Correlates of genital Chlamydial trachomatis infection in a cohort of infertile women in Ibadan, Nigeria

Background: Genital Chlamydial trachomatis infection, though often asymptomatic, is an established indirect causative agent of female infertility via its activities on the tubal physiology. Many risk factors are postulated for its acquisition and the main thrust of this study was to establish the organisms’ correlates among infertile women attending gynaecologic clinic in Ibadan.Methods: A systematic sampling technique was used on each selected day to recruit women who met the inclusion criteria into the study using a sampling frame of 2. Interviewer-administered questionnaires were used to obtain attributes considered as risk factors for acquiring genital Chlamydia trachomatis infection from 150 consenting infertile women between January and November 2015. These attributes included sexual history, social status, alcohol intake and past history of sexually transmitted infections (STIs). Blood samples and endocervical swabs were subsequently taken for detection of C. trachomatis infection using polymerase chain reaction (PCR). Data analysis was done using SPSS version 20.0.Results: The mean age of the respondents was 34.1±5.6 years and 7.30% were positive for C. trachomatis. Chlamydia trachomatis infection was significantly associated with past history of gonorrhoea, history of multiple sexual partners, husband that has other sexual partners and lifetime sexual partners greater than one.Conclusions: The prevalence of asymptomatic C. trachomatis among infertile women indicated the pathogen as a potential aetiologic agent of female infertility and supported the asymptomatic nature of the infection. The risk factors found to be associated with the organisms’ infection lend out further support to the sexual transmissibility of C. trachomatis

Bilateral ovarian serous cystadenocarcinoma in a teenager: a case report

Epithelial ovarian cancers are uncommon among young girls and teenagers  compared to germ cell tumors. We report a case of bilateral ovarian serous cystadenocarcinoma in a teenage girl with the attendant challenges of diagnosis, management and follow up. HT, 19 year old had presented at a secondary care level with features suggestive of benign ovarian tumor and had ovariectomy done. However, histology report revealed a malignant epithelial cancer, necessitating a repeat exploration. She was found to have surgical stage 3c disease and subsequently has total abdominal hysterectomy with bilateral salpingectomies, right oophorectomy and omentectomy. She was further managed with  paclitaxelcarboplatin combination chemotherapy but defaulted after the 3rd cycle on account of financial constraints. She succumbed to the disease 11months post diagnosis. Though uncommon, detailed evaluation of teenage patients for malignant ovarian cancer is expedient. The financial burden of cancer care in our environment is also highlighted.Key words: Adolescent, ovarian epithelial cancer, ovariectomy, serous cystadenocarcinom

An Assessment of Ovarian Cancer Histotypes Across the African Diaspora

ObjectiveOvarian cancer in Black women is common in many West African countries but is relatively rare in North America. Black women have worse survival outcomes when compared to White women. Ovarian cancer histotype, diagnosis, and age at presentation are known prognostic factors for outcome. We sought to conduct a preliminary comparative assessment of these factors across the African diaspora. MethodsPatients diagnosed with ovarian cancer (all histologies) between June 2016-December 2019 in Departments of Pathology at 25 participating sites in Nigeria were identified. Comparative population-based data, inclusive of Caribbean-born Blacks (CBB) and US-born Blacks (USB), were additionally captured from the International Agency for Research on Cancer and Florida Cancer Data Systems. Histology, country of birth, and age at diagnosis data were collected and evaluated across the three subgroups: USB, CBB and Nigerians. Statistical analyses were done using chi-square and student's t-test with significance set at pResultsNigerians had the highest proportion of germ cell tumor (GCT, 11.5%) and sex-cord stromal (SCST, 16.2%) ovarian cancers relative to CBB and USB (p=0.001). CBB (79.4%) and USB (77.3%) women were diagnosed with a larger proportion of serous ovarian cancer than Nigerians (60.4%) (p<0.0001). Nigerians were diagnosed with epithelial ovarian cancers at the youngest age (51.7 +/- 12.8 years) relative to USB (58.9 +/- 15.0) and CBB (59.0 +/- 13.0,p<0.001). Black women [CBB (25.2 +/- 15.0), Nigerians (29.5 +/- 15.1), and USB (33.9 +/- 17.9)] were diagnosed with GCT younger than White women (35.4 +/- 20.5, p=0.011). Black women [Nigerians (47.5 +/- 15.9), USB (50.9 +/- 18.3) and CBB (50.9 +/- 18.3)] were also diagnosed with SCST younger than White women (55.6 +/- 16.5, p<0.01). ConclusionThere is significant variation in age of diagnosis and distribution of ovarian cancer histotype/diagnosis across the African diaspora. The etiology of these findings requires further investigation