Impact of health system challenges on prostate cancer control: health care experiences in Nigeria

Prostate cancer is the second most frequently diagnosed cancer of men (913 000 new cases, 13.8% of the total) and the fifth most common cancer overall. Prostate cancer is the sixth leading cause of death from cancer in men (6.1% of the total)

Review of prostate cancer research in Nigeria

Prostate cancer (CaP) disparities in the black man calls for concerted research efforts. This review explores the trend and focus of CaP research activities in Nigeria, one of the ancestral nations for black men. It seeks to locate the place of the Nigerian research environment in the global progress on CaP disparities. Literature was reviewed mainly through a Pubmed search with the terms “prostate cancer”and “Nigeria”, as well as from internet and hard copies of journal pages

Prostate cancer disparities in Black men of African descent: a comparative literature review of prostate cancer burden among Black men in the United States, Caribbean, United Kingdom, and West Africa

<p>Abstract</p> <p>Background</p> <p>African American men have the highest prostate cancer morbidity and mortality rates than any other racial or ethnic group in the US. Although the overall incidence of and mortality from prostate cancer has been declining in White men since 1991, the decline in African American men lags behind White men. Of particular concern is the growing literature on the disproportionate burden of prostate cancer among other Black men of West African ancestry in the Caribbean Islands, United Kingdom and West Africa. This higher incidence of prostate cancer observed in populations of African descent may be attributed to the fact that these populations share ancestral genetic factors. To better understand the burden of prostate cancer among men of West African Ancestry, we conducted a review of the literature on prostate cancer incidence, prevalence, and mortality in the countries connected by the Transatlantic Slave Trade.</p> <p>Results</p> <p>Several published studies indicate high prostate cancer burden in Nigeria and Ghana. There was no published literature for the countries Benin, Gambia and Senegal that met our review criteria. Prostate cancer morbidity and/or mortality data from the Caribbean Islands and the United Kingdom also provided comparable or worse prostate cancer burden to that of US Blacks.</p> <p>Conclusion</p> <p>The growing literature on the disproportionate burden of prostate cancer among other Black men of West African ancestry follows the path of the Transatlantic Slave Trade. To better understand and address the global prostate cancer disparities seen in Black men of West African ancestry, future studies should explore the genetic and environmental risk factors for prostate cancer among this group.</p

An Estimate of the Incidence of Prostate Cancer in Africa: A Systematic Review and Meta-Analysis

Prostate cancer (PCa) is rated the second most common cancer and sixth leading cause of cancer deaths among men globally. Reports show that African men suffer disproportionately from PCa compared to men from other parts of the world. It is still quite difficult to accurately describe the burden of PCa in Africa due to poor cancer registration systems.We systematically reviewed the literature on prostate cancer in Africa and provided a continentwide incidence rate of PCa based on available data in the regio

Association of predicted 10 years cardiovascular mortality risk with duration of HIV infection and antiretroviral therapy among HIV-infected individuals in Durban, South Africa

Background: South Africa has the largest population of human immunodeficiency virus (HIV) infected patients on antiretroviral therapy (ART) realising the benefits of increased life expectancy. However, this population may be susceptible to cardiovascular disease (CVD) development, due to the chronic consequences of a lifestyle-related combination of risk factors, HIV infection and ART. We predicted a 10-year cardiovascular mortality risk in an HIV-infected population on long-term ART, based on their observed metabolic risk factor profile. Methods: We extracted data from hospital medical charts for 384 randomly selected HIV-infected patients aged ≥ 30 years. We defined metabolic syndrome (MetS) subcomponents using the International Diabetes Federation definition. A validated non-laboratory-based model for predicting a 10-year CVD mortality risk was applied and categorised into five levels, with the thresholds ranging from very low-risk ( 30%). Results: Among the 384 patients, with a mean (± standard deviation) age of 42.90 ± 8.20 years, the proportion of patients that were overweight/obese was 53.3%, where 50.9% had low high-density lipoprotein (HDL) cholesterol and 21 (17.5%) had metabolic syndrome. A total of 144 patients with complete data allowed a definitive prediction of a 10-year CVD mortality risk. 52% (95% CI 44-60) of the patients were stratified to very low risk ( 30%) of 10-year CVD mortality. The CVD risk grows with increasing age (years), 57.82 ± 6.27 among very high risk and 37.52 ± 4.50; p < 0.001 in very low risk patients. Adjusting for age and analysing CVD risk mortality as a continuous risk score, increasing duration of HIV infection (p = 0.002) and ART (p = 0.007) were significantly associated with increased predicted 10 year CVD mortality risk. However, there was no association between these factors and categorised CVD mortality risk as per recommended scoring thresholds. Conclusions: Approximately 1 in 10 HIV-infected patients is at very high risk of predicted 10-year CVD mortality in our study population. Like uninfected individuals, our study found increased age as a major predictor of 10-year mortality risk and high prevalence of metabolic syndrome. Additional CVD mortality risk due to the duration of HIV infection and ART was seen in our population, further studies in larger and more representative study samples are encouraged. It recommends an urgent need for early planning, prevention and management of metabolic risk factors in HIV populations, at the point of ART initiation

Semen Parameters in Infertile Nigerian Males: A critical Study

Introduction: Approximately one couple in ten are infertile during their reproductive lives. Male factors alone are responsible for infertility in 24% of couples and contributed to the cause in another 24%. The most important male factor is the semen parameter. Seminal fluid analysis is therefore the cornerstone of male infertility investigations. All the indicators suggest that a man had a reasonable chance of fertility with a sperm density exceeding 20x105/ml with more than 50% motility and a seminal volume of at least 1.5ml. Objective: To study the seminal parameters in infertile Nigerian male with a view to determining the distribution or pattern of semen abnormalities in them. Materials and Methods: Semen from 1129 infertile males were analyzed using conventional methods. The motility and the sperm density were estimated. The volume transparency, viscosity, the percentage of abnormal forms and abnormal cellular components were noted. The data were analyzed and displayed in tabular and graphical forms. Results: Two hundred and eighteen (218) (19.3%) were found to be azoospermic, 608 (53.85%) were oligospermic and 303 (26.83%) had normal sperm density. The motility at 2 hours was less than 50% in 66% of the specimen studied. The seminal volume was less than 1.5ml in 30.63% of the specimens. 36.7% had more than 50% abnormal forms. 23.7% and 12.8% of the specimens had significant white blood cells and immature/premature spermatogenic cells respectively. Conclusion: The most common abnormalities in the semen parameters of infertile Nigerian males are asthenozoopermia and oligoszospermia. Conventional technique of semen analysis gives reliable results on sperm characteristics. However, in some situations other tests may be necessary for complete evaluation. Keywords: Semen parameters Male infertility NigerianNQJHM Vol. 15 (2) 2005: pp. 87-9

Indications for Prostatic Biopsy – which is more useful: the Prostate Specific Antigen or the Digital Rectal Examination? – An Analysis of 431 Consecutive Prostatic Biopsies at the Lagos University Teaching Hospital

Objective: To compare the reliability of the digital rectal examination (DRE) and the serum prostate specific antigen (PSA) as an indication for prostate biopsy at the Lagos University Teaching Hospital, (LUTH) Idi-Araba, Nigeria. Patients and Methods: 42 patients were admitted for transperineal trucut biopsy of the prostate at the hospital between January 2000 to December 2001. The indication for biopsy was either an abnormal finding on DRE, serum PSA greater than 4ng/ml or both. The final histopathology report was used as the Gold standard in assessing accuracy of these two screening procedures. Results: PSA>4ng/ml (irrespective of DRE findings) had a positive predictive value (PPV) of 68.6% for prostatic cancer (Ca-P). A raised PSA. alone (i.e. with normal findings on DRE.) had a PPV of 28.6%. DRE (irrespective of PSA) had a PPV of 88.9%. When both an abnormal DRE and a raised PSA were present, the PPV was 95.2%. Conclusion: At LUTH, DRE is more reliable than the serum PSA analysis as an indication for prostate biopsy. NQJHM Vol. 14 (3&4) 2004: pp. 248-25