Multiple myeloma in Nigeria: An insight to the clinical, laboratory features, and outcomes

Aim: In developing African nations, late presentation and occurrence of complications adversely affects survival. This study aims at identifying initial clinical and basic laboratory features of multiple myeloma (MM), which will aid the physician to entertain a high index of suspicion and therefore target his investigations in order to prevent late presentation and avert complications.Materials and Methods: A retrospective analysis of 32 patients diagnosed and managed in Nigeria, West Africa was done. Information on the clinical, laboratory, and radiological data as well as response to treatment was obtained at presentation, 3, 6, 12, and 24 months and analyzed.Results: The median age at diagnosis was 62 years, 17 (53.1%) males and 15 (46.9%) females. The median duration of follow‑up was 24 weeks (range, 2-288 weeks). The average percentage of bone marrow plasmacytosis at diagnosis was 38%. Clinical features at presentation were anemia (71.9%) and bone pains (78.1%), while pathological fractures were found in 69%, and nephropathy in 13.8%. The longest duration of survival of 288 and 252 weeks were recorded in patients on melphalan and prednisolone with or without thalidomide.Conclusion: Presence of bone pain and anemia in elderly patients should alert the clinician to investigate along the lines of MM. Majority of patients have osteolytic lesions on X‑ray and pathological fractures, and benefit from melphalan based combinations in situations where facilities for transplant are not available.Key words: Clinical features, chemotherapy, laboratory features, multiple myeloma, Nigeria, treatmen

Stroke prevalence amongst sickle cell disease patients in Nigeria: a multi-centre study

Background: Stroke is a life-changing, debilitating complication of sickle cell disease (SCD). Previous studies had recorded high stroke prevalence amongst this group of patients. Nigeria has a large population of people affected by this condition and this study aims to assess the stroke prevalence in this large population.Methodology: Stroke prevalence data from 14 physicians working in 11 tertiary health centres across the country was collated by doctors using the sickle cell registers and patient case notes. This data was then collated and used to obtain the overall stroke prevalence in adult and children.Results: The stroke prevalence in sickle cell disease patients in Nigeria was observed to be 12.4 per 1000 patients. Prevalence in the adult patients was 17.7 per 1000 patients and 7.4 per 1000 patients in children. Twenty three percent of the affected patients had more than stroke episode.Conclusion: The stroke prevalence in Nigeria is lower than previously recorded rates and further studies will be required to investigate other factors which may play a role.Keywords: sickle cell, stroke, Nigeria, prevalenc