Systematic Analysis of Factors Associated with Late Breast Cancer Screening in Women in Sub-Saharan Africa from 2014 to 2020

Research background: Breast cancer remains a major public health problem, with a high number of new cases and deaths each year. However, despite advances in research to improve this disease, there is a high rate of late detection, leading to diagnosis at an advanced stage and a reduced chance of survival. Objective: The aim of this study is to identify the factors associated with late detection of breast cancer in women in Sub-Saharan Africa from 2014 to 2020.Setting: This systematic review focuses on sub-Saharan Africa. Methods: We searched for articles in four databases (PubMed, Embase, Global-Health and CINAHL) between 2014 and 2020 and performed a narrative synthesis to organize and group the different factors associated with late breast cancer detection. Result: After reviewing 583 publications, 6 studies were selected, highlighting factors such as lack of awareness, knowledge gaps, difficulties in accessing health services and financial constraints associated with late breast cancer screening. The participants, who ranged in number from 20 to 1776, were mainly aged between 18 and 25, with a mean age of 25 years and 6 months. Conclusion: The analysis enabled us to identify various factors associated with late breast cancer screening. Collaboration between health professionals, community organizations and policy-makers is essential to foster an environment conducive to the prevention and early detection of breast cancer.

Transanal Evisceration of Small Bowel about One Case at the University Hospital Yalgado Ouédraogo of Ouagadougou

Introduction: Transanal evisceration of small bowel is an extremely rare condition that can occur spontaneously or after trauma. Objective: To report a case of Transanal evisceration of small bowel to describe the circumstances of occurrence and our therapeutic attitude. Observation: An 80-year-old female patient was received at the visceral Emergency of University Hospital Yalgado Ouédraogo for the outcome of the small intestine by the anus with the waning of a defecation effort. The physical examination of the patient accustomed to evacuation purgation noted, eviscerated the small bowel through the anus, edematous but viable. The preoperative laboratory tests were normal. In emergency, under general anesthesia, a laparotomy was possible to objectify the incarceration of intestinal loops through linear perforation of 5 cenimeter from the anterior surface of the rectosigmoid hinge. We conducted an ileo-ileal resection anastomosis, a suture rectosigmoid breach and anal extraction of small bowel incarcerated measuring 200 centimeter. The evolution was simple. Conclusion: The weakening of the rectal mucosa by repeated purges has certainly been the contributory factor. The surgical treatment must be precocious to avoid extensive intestinal resection.

Survey on the Knowledge, Attitudes, Primary Prevention Practices and Screening of Skin Cancers in Albinos in Burkina Faso

The objective is to study the knowledge that albinos have on skin cancers, and their attitudes in terms of primary prevention and the screening practices for skin cancers in Burkina Faso. Methods: This is a cross-sectional and descriptive KAP study conducted from May 18th to July 7th 2015. It involved albinos aged at least 12 years. Their general knowledge, prevention attitudes and screening practices were considered. Results: All the responding albinos had already heard about skin cancers. Their main source of information was health workers (65.6%). They were showing at least two risk factors (99.2%) but only 68.3% affirmed having already undergone screening for skin cancer. Ignorance of the existence of screening was the main obstacle to it (16/26). The prevention means used was sun avoidance, the use of cream and protection clothing respectively in 84%, 41.5% and 51.2%. The skin lesions found were hyperpigmented macules (77.8%) then actinic keratosis (40.7%) and finally cheilitis (35.8%). We detected 4 cases of skin cancers confirmed by biopsy. Conclusion: Risk factors are frequent. Participation to screening is still insignificant. A lot is still to be done to extend the protection means. A good awareness-raising campaign and the accessibility to protection means remain for all, the best defense in the fight against skin cancers in albinos.

Gastric Adenocarcinoma Treatment in Africa: Surgery Alone or Perioperative Chemotherapy?

Aim: Evaluate the impact of MAGIC trial on gastric adenocarcinoma’s management in Africa. Method and methodology: It was about a review of literature on therapeutic aspects of gastric adenocarcinoma in the African area. We have taken a census of 21 articles including 2792 patients published between 1980 and 2013. We have distinguished articles published before 2006 (group 1) from those published after 2006 (group 2) to better understand therapeutic changes after that perioperative chemotherapy has become a standard in gastric adenocarcinoma’s management. Results: Surgery remains in Africa the first and practically the only treatment weapon in gastric adenocarcinoma: 46% to 92% people in the 1st group and 65% to 100% people in the 2nd group underwent surgical procedures. Perioperative chemotherapy takes longer to be part of therapeutic habits (0.18%). Factors related to patients such alteration of general state with a WHO performance status superior to 2 in 72% of cases, the lack of financial accessibility to anticancerous drugs explains partly the non-use of perioperative chemotherapy. This is also due to factors peculiar to our sanitation structures which don’t have enough cancer specialists. So we noticed that MAGIC trial is simply ignored in certain studies. The lack of adoption of perioperative chemotherapy explains with delayed diagnosis the low survival of patients in the African area. Conclusion: MAGIC trial practically has no effect on therapeutic behavior yet comparatively to gastric adenocarcinoma in Africa. The insurance particularly relies on surgery only until now. However, it might enable us to improve gastric adenocarcinoma’s survival rates.

Urological Cancers in Burkina Faso: Epidemiological and Anatomopathological Aspects of 2204 Cases

Purpose: To study the epidemiological and anatomopathological aspects of urological cancers in Burkina Faso from 1988 to 2018. Patients and Methods: A cross-sectional, retrospective and descriptive study of histologically confirmed cancers that are collected from pathological anatomy laboratory records. The aspects studied were age, sex, location and histological type. Results: A total of 2204 cases of urological cancer were collected. The predominance was male with a sex-ratio of 9.6. The average age was 63.32 years. We found 1602 cases of prostate cancer (72.68%), 361 cancers of the bladder and excretory tract (16.4%), 180 cancers of the kidney (8.16%), 33 testis cancers (1.5%) and 28 penile cancers (1.3%). The predominant histological type of prostate cancer was adenocarcinoma (96.4%) with a Gleason score 7 in 30.4% of cases. Bladder cancer consisted of 50% epidermoid carcinomas. Kidney cancer was mostly nephrotoblastomas with 42.2% of cases. We noted 42.4% of seminomas among testis cancers and 89.3% of epidermoid carcinomas within penile cancers. Conclusion: The incidence of urological cancers is increasing in Burkina Faso. These cancers occur at a relatively advanced age with male predominance. Prostate cancers are at the forefront of these urological cancers. The establishment of a cancer registry would allow better follow up of cancers in our countries.

Testicular Seminoma and Peritonitis about One Case at the Yalgado Ouedraogo University Hospital of Ouagadougou

Introduction: Testicular seminoma is a highly lymphophilic germ cell tumor. It is the most common germ cell tumor in young adults. We are reporting one case of testicular seminoma complicated with an acute generalized peritonitis (AGP), in order to describe the circumstances of diagnosis and discuss about treatment. Observation: It involved a 39-year-old patient, admitted for vague abdominal pains that were evolving since 72 hours with a history of right orchiectomy because of testicular seminoma in 2011. The analysis revealed a peritoneal syndrome, a right inguinal lymphadenopathy of 10 cm diameter and an empty right scrotum. The exploration revealed fistulized necrotic retro-peritoneal lymphadenopathies in the peritoneal cavity and ileal perforation on contact with these lymphadenopathies. Necrosectomy and ileal resections were performed. After the operation, the scanner revealed a conglomeration of retro-peritoneal adenomegalies extending to the right femoral region associated with bilateral pleurisy. The β-HCG and the LDH were 8000 IU/L and 24,500 IU/L, respectively. The seminoma was ranked T3N3M1. The immediate post-operative care was uneventful. The patient was lost from sight for a month and was readmitted in a context of alteration of his general condition. He died before the end of the pre-chemotherapeutic assessment. Conclusion: Scrotal mass is the usual way of revelation of testicular seminoma. In poorly followed-up cases, exceptional complications such as peritonitis may occur and are direct consequences of poor prognosis.

Chemotherapy Induced Amenorrhea in Women Treated with Chemotherapy for Breast Carcinoma in Yalgado Ouédraogo Teaching Hospital in Ouagadougou, Burkina Faso

Background: We conducted this study to identify factors associated with the onset and reversibility of chemotherapy-induced amenorrhea in Yalgado Ouédraogo Teaching Hospital of Ouagadougou. Methods: A historical cohort study was performed and covered the period from 1 January 2014 to 31 July 2015. No menopausal patients managed for a histologically confirmed breast carcinoma and having benefited from chemotherapy were included in the study. Logistic regression analysis was used to determine the factors associated with the occurrence of chemotherapy-induced amenorrhea as well as its reversibility. Results: Seventy patients were included. The mean age was 38.5 years. Thirteen patients were obese and 19 (40.4%) had their menarche after age of 15 years. Adjuvant chemotherapy was administered to 31 patients while 12 had received neoadjuvant chemotherapy. Sequential chemotherapy with an anthracycline and a taxanetherapeutic protocol was the most used. Forty-seven patients had a chemotherapy-induced amenorrhea. The risk of having a chemotherapy-induced amenorrhea increases by 25% for each additional year of age at diagnosis of cancer (p = 0.0001). Obesity and menarche after age 15 were found to be protective factors. After adjusting these variables together, age, obesity, and age at menarche were factors independently associated with the occurrence of the chemotherapy-induced amenorrhea. The reversibility was effective in 11 cases (37.9%) and especially concerned patients younger than 40 years (p = 0.03). Conclusion: Age is the primary risk factor. Reliable markers of ovarian function need to be developed to better select fertility conservation protocols.

Thoracic Wounds by Firearm at the University Hospital Yalgado Ouedraogo (YO)

Introduction: Thoracic wounds by firearms are frequent and severe. They may involve the patient’s prognosis. Objective: To study the epidemiological, clinical, paraclinical, therapeutic and evolutionary aspects of the thoracic wounds by firearms. Material and method: This was a cross-sectional, descriptive study of all patients over the age of 15 who consulted in the university hospital-YO in the department of general and digestive surgery over a period of 5 years. Results: We collected 50 cases of thoracic wounds by firearms on 183 thoracic wounds with a prevalence of 27.3%. There were 48 men (96%). The average age was 30 years. The patients came from urban areas in 66% of cases;the informal sector accounted for 44% of the cases. The pistol was the most involved firearm (46.9%). The consultation period was less than 6 hours in 78% of patients. An unstable hemodynamic state was found in 42% (n = 21). A fluid and mixed pleural effusion syndrome was found in 46% and 26% of patients, respectively. Associated lesions were diaphragm involvement, and lesions of intra-abdominal hollow organs. Thoracic drainage was performed in 24 patients (48%) and was associated with a laparotomy in 8 patients. The average hospital stay was 7.5 days. Mortality was 14%. Conclusion: the thoracic wounds by firearms are frequent in civilian practice. The thoracic CT allows mapping of the lesions and thoracic drainage constitutes the essential part of surgical treatment. The fight against the proliferation of weapons deserves to be promoted.