Timeliness of diagnosis of breast and cervical cancers and associated factors in low-income and middle-income countries: a scoping review protocol.

INTRODUCTION: Breast and cervical cancer are leading causes of morbidity and mortality in women globally, with disproportionately high burdens in low-income and middle-income countries (LMICs). While the incidence of both cancers increases across LMICs, many cases continue to go undiagnosed or diagnosed late. The aim of this review is to comprehensively map the current evidence on the time to breast or cervical cancer diagnosis and its associated factors in LMICs. METHODS AND ANALYSIS: This scoping review (ScR) will be informed by Arksey and O'Malley's enhanced ScR methodology framework. It will be reported in accordance with the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews. We will conduct a comprehensive search of the following electronic databases: MEDLINE (via PubMed), Cochrane Library, Scopus and the Cumulative Index to Nursing and Allied Health Literature (CINAHL). Two reviewers will independently screen all abstracts and full texts using predefined inclusion criteria. All publications describing the time to diagnosis and its associated factors in the contexts of breast or cervical cancer will be considered for inclusion. Evidence will be narratively synthesised and analysed using a predefined conceptual framework. ETHICS AND DISSEMINATION: As this is a ScR of publicly available data, with no primary data collection, it will not require ethical approval. Findings will be disseminated widely through a peer-reviewed publication and forums such as conferences and community engagement sessions. This review will provide a user-friendly evidence summary for understanding the enormity of diagnostic delays and associated factors for breast and cervical cancers in LMICs, while helping to inform policy actions and implementation of interventions for addressing such delays

Effectiveness of interventions for improving timely diagnosis of breast and cervical cancers in low and middle-income countries: a systematic review protocol.

INTRODUCTION: Breast and cervical cancers pose a major public health burden globally, with disproportionately high incidence, morbidity and mortality in low- and middle-income countries (LMICs). The majority of women diagnosed with cancer in LMICs present with late-stage disease, the treatment of which is often costlier and less effective. While interventions to improve the timely diagnosis of these cancers are increasingly being implemented in LMICs, there is uncertainty about their role and effectiveness. The aim of this review is to systematically synthesise available evidence on the nature and effectiveness of interventions for improving timely diagnosis of breast and cervical cancers in LMICs. METHODS AND ANALYSIS: A comprehensive search of published and relevant grey literature will be conducted. The following electronic databases will be searched: MEDLINE (via PubMed), Cochrane Library, Scopus, CINAHL, Web of Science and the International Clinical Trials Registry Platform (ICTRP). Evidence will be synthesised in accordance with the Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA). Two reviewers will independently screen the search outputs, select studies using predefined inclusion criteria and assess each included study for risk of bias. If sufficient data are available and studies are comparable in terms of interventions and outcomes, a meta-analysis will be conducted. Where studies are not comparable and a meta-analysis is not appropriate, a narrative synthesis of findings will be reported. ETHICS AND DISSEMINATION: As this will be a systematic review of publicly available data, with no primary data collection, it will not require ethical approval. Findings will be disseminated widely through a peer-reviewed publication and forums such as conferences, workshops and community engagement sessions. This review will provide a user-friendly evidence summary for informing further efforts at developing and implementing interventions for addressing delays in breast and cervical cancer diagnosis in LMICs. PROSPERO REGISTRATION NUMBER: CRD42020177232.This research was jointly supported by the Cancer Association of South Africa (CANSA), the University of Cape Town and the SA Medical Research Council with funds received from the SA National Department of Health, GlaxoSmithKline Africa Non-Communicable Disease Open Lab (via a supporting grant, Project Number: 023), the UK Medical Research Council (via the Newton Fund). FMW is Director of the multi-institutional CanTest Collaborative, which is funded by Cancer Research UK (C8640/A23385). Authors retained control of the final content of the publication

Optimum temperature and stocking density for transportation of tilapia (Oreochromis niloticus) broodstock in the semi-arid zone of Nigeria

Oreochromis niloticus broodstock of mean weight 32.3g were cropped in the morning with dragnet from a 1 ha reservoir and transported in round tanks to the Hatchery complex of the National Institute for Freshwater Fisheries Research where they were stocked into 5m x 5m indoor concrete tanks filled with clean water and with aerators at a density of 4 fish/m1. They were acclimated for 5 days and then packaged into 60 liter capacity water proof bags at the following stocking densities: 60, 80, 100, 120, 140 fish/60 lit bag. Each stocking density had bags with ice blocks and bags without ice blocks in triplicate. The water proof bags were oxygenated, loaded into quick fitting plastic bowls and transported in a bus from New Bussa to Warra, Kebbi state, a journey of 3 hours. The trip was repeated four times. Percentage survival in bags with ice block were 100%for stocking densities 60, 80, 100 fish/60 lit bag, 95.1%for 120 fish/60 lit bag and 84. 7%for 1-10 fish/60 lit bag (mean temperature 23.5~?C). Mortalities were recorded in all the bags without ice block but the highest survival was in the bag with stocking density 60fish/60 lit bag (mean temperature 29.2~?C)

Implementation of and Early Outcomes From Anal Cancer Screening at a Community-Engaged Health Care Facility Providing Care to Nigerian Men Who Have Sex With Men.

PurposeAnal cancer risk is substantially higher among HIV-infected men who have sex with men (MSM) as compared with other reproductive-age adults, but screening is rare across sub-Saharan Africa. We report the use of high-resolution anoscopy (HRA) as a first-line screening tool and the resulting early outcomes among MSM in Abuja, Nigeria.MethodsFrom August 2016 to August 2017, 424 MSM enrolled in an anal cancer screening substudy of TRUST/RV368, a combined HIV prevention and treatment cohort. HRA-directed biopsies were diagnosed by histology, and ablative treatment was offered for high-grade squamous intraepithelial lesions (HSIL). HRA proficiency was assessed by evaluating the detection of squamous intraepithelial lesions (SIL) over time and the proportion biopsied. Prevalence estimates of low-grade squamous intraepithelial lesions and HSIL with 95% CIs were calculated. Multinomial logistic regression was used to identify those at the highest risk of SIL.ResultsMedian age was 25 years (interquartile range [IQR], 22-29), median time since sexual debut was 8 years (IQR, 4-12), and 59% (95% CI, 54.2% to 63.6%) were HIV infected. Rate of detection of any SIL stabilized after 200 screenings, and less than 20% had two or more biopsies. Preliminary prevalence estimates of low-grade squamous intraepithelial lesions and HSIL were 50.0% (95% CI, 44.7% to 55.3%) and 6.3% (95% CI, 4.0% to 9.3%). HIV infection, at least 8 years since anal coital debut, concurrency, and external warts were independently statistically associated with SIL.ConclusionProficiency with HRA increased with experience over time. However, HSIL detection rates were low, potentially affected by obstructed views from internal warts and low biopsy rates, highlighting the need for ongoing evaluation and mentoring to validate this finding. HRA is a feasible first-line screening tool at an MSM-friendly health care facility. Years since anal coital debut and external warts could prioritize screening

Circular Economy: Nigeria Perspective

Nigeria is a lower middle-income country and is ranked as the largest economy in Africa with a gross domestic product of 444.92 billion (www.imf.org). The country is located on the western coast of Africa, has an area of 923, 763 km2 and is bounded by Benin Republic in the west, Niger Republic in the north, Cameroun in the east and Gulf of Guinea in the south

Timeliness of diagnosis of breast and cervical cancers and associated factors in low-income and middle-income countries: a scoping review.

OBJECTIVES: Addressing the barriers to early breast and cervical cancer diagnosis in low and middle-income countries (LMICs) requires a sound understanding and accurate assessment of diagnostic timeliness. This review aimed to map the current evidence on the time to breast and cervical cancer diagnosis and associated factors in LMICs. DESIGN: Scoping review. SOURCES: MEDLINE (via PubMed), Cochrane Library, Scopus and CINAHL. ELIGIBILITY CRITERIA: Studies describing the time to diagnosis and associated factors in the context of breast and cervical cancer in LMICs published from 1 January 2010 to 20 May 2021. STUDY SELECTION AND DATA SYNTHESIS: Two reviewers independently screened all abstracts and full texts using predefined inclusion criteria. The review was reported in accordance with the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews. Evidence was narratively synthesised using predefined themes. RESULTS: Twenty-six studies conducted across 24 LMICs were included in the review, most (24/26) of which focused on breast cancer. Studies varied considerably in their conceptualisation and assessment of diagnostic time, events, intervals and delays, with a minority of the studies reporting the use of validated methods and tools. Patient-related intervals and delays were more frequently evaluated and reported than provider-related and health system-related intervals and delays. Across studies, there were variations in the estimated lengths of the appraisal, help-seeking, patient and diagnostic intervals for both cancers and the factors associated with them. CONCLUSIONS: Despite the significant burden of breast and cervical cancer in LMICs, there is limited information on the timeliness of diagnosis of these cancers. Major limitations included variations in conceptualisation and assessment of diagnostic events and intervals. These underscore the need for the use of validated and standardised tools, to improve accuracy and translation of findings to better inform interventions for addressing diagnostic delays in LMICs

Drift dynamics in microbial communities and the effective community size

The structure and diversity of all open microbial communities are shaped by individual births, deaths, speciation and immigration events; the precise timings of these events are unknowable and unpredictable. This randomness is manifest as ecological drift in the population dynamics, the importance of which has been a source of debate for decades. There are theoretical reasons to suppose that drift would be imperceptible in large microbial communities, but this is at odds with circumstantial evidence that effects can be seen even in huge, complex communities. To resolve this dichotomy we need to observe dynamics in simple systems where key parameters, like migration, birth and death rates can be directly measured. We monitored the dynamics in the abundance of two genetically modified strains of Escherichia coli, with tuneable growth characteristics, that were mixed and continually fed into 10 identical chemostats. We demonstrated that the effects of demographic (non‐environmental) stochasticity are very apparent in the dynamics. However, they do not conform to the most parsimonious and commonly applied mathematical models, where each stochastic event is independent. For these simple models to reproduce the observed dynamics we need to invoke an “effective community size”, which is smaller than the census community size

Phytochemical Composition, Antioxidant and Antimicrobial Potentials of some Indigenous Plants in Umudike, Abia State, Nigeria

Twenty four ethanol leaf and stem bark extracts of 17 indigenous plants were examined for their phytochemical composition, antimicrobial and antioxidant properties. Phytochemical compositions were analysed with GC-MS while antimicrobial activities on Staphylococcus aureus and Pseudomonas aeruginosa were investigated by the agar well diffusion method. The antioxidant activities were determined with Ferric reducing antioxidant power (FRAP), total phenolic content (TPC) and 2, 2,-dihenyl-1-picryhydazyl (DPPH) radical scavenging assays. The antibacterial activity was more towards the gram positive S. aureus than the gram negative P. aeruginosa for all the plant extracts.  A wide range of phenolic concentrations among the aqueous plant extracts which varied from 28.04 to 500.26mg GAE per gram were observed.  Inhibition percentages of DPPH ranged from 19.13 to 95.77% showing effectiveness in radical scavenging. GC-MS characterization of the plant extracts showed a total of 18 components including alkaloids, flavonoids, phenols, saponins, terpenoids, steroids and glycosides. Irvingia gabonensis leaf (IGL) extract and Tamarind stem bark (TSB) exhibited excellent ferric reducing abilities of 2.11 and 1.56 respectively while Voucanga Africana leaf (VCA) extract indicated the lowest ferric reducing power of 0.50. Extracts of IGL and TSB exhibited the highest antioxidant capacities and therefore could be the main sources of natural antioxidant. An important relationship between total phenolic content was observed showing that the major contributor to the antioxidant properties were phenolic compounds

Review: Nutritional ecology of heavy metals

The aim of this review is to focus the attention on the nutrition ecology of the heavy metals and on the major criticisms related to the heavy metals content in animal feeds, manure, soil and animal-origin products. Heavy metals are metallic elements that have a high density that have progressively accumulated in the food chain with negative effects for human health. Some metals are essential (Fe, I, Co, Zn, Cu, Mn, Mo, Se) to maintain various physiological functions and are usually added as nutritional additives in animal feed. Other metals (As, Cd, F, Pb, Hg) have no established biological functions and are considered as contaminants/undesirable substances. The European Union adopted several measures in order to control their presence in the environment, as a result of human activities such as: farming, industry or food processing and storage contamination. The control of the animal input could be an effective strategy to reduce human health risks related to the consumption of animal-origin products and the environmental pollution by manure. Different management of raw materials and feed, animal species as well as different legal limits can influence the spread of heavy metals. To set up effective strategies against heavy metals the complex interrelationships in rural processes, the widely variability of farming practices, the soil and climatic conditions must be considered. Innovative and sustainable approaches have discussed for the heavy metal nutrition ecology to control the environmental pollution from livestock-related activities