期刊文献+
共找到2篇文章
< 1 >
每页显示 20 50 100
Systematic review and meta-analysis of esophageal cancer in Africa:Epidemiology, risk factors, management and outcomes 被引量:10
1
作者 Akwi W Asombang Nathaniel Chishinga +6 位作者 Alick Nkhoma Jackson Chipaila bright nsokolo Martha Manda-Mapalo Joao Filipe G Montiero Lewis Banda Kulwinder S Dua 《World Journal of Gastroenterology》 SCIE CAS 2019年第31期4512-4533,共22页
BACKGROUND Esophageal cancer(EC)is associated with a poor prognosis,particularly so in Africa where an alarmingly high mortality to incidence ratio prevails for this disease.AIM To provide further understanding of EC ... BACKGROUND Esophageal cancer(EC)is associated with a poor prognosis,particularly so in Africa where an alarmingly high mortality to incidence ratio prevails for this disease.AIM To provide further understanding of EC in the context of the unique cultural and genetic diversity,and socio-economic challenges faced on the African continent.METHODS We performed a systematic review of studies from Africa to obtain data on epidemiology,risk factors,management and outcomes of EC.A non-systematic review was used to obtain incidence data from the International Agency for Research on Cancer,and the Cancer in Sub-Saharan reports.We searched EMBASE,PubMed,Web of Science,and Cochrane Central from inception to March 2019 and reviewed the list of articles retrieved.Random effects metaanalyses were used to assess heterogeneity between studies and to obtain odds ratio(OR)of the associations between EC and risk factors;and incidence rate ratios for EC between sexes with their respective 95%confidence intervals(CI).RESULTS The incidence of EC is higher in males than females,except in North Africa where it is similar for both sexes.The highest age-standardized rate is from Malawi(30.3 and 19.4 cases/year/100000 population for males and females,respectively)followed by Kenya(28.7 cases/year/100000 population for both sexes).The incidence of EC rises sharply after the age of 40 years and reaches a peak at 75 years old.Meta-analysis shows a strong association with tobacco(OR 3.15,95%CI:2.83-3.50).There was significant heterogeneity between studies on alcohol consumption(OR 2.28,95%CI:1.94-2.65)and on low socioeconomic status(OR 139,95%CI:1.25-1.54)as risk factors,but these could also contribute to increasing the incidence of EC.The best treatment outcomes were with esophagectomy with survival rates of 76.6%at 3 years,and chemo-radiotherapy with an overall combined survival time of 267.50 d.CONCLUSION Africa has high incidence and mortality rates of EC,with preventable and nonmodifiable risk factors.Men in this setting are at increased risk due to their higher prevalence of tobacco and alcohol consumption.Management requires a multidisciplinary approach,and survival is significantly improved in the setting of esophagectomy and chemoradiation therapy. 展开更多
关键词 ESOPHAGEAL CANCER in AFRICA ESOPHAGEAL SQUAMOUS cell carcinoma CANCER in AFRICA Systematic review
下载PDF
Chronic hepatitis B virus monoinfection at a university hospital in Zambia 被引量:1
2
作者 Michael J Vinikoor Edford Sinkala +11 位作者 Annie Kanunga Mutinta Muchimba bright nsokolo Roma Chilengi Gilles Wandeler Joseph Mulenga Tina Chisenga Debika Bhattacharya Michael S Saag Graham Foster Michael W Fried Paul Kelly 《World Journal of Hepatology》 CAS 2018年第9期622-628,共7页
AIM To characterize antiviral therapy eligibility among hepatitis B virus(HBV)-infected adults at a university hospital in Zambia.METHODS Hepatitis B surface antigen-positive adults(n = 160) who were h IV-negative and... AIM To characterize antiviral therapy eligibility among hepatitis B virus(HBV)-infected adults at a university hospital in Zambia.METHODS Hepatitis B surface antigen-positive adults(n = 160) who were h IV-negative and referred to the hospital after a routine or clinically-driven HBV test were enrolled. Alanine Aminotransferase(ALT),Aspartate Aminotransferase(AST),platelet count,hepatitis B e-antigen,and HBV DNA were measured. Liver fibrosis/cirrhosis was assessed by physical examination,AST-to-platelet ratio index,and transient elastography. In antiviral therapy-na?ve individuals,we described hBV stages and antiviral therapy eligibility per World health Organization(WhO) and by hBV test(routine vs clinical). Elevated ALT was > 19 in women and > 30 U/L in men. Among treatmentexperienced individuals,we described medication side effects,adherence,and viral suppression.RESULTS The median age was 33 years,71.9% were men,and 30.9% were diagnosed with HBV through a clinicallydriven test with the remainder identified via routine testing(at the blood bank,community events,etc.). Among 120 treatment-na?ve individuals,2.5% were categorized as immune tolerant,11.7% were immune active,35.6% were inactive carriers,and 46.7% had an indeterminate phenotype. Per WhO guidelines,13(10.8%) were eligible for immediate antiviral therapy. The odds of eligibility were eight times higher for those diagnosed at clinical vs routine settings(adjusted odds ratio,8.33; 95%CI: 2.26-29.41). Among 40 treatmentexperienced hBV patients,virtually all took tenofovir,and a history of mild side effects was reported in 20%. Though reported adherence was good,12 of 29(41.4%) had HBV DNA > 20 IU/m L. CONCLUSION Approximately one in ten HBV-monoinfected Zambians were eligible for antivirals. Many had indeterminate phenotype and needed clinical follow-up. 展开更多
关键词 HEPATITIS B VIRUS LIVER FIBROSIS Treatment TENOFOVIR AFRICA
下载PDF
上一页 1 下一页 到第
使用帮助 返回顶部