22 research outputs found
Enhancement strategies for transdermal drug delivery systems: current trends and applications
Twelve-month observational study of children with cancer in 41 countries during the COVID-19 pandemic
Introduction Childhood cancer is a leading cause of death. It is unclear whether the COVID-19 pandemic has impacted childhood cancer mortality. In this study, we aimed to establish all-cause mortality rates for childhood cancers during the COVID-19 pandemic and determine the factors associated with mortality. Methods Prospective cohort study in 109 institutions in 41 countries. Inclusion criteria: children <18 years who were newly diagnosed with or undergoing active treatment for acute lymphoblastic leukaemia, non-Hodgkin's lymphoma, Hodgkin lymphoma, retinoblastoma, Wilms tumour, glioma, osteosarcoma, Ewing sarcoma, rhabdomyosarcoma, medulloblastoma and neuroblastoma. Of 2327 cases, 2118 patients were included in the study. The primary outcome measure was all-cause mortality at 30 days, 90 days and 12 months. Results All-cause mortality was 3.4% (n=71/2084) at 30-day follow-up, 5.7% (n=113/1969) at 90-day follow-up and 13.0% (n=206/1581) at 12-month follow-up. The median time from diagnosis to multidisciplinary team (MDT) plan was longest in low-income countries (7 days, IQR 3-11). Multivariable analysis revealed several factors associated with 12-month mortality, including low-income (OR 6.99 (95% CI 2.49 to 19.68); p<0.001), lower middle income (OR 3.32 (95% CI 1.96 to 5.61); p<0.001) and upper middle income (OR 3.49 (95% CI 2.02 to 6.03); p<0.001) country status and chemotherapy (OR 0.55 (95% CI 0.36 to 0.86); p=0.008) and immunotherapy (OR 0.27 (95% CI 0.08 to 0.91); p=0.035) within 30 days from MDT plan. Multivariable analysis revealed laboratory-confirmed SARS-CoV-2 infection (OR 5.33 (95% CI 1.19 to 23.84); p=0.029) was associated with 30-day mortality. Conclusions Children with cancer are more likely to die within 30 days if infected with SARS-CoV-2. However, timely treatment reduced odds of death. This report provides crucial information to balance the benefits of providing anticancer therapy against the risks of SARS-CoV-2 infection in children with cancer
Estimating the burden of selected non-communicable diseases in Africa: a systematic review of the evidence
Background
The burden of non-communicable diseases (NCDs) is rapidly increasing globally, and
particularly in Africa, where the health focus, until recently, has been on infectious diseases. The
response to this growing burden of NCDs in Africa has been affected owing to a poor
understanding of the burden of NCDs, and the relative lack of data and low level of research on
NCDs in the continent. Recent estimates on the burden of NCDs in Africa have been mostly
derived from modelling based on data from other countries imputed into African countries, and
not usually based on data originating from Africa itself. In instances where few data were
available, estimates have been characterized by extrapolation and over-modelling of the scarce
data. It is therefore believed that underestimation of NCDs burden in many parts of Africa cannot
be unexpected. With a gradual increase in average life expectancy across Africa, the region now
experiencing the fastest rate of urbanization globally, and an increase adoption of unhealthy
lifestyles, the burden of NCDs is expected to rise. This thesis will, therefore, be focussing on
understanding the prevalence, and/or where there are available data, the incidence, of four major
NCDs in Africa, which have contributed highly to the burden of NCDs, not only in Africa, but
also globally.
Methods
I conducted a systematic search of the literature on three main databases (Medline, EMBASE and
Global Health) for epidemiological studies on NCDs conducted in Africa. I retained and
extracted data from original population-based (cohort or cross sectional), and/or health service
records (hospital or registry-based studies) on prevalence and/or incidence rates of four major
NCDs in Africa. These include: cardiovascular diseases (hypertension and stroke), diabetes,
major cancer types (cervical, breast, prostate, ovary, oesophagus, bladder, Kaposi, liver, stomach,
colorectal, lung and non-Hodgkin lymphoma), and chronic respiratory diseases (chronic
obstructive pulmonary disease (COPD) and asthma). From extracted crude prevalence and
incidence rates, a random effect meta-analysis was conducted and reported for each NCD. An
epidemiological model was applied on all extracted data points. The fitted curve explaining the
largest proportion of variance (best fit) from the model was further applied. The equation
generated from the fitted curve was used to determine the prevalence and cases of the specific
NCD in Africa at midpoints of the United Nations (UN) population 5-year age-group population
estimates for Africa.
Results
From the literature search, studies on hypertension had the highest publication output at 7680, 92
of which were selected, spreading across 31 African countries. Cancer had 9762 publications and
39 were selected across 20 countries; diabetes had 3701 publications and 48 were selected across
28 countries; stroke had 1227 publications and 19 were selected across 10 countries; asthma had
790 publications and 45 were selected across 24 countries; and COPD had the lowest output with
243 publications and 13 were selected across 8 countries. From studies reporting prevalence
rates, hypertension, with a total sample size of 197734, accounted for 130.2 million cases and a
prevalence of 25.9% (23.5, 34.0) in Africa in 2010. This is followed by asthma, with a sample
size of 187904, accounting for 58.2 million cases and a prevalence of 6.6% (2.4, 7.9); COPD,
with a sample size of 24747, accounting for 26.3 million cases and a prevalence of 13.4% (9.4,
22.1); diabetes, with a sample size of 102517, accounting for 24.5 million cases and a prevalence
of 4.0% (2.7, 6.4); and stroke, with a sample size of about 6.3 million, accounting for 1.94
million cases and a prevalence of 317.3 per 100000 population (314.0, 748.2). From studies
reporting incidence rates, stroke accounted for 496 thousand new cases in Africa in 2010, with a
prevalence of 81.3 per 100000 person years (13.2, 94.9). For the 12 cancer types reviewed, a total
of 775 thousand new cases were estimated in Africa in 2010 from registry-based data covering a
total population of about 33 million. Among women, cervical cancer and breast cancer had 129
thousand and 81 thousand new cases, with incidence rates of 28.2 (22.1, 34.3) and 17.7 (13.0,
22.4) per 100000 person years, respectively. Among men, prostate cancer and Kaposi sarcoma
closely follows with 75 thousand and 74 thousand new cases, with incidence rates of 14.5 (10.9,
18.0) and 14.3 (11.9, 16.7) per 100000 person years, respectively.
Conclusion
This study suggests the prevalence rates of the four major NCDs reviewed (cardiovascular
diseases (hypertension and stroke), diabetes, major cancer types, and chronic respiratory diseases
(COPD and asthma) in Africa are high relative to global estimates. Due to the lack of data on
many NCDs across the continent, there are still doubts on the true prevalence of these diseases
relative to the current African population. There is need for improvement in health information
system and overall data management, especially at country level in Africa. Governments of
African nations, international organizations, experts and other stakeholders need to invest more
on NCDs research, particularly mortality, risk factors, and health determinants to have
evidenced-based facts on the drivers of this epidemic in the continent, and prompt better,
effective and overall public health response to NCDs in Africa
A year of genomic surveillance reveals how the SARS-CoV-2 pandemic unfolded in Africa.
The progression of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic in Africa has so far been heterogeneous, and the full impact is not yet well understood. In this study, we describe the genomic epidemiology using a dataset of 8746 genomes from 33 African countries and two overseas territories. We show that the epidemics in most countries were initiated by importations predominantly from Europe, which diminished after the early introduction of international travel restrictions. As the pandemic progressed, ongoing transmission in many countries and increasing mobility led to the emergence and spread within the continent of many variants of concern and interest, such as B.1.351, B.1.525, A.23.1, and C.1.1. Although distorted by low sampling numbers and blind spots, the findings highlight that Africa must not be left behind in the global pandemic response, otherwise it could become a source for new variants
Baggasse charcoal optimization based on different concentration and immersing time to stabilize quality of cooking oil
Effect of soil type, salinity, and allelochemicals on germination and seedling growth of a medicinal plant Lepidium sativum L.
Coaxially Electrospun Scaffolds Based on Hydroxyl-Functionalized Poly(epsilon-caprolactone) and Loaded with VEGF for Tissue Engineering Applications
Item does not contain fulltextThe aim of this study was to fabricate nanofibrous scaffolds based on blends of a hydroxyl functionalized polyester (poly(hydroxymethylglycolide-co-epsilon-caprolactone), pHMGCL) and poly(epsilon-caprolactone) (PCL), loaded with bovine serum albumin (BSA) as a protein stabilizer and vascular endothelial growth factor (VEGF) as a potent angiogenic factor by means of a coaxial electrospinning technique. The scaffolds were characterized by scanning electron microscopy (SEM), fluorescence microscopy (FM), and differential scanning calorimetry (DSC). The scaffolds displayed a uniform fibrous structure with a fiber diameter around 700 nm. The release of BSA from the core of the fibers was studied by high performance liquid chromatography (HPLC), and it was shown that the coaxial scaffolds composed of blends of pHMGCL and PCL exhibited faster release than the comparative PCL scaffolds. VEGF was also incorporated in the core of the scaffolds, and the effect of the released protein on the attachment and proliferation of endothelial cells was investigated. It was shown that the incorporated protein preserved its biological activity and resulted in initial higher numbers of adhered cells. Thus, these bioactive scaffolds based on blends of pHMGCL/PCL loaded with VEGF can be considered as a promising candidate for tissue engineering applications