The practice of hepatocellular cancer surveillance in Nigeria

Background: Hepatocellular cancer is a disease of global and public health importance due to the widespread distribution of risk factors and associated high case fatality. Hepatocellular Cancer (HCC) in Sub-Saharan Africa is commonly seen among the younger age groups (<45 years) who present mostly in the terminal stage, when the disease is not amenable to any curative therapy. Hepatocellular Carcinoma surveillance employs the use of simple, cheap and readily available investigations, to detect early curable cancer in individuals with risk factors for HCC.Objectives:The aim of this study is to assess the practice of hepatocellular cancer screening among physicians.Methodolgy:This is a nationwide online survey carried out among physicians who care for patients with HCC. A questionnaire was sent out via a web link to all consenting doctors in Nigeria. The responses were collated in a cloud-based application and data was analysed using Epi-info version 20.Results:Atotal of 218 respondents, 142 were males (65.1 %) with a mean age of 37.6 ± 5.7 years. The modal age group was 31-40 years 153 (69.5%). The main factors considered as a hindrance to surveillance were; the cost of the tests (57.7%), failure of return of patients (50.5%) and not being aware of a surveillance program (45.2 %). The majority of the respondents were Gastroenterologists and Family Physicians. 54% of the gastroenterologists and 64% of the family physicians have never offered HCC surveillance to their patients.Conclusion:This survey highlights a knowledge gap in HCC surveillance among physicians. There is a need to make HCCsurveillance a daily routine among patients at risk by all physicians. Keywords: Surveillance, Hepatocellular Carcinoma, HBV, HCV, Cancer screening

Twelve-month observational study of children with cancer in 41 countries during the COVID-19 pandemic

Introduction Childhood cancer is a leading cause of death. It is unclear whether the COVID-19 pandemic has impacted childhood cancer mortality. In this study, we aimed to establish all-cause mortality rates for childhood cancers during the COVID-19 pandemic and determine the factors associated with mortality. Methods Prospective cohort study in 109 institutions in 41 countries. Inclusion criteria: children <18 years who were newly diagnosed with or undergoing active treatment for acute lymphoblastic leukaemia, non-Hodgkin's lymphoma, Hodgkin lymphoma, retinoblastoma, Wilms tumour, glioma, osteosarcoma, Ewing sarcoma, rhabdomyosarcoma, medulloblastoma and neuroblastoma. Of 2327 cases, 2118 patients were included in the study. The primary outcome measure was all-cause mortality at 30 days, 90 days and 12 months. Results All-cause mortality was 3.4% (n=71/2084) at 30-day follow-up, 5.7% (n=113/1969) at 90-day follow-up and 13.0% (n=206/1581) at 12-month follow-up. The median time from diagnosis to multidisciplinary team (MDT) plan was longest in low-income countries (7 days, IQR 3-11). Multivariable analysis revealed several factors associated with 12-month mortality, including low-income (OR 6.99 (95% CI 2.49 to 19.68); p<0.001), lower middle income (OR 3.32 (95% CI 1.96 to 5.61); p<0.001) and upper middle income (OR 3.49 (95% CI 2.02 to 6.03); p<0.001) country status and chemotherapy (OR 0.55 (95% CI 0.36 to 0.86); p=0.008) and immunotherapy (OR 0.27 (95% CI 0.08 to 0.91); p=0.035) within 30 days from MDT plan. Multivariable analysis revealed laboratory-confirmed SARS-CoV-2 infection (OR 5.33 (95% CI 1.19 to 23.84); p=0.029) was associated with 30-day mortality. Conclusions Children with cancer are more likely to die within 30 days if infected with SARS-CoV-2. However, timely treatment reduced odds of death. This report provides crucial information to balance the benefits of providing anticancer therapy against the risks of SARS-CoV-2 infection in children with cancer

Anti-nutrient Content, and in vitro Protein Digestibility (IVPD) of Infant Food Produced from African Yam Bean (Sphenostylis sternnocarpa), and Bambara Groundnuts (Voandezela subterranean)

Abstract. African yam bean (AYB) (Sphenostylis stenocarpa) and bambara groundnut (BG) (Voadzeia subterranean) are some of the pulses with unutilized high nutritional value. The aim of this study was to assess the anti-nutrient content of raw and processed AYB and BG, and infant weaning diets formulated from flour processed from both crops, using a Nestle Infant formula (Nutrend) as standard. Reduction of anti-nutrient content was carried out using soaking and germination procedures, followed by oven drying at 105 o C. After germination there was 92.13% tannin, 82.01% phytate, 60.14% cyanate and 80.36% oxalate reductions in AYB. There was 84.34% tannin, 82.34% phytate, 50.04% cyanate and 82.14% oxalate decreases in BG. Anti-nutrient contents of diets ranged from 14.31±0.75 -15.20± 0.61 mg/g for tannin, 17.02±0.81 -24.82±1.65 mg/g for phytate, 1.34±0.01 -1.43±0.01 mg/g for cyanate and 0.14±0.02 -0.55±0.05 mg/g for oxalate. These values compared well with those of the standard formula which gave 15.20±0.52 mg/g, 26.01±1.64 mg/g, 1.56±0.03 mg/g and 0.82±0.05 mg/g anti-nutrient contents of tannin, phytate, cyanate and oxalate. There was a significant (p<0.05) increase in digestibility values of diet 1 (87.60%), diet 2 (85.65%), and diet 3 (84.35%), while the standard diet 4 gave 85.31% digestibility value. Protein concentration (Pe%) of diets were 25.97%, 24.27% and 22.96%, for diets 1, 2 and 3, compared to 18.03% obtained for standard diet 4. The PE% profile and low antinutritional contents in test diets suggest that the diet formulas may serve as alternative infant weaning formulations. Thus, AYB and BG may serve as alternative infant weaning food and bridge in food security gap for weaning formulas