KNOWLEDGE ON THE USE OF BIOSIMILARS IN HAEMATOLOGICAL MALIGNANCIES AMONGST HEALTHCARE WORKERS AT A TERTIARY HOSPITAL IN NORTHEAST NIGERIA

Introduction

Haematological malignancies like other cancers are on the rise. With the improved understanding of the biology of cancers, various biological molecules (biologics and biosimilars) are being discovered and used as supportive and/or specific treatment options. These novel treatments have revolutionized the care of cancer patients and significantly improved survival. While biosimilars are widely available, their use is still limited in some low- and middle-income countries, including Nigeria. Barriers to the use of biosimilars in cancer care include poor knowledge of stakeholders, financial disincentives, and unfavourable regulatory policies. This study aimed to determine the knowledge of healthcare workers (HCWs) at a tertiary hospital in Bauchi, Nigeria, before and after a structured training program on the use of biosimilars in haematological malignancies.

Methodology

Healthcare workers underwent a week-long training on biosimilars. Knowledge pre- and post-training were ascertained using interviewer-administered questionnaires. Participant data were summarized as percentages in charts and tables and compared using the Z-test in Microsoft Excel 2016. P values≤0.05 were considered significant.

Results

One hundred and sixty-one (161) participants attended the training, with females constituting 56.5%. Participant knowledge of cancer and haematological malignancies was significantly higher after training (82.1% vs. 61.5%; Z = 4.1, p < 0.001). Similarly, post-test scores assessing knowledge of biologics and biosimilars used in haematological malignancies were significantly higher than pre-test scores (80.0% vs. 44.1%; Z= 6.6, p < 0.001).

Conclusion

Knowledge of biosimilars and their use in haematological malignancies was low amongst HCWs, but improved significantly after an educational program.

Gastroesophageal reflux disease in a typical African population: a symptom-based multicenter study

BACKGROUND

The prevalence of gastroesophageal reflux disease (GERD) in Africa is not known but is believed to be increasing because of demographic and epidemiologic transition. The main objectives of this study were to determine the prevalence and risk factors of GERD, and its degree of overlap with dyspepsia and irritable bowel syndrome (IBS) in Nigeria, a typical African population.

METHODS

This was an observational, cross-sectional and descriptive study of adult Nigerians. Diagnosis of GERD was by means of the gastroesophageal reflux disease questionnaire (GERDQ) while the diagnosis of dyspepsia and IBS was based on the Rome III criteria for the diagnosis of functional gastrointestinal disorders. The GERDQ and Rome III questionnaires for dyspepsia and IBS were merged into a composite questionnaire and administered to the study participants who were recruited with a multi-stage sampling technique.

RESULTS

Out of 3520 subjects who participated in the study across the country, 269 (7.6%) satisfied the diagnostic criteria for GERD, while 107 (3.0%) had GERD associated with significant impairment of quality of life. Risk factors of GERD (represented by odds ratios) were age 1.014(95% CI: 1.006-1.022), use of analgesics 1.461 (95% CI: 1.060-2.025), and use of herbs 1.318 (95% CI: 1.020-1.704). Overlap of GERD with dyspepsia and/or IBS was observed in over 50% of cases.

CONCLUSIONS

The prevalence of GERD in this study is 7.6%. Age, use of analgesics and use of herbs increase the risk, albeit minimally. A high degree of overlap with dyspepsia and IBS exists in Nigerian patients with GERD.

Oesophageal variceal band ligation using a saeed six-shooter multiband ligator; experience at Jos University Teaching Hospital, Nigeria: case report

BACKGROUND

Oesophageal varices are common sequelae of cirrhosis, which when they bleed can be difficult to control. Oesophageal variceal band ligation, being the best modality for controlling variceal bleeding has not been common practice in West Africa, a region recognized to have a high prevalence of liver diseases. We present a case of band ligation of the varices of a patient that presented to our hospital with variceal haemorrhage, secondary to liver cirrhosis.

METHOD

We started by presenting a summary of the presentation of a 31 year old man at the Jos University Teaching Hospital and how we established the diagnosis of grade IV bleeding oesophageal varices. The subject had four bands applied to the oesophageal varices using a saeed six shooter oesophageal Multi-band ligator (North Carolina, USA) using a forward-viewing GIF P30 gastroscope (Tokyo, Japan) with the bands mounted on an Opti-vu barrel-shaped piece. He had a total of three sessions after which he was maintained on propranolol.

RESULT

The last recheck endoscopy demonstrated obliterated varices after which he was maintained on propranolol.

CONCLUSION

We present a case of successful variceal band ligation of a cirrhotic with extensive oesophageal varices presenting in a resource-constraint medical setting.