Five year review of oropharyngeal cancer patients at University of Ilorin Teaching Hospital, north central Nigeria

Oropharyngeal tumours constitutes 10 to 12% of all head and neck malignancies, and Squamous cell carcinoma (SCC) is the most common histological variant seen in 90% of cases. Studies have confirmed the high prevalence of the disease among males, and the roles of alcohol intake and cigarette smoking as risk factors are well documented. This is a retrospective  review of  socio-demographic and risk factors of oropharyngeal cancers in our practice. All cases of orophyryngeal cancer seen at Ear, Nose and Throat Department of University of Ilorin Teaching  Hospital (U.I.T.H) between July 2008 and June 2013 were reviewed. UITH has over 600 beds and is a tertiary institution for the University Medical Scohool.There were 27 cases, 15 (54.6%) were within 40-60 years, 7 (27.3%) were below 40 years, and 5 (18.2%) above 60 years. Seventeen (63.6%) were females and 10 (36.4%) males with male to female ratio of 1:1.7.  Twenty (72.7%) were non-smokers while 7 (27.3%) were smokers. Ten cases (36.4%) had history of alcohol intake while 17 (63.4%) did not take alcohol. Lateral wall and tonsil tumours constituted 55.6% (15) of the total, closely followed by base of the tongue tumours 7 (27.3%), then soft palatal tumours 5 (18.2%). There was none in the posterior pharyngeal wall. Seven patients (26.0%) had surgery followed by chemoradiation, 3 (11.1%) had chemoradiation only, while 17 (63.4%) either declined surgery or defaulted clinic follow-up. Two of the patients (7.4%) had associated HIV infection. This study showed relative high incidence of oropharyngeal tumours in young and middle aged females; who are non-alcohol drinking and non-smokers. Incidental finding of HIV infection in some of the patients is a pointer to the possible role of sexually transmitted viral infections in the epidemiology of oropharyngeal cancers and a focus for preventive measures.Keywords: Oropharyngeal cancer, risk factor, sexually transmitted viral infectio

Control versus no control : options for avian influenza H5N1 in Nigeria

In January 2006, an outbreak of a highly pathogenic avian influenza (HPAI) was recorded in Nigeria for the first time. This present work describes an estimation of possible costs associated with a vaccination-based control policy added to other measures to restrict HPAI H5N1 virus infections. The evaluations used epidemiological and production data, including budgets necessary for the vaccine acquisition, distribution and administration in arriving at the final costs. Using decision tree and cost benefit analysis the economical benefits for Nigeria and countries with similar veterinary infrastructures, biosecurity and farming systems are calculated. The result indicated that a halting in the continued spread of the virus through effective control measure will be 52 times better than taking no action. This should help policy makers in deciding in favour of vaccination combined with other tools as an effective means of controlling avian influenza H5N1. Control of HPAI H5N1 will best be understood by policy makers in financial terms. Effective control through vaccination of poultry is much cheaper and reduces the chances of human zoonoses. Poultry vaccination combined with other control measures will be the most effective means of control in most developing economies