Trends and Histopathological Patterns of Kaposi Sarcoma at The University of Benin Teaching Hospital, Benin City, Nigeria

Objectives: Kaposi sarcoma (KS) shows greater geographic variation in incidence than almost any other vascular tumor globally. KS is common in parts of Sub-Saharan Africa accounting for 9% of all diagnosed cancer cases in men in the early 1990’s in Uganda and Zaire. KS is classified by the World Health Organization as a borderline vascular tumor. We aimed to determine the trends and histopathological patterns of KS as seen in the University of Benin Teaching Hospital in Benin City, Nigeria, and to compare with similar work in other centers. Methods: We conducted a retrospective analysis of all histologically confirmed KS seen over a 20-year period at the Pathology Department of the University of Benin Teaching Hospital. Results: A total of 269 histologically diagnosed vascular tumors were analyzed. Of these, borderline tumors constituted 30.9% (n = 83). KS constituted 79 (95.2%) out of the 83 borderline vascular tumors. Out of the 79 cases of KS, 76 (96.2%) cases were confirmed in HIV/AIDS patients on highly active antiretroviral therapy. The male to female ratio of KS was 1.1:1.0 while the mean age was 39.2±3.6 years. There was a sharp rise in the trend of KS from 2005 to a peak in 2008. The leg and foot region was the most common site of occurrence. There were two cases seen in the cervical lymph node in the pediatric age group. Conclusions: KS was the most common borderline vascular tumor with almost all cases confirmed as HIV/AIDS patients. The mean age of presentation was in the fourth decade of life with a sharp rise in its incidence from 2005 with a peak incidence in 2008. This was followed by a slight decline from 2009 to 2013. Mixed and nodular KS were the most frequently encountered types and patterns, respectively

Clinicopathological features of inflammatory bowel disease in Benin City, Nigeria

Background: Conventionally, inflammatory bowel disease (IBD) is considered to be more common in western countries. Nevertheless, it is relatively rare in most developing countries. Aim: The purpose of this study is to determine the frequency and morphological patterns of IBD in Benin City, Nigeria, and to compare our findings with the reports from other centers. Materials and Methods: The study is a four-year analysis of 32 histologically confirmed cases of IBD, presenting at the University of Benin Teaching Hospital (UBTH) and a private specialist gastroenterology hospital, based in Benin City, Southern Nigeria. Both centers serve as referral centers to most hospitals in South-Southern Nigeria. All suspected patients were examined with rectosigmoidoscopy and colonoscopy after obtaining consent. These specimens were formalin-fixed, paraffin-embedded, sectioned at 3-5 microns, and stained with hematoxylin and eosin (H and E). Results: In this four-year study, there were a total of 78 suspected cases, of which 32 were histologically confirmed IBD cases. Among the 32 patients, 14 (43.8%) were cases of Crohn′s disease (CD), while 12 (37.5%) were cases of ulcerative colitis (UC). The remaining six patients (18.7%) were with indeterminate colitis (IC). A total of 21 males and 11 females presented, giving a ratio of 1.9:1, with a mean age of 51.1 years ± 7.2 standard deviation (SD). In CD, seven cases constituting 53.9%, had ileocolonic involvement. In UC, six cases involved left-sided colitis, accounting for 50%. Conclusion: IBD was twice more common in males than females, with majority of involvement in both the colonic and ileo-colonic anatomic sites. However, there is a slight higher preponderance of CD than UC in this environment

Paucity of HPV-Related Head and Neck Cancers (HNC) in Nigeria

Introduction: The burden of HPV-related Head and Neck Cancers (HNC) has been rising in the U.S. and other developed countries but this trend has not been reported in Africa. Objective of study was to evaluate the prevalence of HPV infection in HNC cancer cases seen between 1990 and 2011 at the tertiary health care institutions in Nigeria. Methods: We retrieved 149 head and neck cancer formalin fixed, paraffin embedded tumor specimens diagnosed between 1990 and 2011 from four teaching hospitals in Nigeria. One hundred and twenty-three blocks (83%) contained appropriate HNC for analysis while DNA extraction was successful in 60% (90/149). PCR amplification was successful in 33% (49/149) and Linear Array genotyping for HPV was successful in 11% (17/149) of these cases. These were in tumors from the larynx (6), cervical lymph nodes (3), nasal cavity (2), parotid (1), palate (1), maxillary sinus (1) and mandible (1). Two cases were non-specific and none were from the oropharynx. Histologically, 41% (7/17) of the successfully genotyped blocks were squamous cell carcinomas (larynx 6, maxillary sinus 1). Results and Conclusion We were unable to detect HPV in any of the HNC samples in our study. Our result may suggest that there is a low prevalence of HPV-related HNC among the adult population in Nigeria. Our results provide a benchmark to compare future incidence of HPV -related HNC in this community in future. We had significant analytical challenges from possible poor tissue processing and urge that future studies should prospectively collect samples and ensure high quality sample processing

Mainstreaming the private health sector in the response to COVID-19 : Facility readiness assessment for screening services in Edo state, Nigeria

Introduction: The COVID-19 pandemic presents an opportunity for the Nigerian health system to harness the potentials available in the private sector to augment the capacity within the public health system. This survey was carried out to assess private facility readiness in providing screening services in Edo State. Methods: This was a descriptive cross-sectional study carried out among private facilities in Edo state. Facilities were selected using stratified sampling technique. Data was collected using adapted questionnaires and an observational checklist. Facility readiness was assessed using the Nigeria Centre for Disease Control recommendations for screening. Parameters were scored and overall scores were converted to proportions. Facilities that scored 70% and above were adjudged to be ready while facilities that scored 69% and below were adjudged to be not ready. Results: A total of 252 health facilities were assessed, comprising 149 (59.1%) hospitals/clinics, 62 (24.6%) pharmacies and 41 (16.3%) laboratories. One hundred and forty-two (95.3%), 60 (96.8%) and 41 (100.0%) hospitals/clinics, pharmacies and laboratories, respectively had hand hygiene facilities. However, overall facility readiness assessment scores for screening services were low with only 51 (34.2%) hospitals/clinics, 2 (3.2%) pharmacies and 2 (4.9%) laboratories achieving high enough scores to be adjudged ready for screening services. Conclusion: Overall facility readiness of the private health sector to provide screening services in Edo State was assessed to be low. The government and facility owners will need to ensure that screening services are improved in all facilities to help mitigate community spread of COVID-19.publishedVersionPeer reviewe

Outcomes of Molecular Analysis.

<p>Outcomes of Molecular Analysis.</p

General Characteristics of Samples Tested for HBV DNA (n = 17).

<p>General Characteristics of Samples Tested for HBV DNA (n = 17).</p

Distribution by Anatomical Site and Pathological Diagnosis of Final Sample (n = 17).

<p>Distribution by Anatomical Site and Pathological Diagnosis of Final Sample (n = 17).</p

Overview of the current status of familial hypercholesterolaemia care in over 60 countries - The EAS Familial Hypercholesterolaemia Studies Collaboration (FHSC)

Management of familial hypercholesterolaemia (FH) may vary across different settings due to factors related to population characteristics, practice, resources and/or policies. We conducted a survey among the worldwide network of EAS FHSC Lead Investigators to provide an overview of FH status in different countries

Overview of the current status of familial hypercholesterolaemia care in over 60 countries - The EAS Familial Hypercholesterolaemia Studies Collaboration (FHSC)

Background and aims: Management of familial hypercholesterolaemia (FH) may vary across different settings due to factors related to population characteristics, practice, resources and/or policies. We conducted a survey among the worldwide network of EAS FHSC Lead Investigators to provide an overview of FH status in different countries. Methods: Lead Investigators from countries formally involved in the EAS FHSC by mid-May 2018 were invited to provide a brief report on FH status in their countries, including available information, programmes, initiatives, and management. Results: 63 countries provided reports. Data on FH prevalence are lacking in most countries. Where available, data tend to align with recent estimates, suggesting a higher frequency than that traditionally considered. Low rates of FH detection are reported across all regions. National registries and education programmes to improve FH awareness/knowledge are a recognised priority, but funding is often lacking. In most countries, diagnosis primarily relies on the Dutch Lipid Clinics Network criteria. Although available in many countries, genetic testing is not widely implemented (frequent cost issues). There are only a few national official government programmes for FH. Under-treatment is an issue. FH therapy is not universally reimbursed. PCSK9-inhibitors are available in ∼2/3 countries. Lipoprotein-apheresis is offered in ∼60% countries, although access is limited. Conclusions: FH is a recognised public health concern. Management varies widely across countries, with overall suboptimal identification and under-treatment. Efforts and initiatives to improve FH knowledge and management are underway, including development of national registries, but support, particularly from health authorities, and better funding are greatly needed