapse
Affiliation(s)
- A M Dauda
- Department of Pathology/Haematology,University of Jos, Nigeria.
| | | | | | | | | | | |
Collapse
|
22
|
Silas OA, Adoga AA, Manasseh AN, Echejoh GO, Vhriterhire RA, Mandong BM. Persistent alveolar soft-part sarcoma with liver metastasis: a case report. J Med Case Rep 2010; 4:233. [PMID: 20673324 PMCID: PMC2922299 DOI: 10.1186/1752-1947-4-233] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2009] [Accepted: 07/30/2010] [Indexed: 11/10/2022] Open
Abstract
Introduction Alveolar soft-part sarcomas are rare, slow-growing tumors that metastasize commonly via vascular routes to the lungs, bones, lymph nodes and brain, causing morbidity and mortality. To the best of our knowledge, this is the first case describing metastasis to the liver reported from Nigeria. Case presentation A 57-year-old man of the Urhobo ethnic group of Nigeria presented with a persistent mass in his left calf. It was initially diagnosed as soft-tissue sarcoma, and its associated systemic effects lead to his death before a histological diagnosis could be obtained. Conclusions Alveolar soft-part sarcoma with metastasis to the liver can occur in our region (northeast Africa), and a high index of suspicion is required to make an early diagnosis, followed by prompt surgical excision with clear margins in order to prevent mortality.
Collapse
Affiliation(s)
- Olugbenga A Silas
- Department of Pathology, Jos University Teaching Hospital, PMB 2076, Jos, Plateau State, Nigeria.
| | | | | | | | | | | |
Collapse
|
23
|
Silas OA, Echejoh GO, Manasseh AN, Mandong BM. Patterns of malignant salivary gland tumours in Jos University Teaching Hospital (JUTH), Jos: a ten-year retrospective study. Niger J Med 2010; 18:282-5. [PMID: 20120646 DOI: 10.4314/njm.v18i3.51182] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Salivary gland tumours are common head and neck tumours and more common in western world than Africans. Most salivary gland tumours are benign but the morbidity and mortality as expected is higher with malignant tumours. This study is aimed at describing the histological pattern, age, sex and site distribution of malignant salivary gland tumours in Jos University Teaching Hospital (JUTH) Jos from January 1998 to December 2007. METHODS This is a descriptive study of all histologically confirmed malignant salivary gland tumours over a period of ten years. Fresh sections of tissue blocks of these lesions were made using the microtome (3 micrones). They were made into slides and stained with Hematoxylin and Eosin (H and E) and Periodic Acid Schiff (PAS) stains. The slides were reported independently by four pathologists. Diagnosis was made and classification done according to the World Health Organisation (WHO) classification of salivary gland tumours 3. Information such as age, sex and-site of distribution of these tumours was gotten from the patient's case files. The data was analyzed manually. RESULTS Muco-epidermoid carcinoma accounted for the highest (32 cases) histologic type. Malignant salivary gland tumours occurred more within the age range 40 to 69 years with the age group 50-59 years accounting for the highest frequency (36 cases). Most of these malignant salivary gland tumours occurred more in the parotid gland, the minor salivary being the least site of occurrence. CONCLUSION Mucoeperdermiod carcinoma is the commonest salivary gland tumour and that malignant salivary gland tumours in this study and it occurred more after the 5th decade of life.
Collapse
Affiliation(s)
- O A Silas
- Department of pathology, Jos University Teaching Hospital, Jos, Plateau State
| | | | | | | |
Collapse
|
24
|
Silas OA, Echejoh GO, Menasseh AN, Mandong BM, Otoh EC. Descriptive pattern of salivary gland tumors in Jos University Teaching Hospital: a 10-year retrospective study. Ann Afr Med 2009; 8:199-202. [PMID: 19884702 DOI: 10.4103/1596-3519.57242] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
|
25
|
Abstract
Rhinosporidiosis is a rare chronic granulomatous infection caused by Rhinosporidium seeberi. It affects mainly the mucosa of the nose, nasopharynx, palate, conjunctiva and the urethra. A seven-year-old girl presented with intranasal polypoid growth with recurrent nose bleeding for one year. Excision biopsy was done, and the tissue was subjected to routine histological processing and stained with hematoxylin and eosin stains with additional mucicarmine special stain. Variable-sized sporangia containing magenta-colored spores and capsule were observed. We hereby present a rare infective disease diagnosed nine years after the first reported case in our center.
Collapse
Affiliation(s)
- Godwins O Echejoh
- Pathology Department, Jos University Teaching Hospital, Jos, Nigeria.
| | | | | | | | | | | | | |
Collapse
|