Self-reported symptoms of uninvestigated dypepsia among University staff in Ilorin, Nigeria

Objectives: Dyspepsia is a common gastrointestinal (GI) symptom which impacts negatively on quality of life, workplace efficiency and overall productivity. Many studies on dyspepsia in our environment are hospital based, but being a complaint frequently treated first by self-medication before presentation to the hospital, such studies may underestimate its prevalence. The objective of the study was to determine the prevalence of the dyspepsia and its associated factors among administrative staff of the College of Health Sciences, University of Ilorin, Nigeria.Methods: This was a cross-sectional study. Pretested structured, close-ended, interviewer-administered questionnaires were administered to 53 administrative staff selected across the different units by stratified random sampling. The questionnaire obtained information about subject's experiences of dyspeptic symptoms and presence of associated factors such as family history, non-steroidal anti-inflammatory drugs (NSAIDS), tobacco and alcohol use, and presence of diabetes mellitus (DM).Results: The prevalence of uninvestigated dyspepsia among the respondents was 37.5%. Age was significantly predictive of the occurrence of dyspepsia among the subjects Odds Ratio- 1.46, 95% Confidence Interval (1.042-2.045) P=0.03. Use of NSAIDS, presence of DM, family history and tobacco use were not predictive of occurrence of dyspepsia.Conclusion: The prevalence of dyspepsia is high among respondents in the study.Keywords: Dyspepsia, prevalence, university, Nigeri

Blood transfusion service in a tertiary hospital in sub- Saharan Africa during the COVID 19 pandemic: Experience from Lagos University Teaching Hospital, Nigeria

Blood transfusion services are as pivotal to the health system during a pandemic as before the pandemic. The effect of a pandemic ontransfusion services depends on the nature, potential for community spread and risk of transfusion transmissibility. As the total number of cases and deaths from COVID-19 rises, and to prevent the community spread of the SARS‐CoV‐2 virus, governments worldwide, as well as the Nigerian government, announced national lockdowns. Lockdowns have affected blood transfusion services. In Nigeria, blood transfusion services are still decentralized and tertiary health centres run independent transfusion units. The Lagos University Teaching Hospital blood transfusion unit was also impacted by the pandemic and the consequent lockdown. The major challenges experienced are in recruitment of voluntary blood donors, follow‐up of donors and patients with concomitant reduction in blood and blood component  supply derived from family replacement donation, inventory and consumable management, staff safety and adequacy for emergency work. These challenges were compounded by the inadequate infrastructure and policies at the outset of the pandemic. Countries in sub-Saharan Africa should invest in health infrastructure and their transfusion services and encourage local manufacture of basic laboratory reagents and consumables. The blood transfusion services and units should put in place strategic continuity of operations plans (COOP) to respond adequately to challenges generated during a pandemic which should focus on shortage, wastage and supply of blood and components in a cost‐effective manner and human resource management.   French title: Service de transfusion sanguine dans un hôpital tertiaire en Afrique subsaharienne pendant la pandémie COVID 19: Expérience de l'hôpital universitaire de Lagos, Nigéria Les services de transfusion sanguine sont aussi essentiels au système de santé pendant une pandémie qu'avant la pandémie. L'effet d'une pandémie sur les services transfusionnels dépend de la nature, du potentiel de propagation communautaire et du risque de transmissibilité transfusionnelle. Alors que le nombre total de cas et de décès dus au COVID-19 augmente et pour empêcher la propagation communautaire du virus SRAS-CoV-2, les gouvernements du monde entier, ainsi que le gouvernement nigérian, ont annoncé des verrouillages nationaux. Les verrouillages ont affecté les services de transfusion sanguine. Au Nigéria, les services de transfusion sanguine sont encore décentralisés et les centres de santé tertiaires gèrent des unités de transfusion indépendantes. L'unité de transfusion sanguine de l'hôpital universitaire de Lagos a également été touchée par la pandémie et le verrouillage qui en a résulté. Les principaux défis rencontrés concernent le recrutement de donneurs de sang volontaires, le suivi des donneurs et des patients avec une réduction concomitante de l'approvisionnement en sang et en composants sanguins provenant du don de remplacement familial, la gestion des stocks et des consommables, la sécurité du personnel et l'adéquation au travail d'urgence. Ces défis ont été aggravés par des infrastructures et des politiques inadéquates au début de la pandémie. Les pays d'Afrique subsaharienne devraient investir dans les infrastructures de santé et leurs services de transfusion et encourager la fabrication locale de réactifs et de consommables de laboratoire de base. Les services et unités de transfusion sanguine devraient mettre en place des plans stratégiques de continuité des opérations (COOP) pour répondre de manière adéquate aux défis générés pendant une pandémie, qui devraient se concentrer sur la pénurie, le gaspillage et l'approvisionnement en sang et en composants de manière rentable et la gestion des ressources humaines

Cancer Incidence, Mortality, Years of Life Lost, Years Lived with Disability, and Disability-Adjusted Life Years for 29 Cancer Groups from 2010 to 2019: A Systematic Analysis for the Global Burden of Disease Study 2019

Importance: The Global Burden of Diseases, Injuries, and Risk Factors Study 2019 (GBD 2019) provided systematic estimates of incidence, morbidity, and mortality to inform local and international efforts toward reducing cancer burden. Objective: To estimate cancer burden and trends globally for 204 countries and territories and by Sociodemographic Index (SDI) quintiles from 2010 to 2019. Evidence Review: The GBD 2019 estimation methods were used to describe cancer incidence, mortality, years lived with disability, years of life lost, and disability-adjusted life years (DALYs) in 2019 and over the past decade. Estimates are also provided by quintiles of the SDI, a composite measure of educational attainment, income per capita, and total fertility rate for those younger than 25 years. Estimates include 95 uncertainty intervals (UIs). Findings: In 2019, there were an estimated 23.6 million (95 UI, 22.2-24.9 million) new cancer cases (17.2 million when excluding nonmelanoma skin cancer) and 10.0 million (95 UI, 9.36-10.6 million) cancer deaths globally, with an estimated 250 million (235-264 million) DALYs due to cancer. Since 2010, these represented a 26.3 (95 UI, 20.3-32.3) increase in new cases, a 20.9 (95 UI, 14.2-27.6) increase in deaths, and a 16.0 (95 UI, 9.3-22.8) increase in DALYs. Among 22 groups of diseases and injuries in the GBD 2019 study, cancer was second only to cardiovascular diseases for the number of deaths, years of life lost, and DALYs globally in 2019. Cancer burden differed across SDI quintiles. The proportion of years lived with disability that contributed to DALYs increased with SDI, ranging from 1.4 (1.1-1.8) in the low SDI quintile to 5.7 (4.2-7.1) in the high SDI quintile. While the high SDI quintile had the highest number of new cases in 2019, the middle SDI quintile had the highest number of cancer deaths and DALYs. From 2010 to 2019, the largest percentage increase in the numbers of cases and deaths occurred in the low and low-middle SDI quintiles. Conclusions and Relevance: The results of this systematic analysis suggest that the global burden of cancer is substantial and growing, with burden differing by SDI. These results provide comprehensive and comparable estimates that can potentially inform efforts toward equitable cancer control around the world.. © 2021 American Medical Association. All rights reserved

The global burden of adolescent and young adult cancer in 2019: a systematic analysis for the Global Burden of Disease Study 2019

Background In estimating the global burden of cancer, adolescents and young adults with cancer are often overlooked, despite being a distinct subgroup with unique epidemiology, clinical care needs, and societal impact. Comprehensive estimates of the global cancer burden in adolescents and young adults (aged 15–39 years) are lacking. To address this gap, we analysed results from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019, with a focus on the outcome of disability-adjusted life-years (DALYs), to inform global cancer control measures in adolescents and young adults. Methods Using the GBD 2019 methodology, international mortality data were collected from vital registration systems, verbal autopsies, and population-based cancer registry inputs modelled with mortality-to-incidence ratios (MIRs). Incidence was computed with mortality estimates and corresponding MIRs. Prevalence estimates were calculated using modelled survival and multiplied by disability weights to obtain years lived with disability (YLDs). Years of life lost (YLLs) were calculated as age-specific cancer deaths multiplied by the standard life expectancy at the age of death. The main outcome was DALYs (the sum of YLLs and YLDs). Estimates were presented globally and by Socio-demographic Index (SDI) quintiles (countries ranked and divided into five equal SDI groups), and all estimates were presented with corresponding 95% uncertainty intervals (UIs). For this analysis, we used the age range of 15–39 years to define adolescents and young adults. Findings There were 1·19 million (95% UI 1·11–1·28) incident cancer cases and 396 000 (370 000–425 000) deaths due to cancer among people aged 15–39 years worldwide in 2019. The highest age-standardised incidence rates occurred in high SDI (59·6 [54·5–65·7] per 100 000 person-years) and high-middle SDI countries (53·2 [48·8–57·9] per 100 000 person-years), while the highest age-standardised mortality rates were in low-middle SDI (14·2 [12·9–15·6] per 100 000 person-years) and middle SDI (13·6 [12·6–14·8] per 100 000 person-years) countries. In 2019, adolescent and young adult cancers contributed 23·5 million (21·9–25·2) DALYs to the global burden of disease, of which 2·7% (1·9–3·6) came from YLDs and 97·3% (96·4–98·1) from YLLs. Cancer was the fourth leading cause of death and tenth leading cause of DALYs in adolescents and young adults globally. Interpretation Adolescent and young adult cancers contributed substantially to the overall adolescent and young adult disease burden globally in 2019. These results provide new insights into the distribution and magnitude of the adolescent and young adult cancer burden around the world. With notable differences observed across SDI settings, these estimates can inform global and country-level cancer control efforts