Epidemiological and Clinical Characteristics of COVID-19 Related Mortality in Oyo State, Nigeria

Background: On March 11, 2020, the World Health Organization classified COVID-19 as a pandemic. SARS-CoV-2, the virus that causes it, travels from person to person through respiratory secretions, direct contact, and aerosol. Although the COVID-19 pandemic has abated, it still infects pockets of susceptible populations around the world. Over 600 million COVID cases and 6 million deaths have been recorded globally with over 3000 deaths recorded in Nigeria. There is, however, a paucity of published research from Africa describing the epidemiological and clinical characteristics of COVID-19 decedents. The aim of this study is to recognize the epidemiological characteristics and comorbidities of COVID-19 mortality cases in Oyo state, Nigeria. Furthermore, this paper aims to understand the relationship between these epidemiological characteristics, comorbidities, and COVID-19 mortality. Understanding the relationship between these variables and COVID-19 mortality would contribute to the existing body of knowledge regarding the early detection and effective management of COVID-19 cases, thereby reducing the morbidity and mortality associated with COVID-19. Method: This is a retrospective cross-sectional study of COVID-19 mortality that occurred in Oyo state, Nigeria between April 12, 2020 and March 12, 2021. A total of 121 confirmed COVID-19 related mortality cases were recorded during this period. Reverse-transcriptase polymerase chain reaction (RT-PCR) testing of nasopharyngeal and oropharyngeal samples was used to confirm SARS-CoV-2 infection. Data collected included age, sex, occupation, local government area, duration of hospitalization, comorbidities, clinical diagnosis, place of date, antemortem, and postmortem COVID-19 status. The independent t-test and Mann-Whitney U/Kruskal-Wallis H test were used to evaluate continuous variables, while a test of proportion and the Chi-square test were used to investigate categorical variables. Statistical analyses were performed with STATA/MP 14.2. Results: The majority of the deceased were male patients (57%) compared to female patients (43%). Mortality was highest among those aged 40 years and above (92.5%) compared to those less than 40 years old (7.5%). The mean age of the deceased was 64 years. Hypertension (36.4%) and diabetes (26.5%) were the most common underlying conditions reported and significant associations were found between having a comorbidity and sex (p =0.028). Almost one-third (31.6%) of the included cases died within a day of hospitalization and the median duration between hospital admission and death was 1 day. There was a significant difference between the duration of hospitalization and status at death. Patients managed as suspected cases had a shorter median duration of hospitalization before death (1.0; IQR 0.5, 2) compared to the confirmed cases (4.0; IQR 1, 8). Conclusion: The results of this study showed that a high proportion of the COVID-19 mortality cases were of age greater than 40 years, male gender, and had comorbidities. Knowledge of these associated characteristics can help physicians identify and effectively manage patients with increased risk for severe outcomes of COVID and hence reduce mortality. It is recommended that people with an increased risk of severe outcomes be vaccinated against COVID-19

Distribution and characteristics of endometriotic lesions in south- western Nigeria: a single institutional experience

Background: Endometriosis poses a significant burden mainly to women of child bearing age. Historically, endometriosis was thought to be of low prevalence among African women. However, recent studies have documented an increased prevalence than previously thought. This study aimed to determine the distribution and characteristics of endometriotic lesions among Nigerian women.Methods: A retrospective study of all histologically diagnosed cases of endometriosis from the records of the Department of Pathology, University College Hospital, Ibadan from 1st January, 1997 to 31st October, 2018.The age of the women, location and distribution of the lesions were analysed.Results: A total of 85 cases of endometriosis were diagnosed histologically in the period under review. The mean age was 35 years with an age range of 18 to 52 years. The most commonly affected age groups were those between 30-39 years (47.1%) and 20-29 years (30.6%). The most commonly affected site was the ovary (58.8%) followed by the umbilicus (11.9%) and fallopian tubes (9.4%). Fourteen patients (28%) had bilateral ovarian involvement. Left sided ovarian lesions predominated (61.1% versus 38.9%). Eighteen (21.2%) patients had lesions at more than one site frequently involving both ovaries.Conclusion: Endometriosis affected mainly women of childbearing age with particular predilection for the ovaries. Endometriosis affecting the umbilicus is not uncommon among Nigerian women.Keywords: Endometriosis, Ibadan, Nigeria, ovary, umbilicu

Nasopharyngeal carcinoma in Ibadan, Nigeria: a clinicopathologic study

Introduction: nasopharyngeal carcinoma is relatively common in our environment. It is one of the most difficult malignancies to diagnose at an early stage. The aim of the study was to determine the clinical features, clinical disease stage of nasopharyngeal carcinoma at presentation and at diagnosis as well as the histologic types at the University College Hospital, Ibadan, Nigeria. Methods: this was a ten year retrospective study of all histologically confirmed nasopharyngeal carcinoma between January 2007 to December 2016 using clinical and pathology records and files. Results: there were 73 cases. The male: female ratio was 1.7. The age of patients ranged from 12 to 80 years with a mean age of 39 ± 16 years. The median age at diagnosis was 40 years. The peak age group of occurrence was 40-49 years. The most common symptoms were namely epistaxis in 67.1% of patients at presentation, neck mass/swelling (64.4%) and nasal mass/obstruction (63.0%). Majority (54.8%) of the patients presented late with stage 3 or 4 disease. Most (94.5%) of the tumours were of the non-keratinizing squamous cell carcinoma subtype. The keratinizing and basaloid variants accounted for 4.1% and 1.4% of the tumours respectively. Conclusion: vague, non-specific symptoms make patients present at late stages of the disease, making it almost impossible to attempt cure. The dominant histopathological type is non-keratinizing squamous cell carcinoma and resembles that seen in most parts of Nigeria and endemic areas of the world