Giant solitary primary intracranial lymphoma masquerading as meningioma: a case and review of literature

Non-Hodgkin's lymphomas (NHL) with intracranial origin are very rare and constitutes about 1-2% of primary central nervous system lymphomas (PCNSL). Diffuse large B cell lymphoma (DLBCL) is the most common subtype of NHL and mostly seen in immunocompromised patients. Therefore, the occurrence of giant solitary DLBCL in an immunocompetent patient is puzzling. We present a case of 68-year-old man who was admitted at our facility with a history of "hypomnesia of two (2) months" duration. Magnetic resonance imaging (MRI) revealed a space occupying lesion in the bilateral frontal lobe and corpus callosum measuring about 5.4cm * 4.6cm * 3.8cm with mixed signal intensities and vasogenic edema around the mass. Radiological, this mass was mistaken for meningioma until histopathological studies revealed DLBCL. Giant solitary primary intracranial lymphomas are very rare and can be mistake for meningioma even with very experience radiologist or neurosurgeon since the radiological features of PCNSL can be very unspecific. We achieved to total resection because of the giant and solitary nature of our case. The prognosis of PCNSL is general very poor when the patient is immunocompromised. In immunocompetent patients, who are well managed with surgery and chemotherapy, the overall survival and quality of life can very encouraging.Keywords: Lymphomas, meningioma, immunocompetent, intracranial, parenchym

Giant intradural cervical spine arteriovenous malformations – A case and review of literature

•Spinal arteriovenous malformations (SAVM) are very rare.•Therapeutic options can be very challenging since none of them provided a definitive cure to this lesion in literature.•Spinal angiography is the gold standard for all-inclusive assessment of SAVMs.•We believe that incorporation intraoperative angiography during surgery in a hybrid theatre can help achieve a better cure

Towards the prevention of sexually transmitted infections (STIs): Healthcare-seeking behaviour of women with STIs or STI symptoms in sub-Saharan Africa

Objective: Sexually transmitted infections (STIs) constitute major public health problems because of their prevalence and contribution to mortality and morbidity worldwide. Healthcare seeking for STIs plays a significant role in the global prevention of STIs. We examined the prevalence and factors associated with healthcare seeking for STIs or STI symptoms among women in sub-Saharan Africa (SSA). Methods: Data on 38 394 women of reproductive age from the most recent Demographic and Health Surveys of 28 countries in SSA were analysed. Percentages were used to summarise the prevalence of healthcare seeking for STIs or STIs symptoms. The factors associated with healthcare seeking for STIs or STI symptoms were examined using multilevel binary logistic regression analysis. We presented the results using adjusted odds ratios (aORs) with 95% confidence intervals (CIs). Results: Overall, the proportion of women with STIs or STI symptoms who sought healthcare was 66.1%, with the highest and lowest proportion found in Liberia (85.6%) and Ethiopia (37.9%) respectively. The likelihood of seeking healthcare for STIs or STI symptoms increased with increasing wealth quintile and level of education. Working women, older women, cohabiting women, women with comprehensive HIV/AIDS knowledge, women exposed to mass media, those who had no barrier to healthcare access, and those covered by health insurance had greater odds of seeking treatment for STIs or STI symptoms. On the contrary, the odds of seeking treatment for STIs or STI symptoms was lower among married women and women who lived in rural areas. Conclusion: The findings of the study call for strengthening of policies, programmes, and interventions geared towards improving the healthcare-seeking behaviour of women with STIs, taking into consideration the factors identified in this study

Comorbid depression and risk of cardiac events and cardiac mortality in people with diabetes: A systematic review and meta-analysis

Objective: To examine the association of comorbid occurrence of diabetes and depression with risk of cardiovascular endpoints including cardiovascular mortality, coronary heart disease and stroke. Research Design and Methods: A systematic review and metaanalysis. We searched PUBMED/MEDLINE, Medscape, Cochrane Library, CINAHL, EMBASE and Scopus databases assessing cardiac events and mortality associated with depression in diabetes up until 1 December 2018. Pooled hazard ratios were calculated using random- effects models. Results: Nine studies met the inclusion criteria. The combined pooled hazard ratios showed a significant association of cardiac events in people with depression and type 2 diabetes, compared to those with type 2 diabetes alone. For cardiovascular mortality the pooled hazard ratio was 1.48 (95% CI: 1.185, 1.845), p=0.001, for coronary heart disease 1.37 (1.165, 1.605), p?0.001 and for stroke 1.33 (1.291, 1.369), p?0.001. Heterogeneity was high in the meta-analysis for stroke events (I-squared = 84.7%) but was lower for coronary heart disease and cardiovascular mortality (15% and 43.4% respectively). Meta-regression analyses showed that depression was not significantly associated with the study level covariates mean age, duration of diabetes, length of follow-up, BMI, sex and ethnicity (p?0.05 for all models). Only three studies were found that examined the association of depression in type 1 diabetes, there was a high degree of heterogeneity and data synthesis was not conducted for these studies. Conclusions: We have demonstrated a 47.9% increase in cardiovascular mortality, 36.8% increase in coronary heart disease and 32.9% increase in stroke in people with diabetes and comorbid depression. The presence of depression in a person with diabetes should trigger the consideration of evidence-based therapies for cardiovascular disease prevention irrespective of the baseline risk of cardiovascular disease or duration of diabetes

Intimate partner violence as a predictor of marital disruption in sub-Saharan Africa: A multilevel analysis of demographic and health surveys

Introduction: Intimate partner violence has gained momentum as health, social, and human right issue across the globe. Women within sub-Saharan Africa often do not report any case of violence due to the acceptance of violence which is rooted in their socio-cultural beliefs and practices. With a high prevalence of marital disruption in sub-Saharan Africa, it is important that we understand the role intimate partner violence plays in this phenomenon. Hence, this present study assessed the association between intimate partner violence and marital disruption among women in sub-Saharan Africa. Methods: This study involved a cross-sectional analysis of data from the Demographic and Health Survey of 25 countries in sub-Saharan Africa. Multilevel binary logistic regression analysis was carried out and the results were presented as adjusted odds ratios (aOR) at 95% Confidence Interval (CI). Results: The prevalence of physical, emotional, and sexual violence in the 25 countries considered in this study were 29.3%, 28%, and 11.5%, respectively. The highest prevalence of physical violence was in Sierra Leone (50.0%) and the lowest prevalence was in Comoros (5.7%). For emotional violence, the highest prevalence was in Sierra Leone (45.9%) and the lowest prevalence was in Comoros (7.9%). The highest prevalence of sexual violence was in Burundi (25.5%) and the lowest prevalence was in Comoros (1.8%). The average prevalence of marital disruption was 7.7%. This ranged from 1.3% in Burkina Faso to 20.2% in Mozambique. We found that women who had ever experienced physical violence were more likely to experience marital disruptions compared to those who had never experienced physical violence [aOR = 1.42, 95% CI = 1.35–1.50]. Women who had ever experienced sexual violence were more likely to experience marital disruption compared to those who had never experienced sexual violence [aOR = 1.29, 95% CI = 1.21–1.37]. Finally, women who had ever experienced emotional violence were more likely to experience marital disruption compared to those who had never experienced emotional violence [aOR = 1.86, 95% CI = 1.76–1.96]. Conclusion: Findings from this study call for proven effective intimate partner violence reduction interventions such as strengthening laws against intimate partner violence in sub-Saharan Africa. Again, marital counseling and health education interventions should be implemented to address the role of intimate partner violence on the wellbeing of women and the stability of couples in sub-Saharan Africa

Determinants of birth registration in sub-Saharan Africa: evidence from demographic and health surveys

Background: Birth registration is a crucial aspect of ensuring that children have access to their rights and benefits, including health care, education, and citizenship. In sub-Saharan Africa (SSA), birth registration rates remain low, with millions of children going unregistered each year. Understanding the predictors of birth registration among children in this sub-region is important for developing targeted interventions to improve registration rates. The study examines the predictors of birth registration among children in SSA. Methods: We performed a cross-sectional analysis of secondary data pooled from the Demographic and Health Survey of 17 countries conducted from 2015 to 2021. A weighted sample of 162,500 children was included in the final analysis. We summarized the proportion of birth registration among children in SSA using a forest plot. We utilized a multilevel binary logistic regression analysis to examine the predictors of birth registration. The results were presented using adjusted odds ratios (aOR) with 95% confidence intervals (CIs). Results: We found that 48.32% [48.15–48.49] of births in SSA were registered. The lowest and highest prevalence of birth registration were found in Ethiopia (2.70 [2.38–3.02]) and Sierra Leone (92.93 [92.36–93.50]), respectively. Increasing child’s age was found to be significantly associated with a higher likelihood of birth registrations, with those aged 4 years [aOR = 1.55; CI = 1.49, 1.62] having the highest odds of birth registration compared to those aged below 1 year. Children born to mothers with primary [aOR = 1.17; CI = 1.11, 1.24], secondary [aOR = 1.44; CI = 1.34, 1.54], and higher education [aOR = 1.71; CI = 1.48, 1.99] were more likely to be registered than those born to mothers who had no formal education. Also, children born in health facilities were more likely to be registered [aOR = 1.60; CI = 1.48, 1.74] than those born at home. The odds of birth registration were significantly higher among children whose mothers received assistance during delivery [aOR = 1.88; CI = 1.72, 2.04], those in the richest wealth index [aOR = 3.91; CI = 3.54, 4.33], and those in rural areas [aOR = 1.92; CI = 1.76, 2.10]. Conclusion: There is low childbirth registration coverage in SSA. The predictors of this phenomenon are the child’s age, maternal level of education, wealth index, place of residence, sub-region, maternal age, place of delivery, assistance during delivery, marital status, and sex of household head. Interventions and policies developed to improve childbirth registration coverage in SSA should prioritize mothers with no formal education, those who deliver at home, those with low socioeconomic status, those living in female headed household, and adolescent mothers

Exposure to interparental violence and intimate partner violence among women in Papua New Guinea

Introduction: Evidence suggests that childhood exposure to interparental violence increases the risk of intimate partner violence (IPV) experience or perpetration in adolescence or adulthood. However, it is unclear if exposure to interparental violence increases the risk of IPV among women in Papua New Guinea. This study, therefore, seeks to fill this gap in the literature by examining the association between childhood exposure to interparental violence and IPV among women in Papua New Guinea. Methods: We used data from the most recent 2016–18 Papua New Guinea Demographic and Health Survey. We included 3,512 women in our analyses. Past-year experience of IPV was the outcome variable in this study. Exposure to interparental violence was the key explanatory variable. We used a multilevel binary logistic regression to examine the association between exposure to interparental violence and IPV. Results: We found a higher probability of experiencing IPV among women exposed to interparental violence [aOR = 1.45, 95% CI = 1.13, 1.86] relative to women who were not exposed. Furthermore, we found that women living in rural areas had a lower likelihood of IPV experience [aOR = O.50, 95% CI = 0.32, 0.80] compared to those in urban settings. Finally, a greater odd of IPV experience was found among women staying in the Highlands Region [aOR = 1.44, 95% CI = 1.06, 1.96] compared to those staying in the Southern Region. Conclusion: Exposure to interparental violence was found to be significantly associated with IPV among women in Papua New Guinea. The findings of this study suggest the need for proven operational strategies to reduce IPV, such as improving anti-IPV laws in Papua New Guinea. We recommend the development and implementation of intercession strategies to reduce the experience and justification of violence among women exposed to interparental violence. In addition, health professionals should implement counseling and health education initiatives to tackle the consequences of IPV on women's well-being

Awareness of obstetric fistula and its associated factors among women of reproductive age in sub-Saharan Africa

Background Awareness about obstetric fistula and its concomitant factors is central to efforts to eliminate obstetric fistula in sub-Saharan Africa. We, therefore, assessed the magnitude of obstetric fistula awareness and its associated factors among women of reproductive age in sub-Saharan Africa. Methods Data for the study were extracted from the most recent Demographic and Health Surveys of 14 countries in sub-Saharan Africa. We included 185,388 women aged 15-49 years in this study. Percentages were used to summarise the prevalence of obstetric fistula awareness across the 14 countries studied. We adopted a multivariable multilevel binary logistic regression to examine the factors associated with obstetric fistula awareness in sub-Saharan Africa. We presented the results of the regression analysis using adjusted odds ratios with their 95% confidence intervals. Statistical significance was set at p < 0.05. Results The average prevalence of obstetric fistula awareness was 37.9%, ranging from 12.8% in Gambia to 63.9% in Uganda. Awareness of obstetric fistula was low among never married and cohabiting women compared to married women. Compared with women with parity 4 or more, those with no birth had the lowest odds of obstetric fistula awareness. The study also showed that obstetric fistula awareness was lower among women who were working, those who are not exposed to mass media, those in the poorest wealth category, those who have never had sex, and those in communities with low literacy level. The study however found that the odds of obstetric fistula awareness increased with age and education, and was higher in urban areas compared to rural areas. Women, who had ever terminated a pregnancy were more likely to be aware of obstetric fistula compared to those who had never terminated a pregnancy. Conclusion The study demonstrated a low awareness of obstetric fistula among women in sub-Saharan Africa. Educative and sensitisation interventions should incorporate the factors identified in the present study during its implementation. To raise women's awareness of obstetric fistula, there is the need for sub-Saharan African countries to consciously raise community literacy rate, increase access to mass media platforms and invest intensively in formal education for women

Interpersonal violence among in-school adolescents in sub-Saharan Africa: Assessing the prevalence and predictors from the Global School-based health survey

Interpersonal violence in adolescents has over the years grown into a serious public health problem that merits a robust intervention. This study, therefore, assessed the prevalence and predictors of interpersonal violence among in-school adolescents in sub-Saharan Africa (SSA). The study involved a cross-sectional analysis of data from the Global School-based Health Survey conducted between 2012 and 2017 from eight sub-Saharan African countries. A total of 14,967 in-school adolescents aged 10-19 years were included in the pooled analysis. A multivariable binomial logistic regression was used to determine the predictors of interpersonal violence using the adjusted odds ratio (aOR) with their respective 95% confidence intervals (CIs). The overall prevalence of interpersonal violence among in-school adolescents in SSA was 53.7%. The odds of interpersonal violence were higher among adolescents who were bullied (aOR = 2.52, 95% CI = 2.23-2.85), had an injury (aOR = 2.42, 95% CI = 2.15-2.72), had suicidal attempts (aOR = 1.40, 95% CI = 1.16-1.70), were truant (aOR = 1.51, 95% CI = 1.33-1.72), used alcohol (aOR = 1.49, 95% CI = 1.06-2.11), and used tobacco (aOR = 1.46, 95% CI = 1.23-1.74). In-school adolescents with peer support, parents or guardians bonding, those whose parents or guardians respected their privacy, and those aged 15 years or older were less likely to experience interpersonal violence. These factors provide education directors and school heads/teachers with relevant information to guide the design of specific interventions such as parent-teacher meetings and programs, peer educator network system, face-to-face counseling sessions, Rational Emotive Behavioural Education (REBE) and substance use cessation therapy to prevent interpersonal violence, particularly physical fights and attacks in school settings. Also, students should be sensitized on the negative effects of interpersonal violence and those who have been exposed to it should be counselled. School rules should be strengthened and appropriate punishment given to students who engage in violence baheviours in schools in order to deter others from engaging in them

In-school adolescents’ loneliness, social support, and suicidal ideation in sub-Saharan Africa: Leveraging Global School Health data to advance mental health focus in the region

Introduction: Adolescent and youth mental health problems are increasingly becoming an area of concern in global health. Young people in sub-Saharan Africa experience significant adversities and systemic challenges despite technological advancements and demographic transition that the region is experiencing. We examined the nexus between experiences of loneliness, low social support, and presence of suicidal ideation among in-school adolescents in sub-Saharan Africa. Method: A total of 19,119 in-school adolescents from eight countries in sub-Saharan Africa were included in this study. Suicidal ideation was the main outcome variable and loneliness, and social support were the explanatory variables. Percentages were used to summarise the prevalence of suicidal ideation, loneliness, and social support among the in-school adolescents. A multivariable binary logistic regression analysis was later used to determine the association between suicidal ideation and the explanatory variables and covariates using Stata v16. Four models were tested using the regression analysis. We presented the regression results using adjusted odds ratios (aOR), with their respective 95% confidence intervals (CIs). Results: Overall, the past year prevalence of loneliness, peer support, one or more close friends, and suicidal ideation were 10%, 33.4%, 90.1%, and 14.5%, respectively. In-school adolescents who felt lonely (aOR = 1.88, 95% CI = 1.69, 2.09) were more likely to experience suicidal ideation. However, those who received peer support (aOR = 0.89, 95% CI = 0.82, 0.97) and had one or more close friends (aOR = 0.77, 95% CI = 0.68, 0.86) were less likely to experience suicidal ideation. Conclusion: These results point to the significant roles of loneliness, and lack of social support, in understanding suicidal ideations. Countries in sub-Saharan Africa need to improve child and adolescent mental health policies and programmes to respond to these risk factors and mental health challenges. Programmes with a differential focus on the needs of males and females, younger and older adolescents will be important in the future