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Breast cancer (BC) is an increasing public health issue worldwide. BC incidence and mortality rates are rising in transitioning countries in Africa, with the most rapid increase occurring in Sub-Saharan Africa (SSA). Female BC represents 25.8% of all cancer diagnosis in SSA. Early age at onset, high grade and triple negative tumors are hallmarks of BC in this region, associated with germline pathogenic variants in susceptibility genes. While several genes have been associated with genetic predisposition (BRCA1, BRCA2, PALB2, TP53, PTEN, CDH1, STK11, ATM, CHEK2, NBN, BARD1, BRIP1, RAD50, RAD51C, RAD51D, … ), most studies have reported contribution of BRCA1 and BRCA2 pathogenic variants. Genetic contribution of BRCA genes has been estimated at 27% in Caucasian women. Available data from population of African origin are scarce and have mainly focused on pathogenic variants of BRCA1 and BRCA2. Reports from main studies on large sample size highlighted that BRCA1 still the major gene associated with BC in SSA. In addition, BRCA2, PALB2, and P53, are also on the top major genes with high penetrance, associated with BC. Mutation spectrum of BC genes in black African women seems to be different from Caucasian with increasing number of founder mutations identified. We hypothesis that the genetic contribution of known BC genes may be different between women of black African origin compared to Caucasians. In this review we explore the genetic contribution of known breast cancer genes in women of African origin, and discuss perspectives for prevention and patients care strategies in the era of precision medicine. [ABSTRACT FROM AUTHOR]

Introduction: Depending on their location and size, keloids often pose functional, aesthetic and even psychological problems. Black Africans and Asians are more prone to keloids, whereas they are rare in whites and albinos. Bleomycin has been reported as a means of treating keloids, but to our knowledge no study in black Africa has looked at this molecule in the treatment of keloids. The aim of this study is to evaluate the efficacy and safety of bleomycin in the treatment of new keloids by intracheloid infiltration in subjects with phenotype VI, who are the most predisposed to this condition. Material and Methods: From 1 January to 31 December 2021, we identified 99 cases, 27 of whom met our inclusion criteria. They received intra-lesional bleomycin spaced 2 weeks apart or more for some with clinical parameters to evaluate the treatment. We judged the evolution: satisfactory, when pruritus and/or pain disappeared, the keloid mass subsided; more or less satisfactory, when pruritus and/or pain decreased, the keloid mass subsided; unsatisfactory, when pruritus and/or pain persisted, the keloid mass remained unchanged. Our data were processed and analysed using Epi Info 7.2.2.6. Results: The mean age of the patients was 30.70 years, with extremes of 2 and 85 years. The sex ratio was 1.25. The major functional sign was isolated pruritus in 66.66%. The consistency of the lesions was hard in 11%. The median number of infiltrations was 3, with extremes of 1 and 5. The local effects observed were pain on infiltration in 92% and necrosis in 77.77% of cases. No systemic effects were noted. Treatment efficacy was satisfactory in 66.66% of cases. Conclusions: Although bleomycin is less available in our countries and less accessible to patients, it could be proposed as a treatment for keloids, although a large study would be needed to evaluate it in large keloids. [ABSTRACT FROM AUTHOR]

Resumen: Los mercados laborales de África Subsahariana se caracterizan por una división de género entre los sectores formal e informal, que proviene de una racionalidad introducida por la segmentación legal colonial racista con sesgo de género en varios regímenes jurídicos dentro y fuera de la legislación laboral. La segmentación en los entornos poscoloniales no puede entenderse ni superarse sin analizar los orígenes institucionales coloniales específicos de mercantilización del trabajo. El «empleo típico colonial en condiciones de explotación» en África Subsahariana favorecía la contratación formal de hombres negros africanos al servicio de empleadores europeos, excluyendo o marginando a las mujeres y las relaciones laborales domésticas. [ABSTRACT FROM AUTHOR]

An accumulating body of evidence shows that various ethnicities are differentially affected by SARS-COV-2 infection. Moreover, some evidence shows that due to the vaccine inequity and millions of people living with HIV, a major catastrophe could occur in African countries that possibly affects the whole world. Given the possibility that Neanderthal genes confer a slight increase in susceptibility, this difference, at least to some extent, might possibly decrease the risk of the emergence of new SARS-CoV-2 variants among black people in Africa. Recent studies show less death and fewer cases among the ethnic group classified as "Black Africans". Although Neanderthal DNA might explain some differences in morbidity and mortality of COVID-19, a multitude of confounders complicate things to where drawing definite conclusions is hard or even impossible. Using selective-pressure-free treatments (e.g. low dose radiotherapy) for COVID-19 pneumonia would be of crucial importance everywhere, but particularly in sub-Saharan Africa, where "long COVID" in millions of people with HIV paves the road for the more frequent emergence of new variants. [ABSTRACT FROM AUTHOR]

Background We sought to address the paucity of data to support the evidence-based management of hypertension to achieve optimal blood pressure (BP) control on a sex-specific basis in Africa. Methods We undertook a post hoc analysis of the multicenter, randomized CREOLE (Comparison of Three Combination Therapies in Lowering Blood Pressure in Black Africans) Trial to test the hypothesis that there would be clinically important differences in office BP control between African men and women. We compared the BP levels of 397 and 238 hypertensive women (63%, 50.9 ± 10.5 years) and men (51.2 ± 11.3 years) from 10 sites across sub-Saharan Africa who completed baseline and 6-month profiling according to their randomly allocated antihypertensive treatment. Results Overall, 442/635 (69.6%) participants achieved an office BP target of <140/90 mm Hg at 6 months; comprising more women (286/72.0%) than men (156/65.5%) (adjusted odds ratio [OR] 1.59, 95% confidence interval [CI] 1.07–2.39; P = 0.023). Women randomized to amlodipine–hydrochlorothiazide (HCTZ) (adjusted OR 3.03, 95% CI 1.71–5.35; P < 0.001) or amlodipine–perindopril (adjusted OR 2.62, 95% CI 1.49–4.58; P = 0.01) were more likely to achieve this target compared with perindopril–HCTZ. Among men, there were no equivalent treatment differences—amlodipine–HCTZ (OR 1.54, 95% CI 0.76–3.12; P = 0.23) or amlodipine–perindopril (OR 1.32, 95% CI 0.65–2.67; P = 0.44) vs. perindopril–HCTZ. Among the 613 participants (97%) with 24-hour ambulatory BP monitoring, women had significantly lower systolic (124.1 ± 18.1 vs. 127.3 ± 16.9; P = 0.028) and diastolic (72.7 ± 10.4 vs. 75.1 ± 10.5; P = 0.007) BP levels at 6 months compared with men. Conclusions These data suggest clinically important differences in the therapeutic response to antihypertensive combination therapy among African women compared with African men. [ABSTRACT FROM AUTHOR]

Background: Prostate cancer, previously reported as relatively rare in Nigeria, is currently the leading cancer and leading cause of cancer-related death in men. Late presentation appears to persist despite higher incidence rates and instituted awareness programs. This study assesses current prostate cancer indices at presentation to a 3rd tier referral hospital in South-east Nigeria and compares these indices with reported indices from previous decades. Materials and Methods: Retrospectively, the medical records of men presenting with histologically confirmed prostate cancer from January 2009 to April 2018 were reviewed. Age, spectrum and duration of clinical features, serum total prostate-specific antigen (tPSA), and prostate biopsy specimen Gleason Score (GS) at presentation were retrieved for the analysis using the SPSS software version 21. Obtained mean values and proportions were compared to reports from previous decades for observable shifts. Results: The medical records of 331 men 51–90 years of age (mean: 69.8 ± 8.0 years) were retrieved. Six (1.8%) men (median tPSA = 28.0 ng/ml; range 10.0–121.4 ng/ml) had screening-detected prostate cancer. About 72.0%, 52.0%, and 30.3% of men present with symptoms after 3 months, 6 months, and 12 months, respectively, and about 55.1% had other clinical features of disease progression beyond lower urinary tract symptoms. Symptom duration, serum tPSA (median 31.4 ng/ml; range 4.0–710.0 ng/ml), and % fPSA (median 20.6%; range 57.1%–8.6%) at presentation, as well as prevalent poorly-differentiated tumor (GS ≥7 [4 + 3] 62.2%) are yet to shift from reports from previous decades. Conclusions: Prostate cancer indices at presentation in South-eastern Nigeria, a resource-poor community in sub-Saharan Africa are yet to positively shift despite efforts at prostate cancer awareness. [ABSTRACT FROM AUTHOR]

Purpose: Although consumption is a universal phenomenon, it is characterised with considerable degree of diversity in relation to various factors such as culture, age, gender, ethnicity and many others. Accordingly, more often than not, these factors underpin consumers' reactions to different market offerings including luxury products. While a plethora of scholarship efforts are evident in the extant literature in regards to luxury consumption, there is dearth of studies around how this is linked hedonism and ethnic consumers. Hence, this paper aims to fill a palpable gap in the literature by exploring the UK Black African women's taste for luxury fashion consumption. Design/methodology/approach: The study is interpretive in nature with the use of 20 in-depth interviews conducted with Black African women through the use of snowballing and purposive sampling methods. Findings: The study shows that the respondents' motivation for luxury consumption is driven by success and evolutionary motives, belongingness, societal pressures, cultural connection, anthropomorphism, consumer brand relationship and hedonism. Originality/value: Apart from the theoretical implication of the study, which revolves around extending the discourse of taste in consumption and ethnic consumer behaviour, the paper will be greatly beneficial for marketing practitioners, especially in the area of segmentation, targeting and positioning vis-à-vis the marketing of luxury products. [ABSTRACT FROM AUTHOR]

Background: The prognostic values of the neutrophil-to-lymphocyte ratio (NLR) and the platelet-to-lymphocyte ratio (PLR) in predicting the in-hospital mortality of Black African patients with advanced hepatocellular carcinoma (HCC) in palliative treatment is unknown. Aim: To determine the prognostic value of NLR and PLR compared with that of Child–Turcotte–Pugh (CTP), model for end-stage liver disease (MELD) scores and the Barcelona clinic liver cancer staging system (BCLC). Methods: The cutoffs, accuracies and association with the mortality of these prognostic scores were determined using a time-dependent area under receiver operating characteristic curves (AUC), the log rank test and Cox proportional hazards ratio. Results: A total of 104 patients with advanced HCC (median age=49.5 years, males=58.7%) were enrolled. All were hospitalized for an enlarged liver mass of at least 15.4 cm in size in the right thoracic quadrant. Overall, 46 (44.2%) patients died in hospital during follow-up. Patients with NLR > 2.5 (log rank test=7.11, p=0.01) or PLR > 92 (log rank test=5.63, p=0.02) had poor survival. Factors associated with the in-hospital mortality were the MELD score (p=0.01), NLR (p=0.03) and hemoglobin level (p=0.02). NLR exhibits better and stable accuracy in predicting the in hospital mortality at time points of 30 (AUC=0.618), 60 (AUC=0.680) and 90 (AUC=0.613) days of follow-up, compared with CTP, MELD scores, BCLC and PLR. However, PLR displayed an enhanced accuracy over 90 days of follow up (AUC=0.688). Conclusion: NLR is useful in predicting the in-hospital mortality in Black African patients with advanced stage HCC in clinical practice. NLR and PLR may be used concomitantly for long-term follow-up. [ABSTRACT FROM AUTHOR]

The African black soap is popular for its cleansing and medicinal properties particularly amongst those of African descent. The "traditional" African black soap" refers to soaps made from the ash‐derived alkali from agricultural waste and oil extracted from vegetable matter without the addition of cosmetic enhancing products. Production of black soap has been traced to west Africa especially Nigeria and Ghana. The raw materials are readily available in the region making the soap available and affordable for most in sub‐Saharan Africa. It has been described as gentle, super fatted and hypoallergenic. It is advertised as antimicrobial, anti‐acne, exfoliating, skin toning, scar fading, and having medicinal properties. It is popular for its management of skin diseases, although some of the claims remain anecdotal. Generations of Africans abroad continue to use modified versions of the soap and claim they are satisfied with the results obtained. However, in the management of patients with skin disorders, especially eczema, in sub‐Saharan Africa, prescribing an ideal skin cleanser can be challenging as many cannot afford the imported nonsoap cleansers with skin friendly pH. Studies have shown that the traditional black soap does have antimicrobial properties against Staphylococcal and some Streptococcal organisms, which are commonly seen in the tropical climate. The recent ban of some antiseptics in popular antibacterial soaps in this environment, emphasizes the need for production of safer antimicrobials. The antimicrobial, physiochemical, and phytochemical properties of the African black soap suggest it may have beneficial effects on the overall skin health. [ABSTRACT FROM AUTHOR]

Background: The effects of virologic parameters, liver fibrosis, and treatment on the HRQoL in black African patients with CHB are unknown. Objective: To determine the magnitude and the effects of hepatitis B e antigen (HBeAg), hepatitis B surface antigenemia (HBs antigenemia), viral load, liver fibrosis and treatment on HRQoL impairment in black African patients with CHB using the SF36 (SF36) and chronic liver disease questionnaires (CLDQ). Materials and Methods: HRQoL comparison was determined in a case–control study and enrolled 214 patients with CHB (mean age: 42 years, male: 65.9%) and 210 healthy controls subjects (mean age: 37.8 years; male: 63.8%). Control subjects were younger than those with CHB (p=0.01). Analysis of covariance, Welch test and linear regression were used to compare HRQoL between subgroups. Results: Adjusted to age and gender, patients with CHB elicited low mean scores on the subscales of role-physical (66.9 vs 78, p=0.001), role-emotional (64 vs 77.5, p=0.01), bodily pain (70.8 vs 96.2, p=0.001), social functioning (74.6 vs 84.5, p=0.003) and general health (64.6 vs 74.4, p=0.03) in comparison with control subjects. Multivariate analysis showed that CHB impaired HRQoL on physical (β= − 16.7 (1.8), p< 0.0001) and mental component summaries (β= − 5.1 (2.0), p=0.01) adjusted to others variables. Patients with HBeAg negative CHB elicited low scores on physical (p=0.004) and mental (p=0.05) component summaries and low CLDQ's average score (p=0.002) in comparison with those positive. Patients with low (≤ 1000 IU/mL) HBs antigenemia (p=0.03) or viral load (p=0.03) scored less on physical component summary and those with significant fibrosis or cirrhosis scored less (p=0.003) on mental component summary. Conclusion: Black African patients with CHB expressed poor HRQoL, particularly those with HBeAg negative CHB, low viral load, or HBs Antigenemia. [ABSTRACT FROM AUTHOR]

This article presents the religious conceptions in the traditional black African universe to determine its effects on ethnicity and, therefore, on community life. The power of tradition is related to cycles, rituals, gerontocracy and rites of initiation. Black African ethnicity as a way of functional expression of different ethnic groups brings to light the cultural practices and perspectives that distinguish these groups from one another. With a method of reviewing and analyzing the literature, it is shown that the significant traits of cultural identity in traditional black Africa are regulated by the location of the subject or group that identifies itself ethnically. [ABSTRACT FROM AUTHOR]

Background: Dermatofibrosarcoma protuberance (DFSP) is the commonest, yet rare, dermal sarcoma globally. There are few reports in the literature of this neoplasm in Nigerians and indeed in sub-Saharan Africa. This study documents our institutional practice observation and compares it with those from other regions of the world. Methods and materials: This study was a retrospective review of all cases of histologically diagnosed DFSP at the University College Hospital, Ibadan, Nigeria, spanning a period of 27 years (January 1989-December 2016). Data on patient age, gender, tumour location, size, tumour recurrence and metastasis status were obtained from clinical and surgical pathology archival files and records. Results: Sixty-nine cases of DFSP were recorded over the period reviewed with a male-female ratio of 1.6:1. The mean age of the study population was 39.6 years. The youngest patient was 5-year old, while the oldest was 86 years and the modal age group was the 4th decade. The trunk was the commonest anatomic tumour location. Recurrences were seen in seven cases with recurrence interval ranging from 6 to 240 months. The correlation between tumour size and age was non-significant (r = -0.183; p = 0.182). There was fibrosarcoma-like transformation in three cases (4.3%) studied. Conclusion: Dermatofibrosarcoma protuberance is rare in our population and occurs more commonly in males and on the trunk. Recurrence can occur beyond the recommended follow-up period of 10 years. [ABSTRACT FROM AUTHOR]

Background: Angiosarcoma is an endothelial malignant tumor; angiosarcoma located in the breast is extremely rare, less than 0.01%. We report a case of a giant angiosarcoma diagnosed postmortem in a 16-year-old girl in a resource-constrained country.Case Presentation: A 16-year-old black African girl was admitted for altered consciousness and a left breast tumor. She was admitted in a state of apparent death. Her death was confirmed on clinical examination. A postmortem biopsy of the mammary tumor showed standard histology of a proliferation of fusiform or rounded tumor cells in places, which were not very cohesive with marked anisokaryosis and numerous foci of tumor necrosis. Immunohistochemistry showed a positivity of CD31 and factor VIII markers with a proliferation index (Ki-67) estimated at 30%.Conclusion: Primary angiosarcoma of the breast is exceptional in adolescents and has a poor prognosis, especially in countries with limited resources. [ABSTRACT FROM AUTHOR]

Myth, Ritual and Spirituality of African people in Anna Świrszczyńska's "Black Words". The paper provides an analysis of poem collection entitled "Black words. Negro stylizations" published by polish poet Anna Świrszczyńska (Swir) in 1967. It studies the ways in which the African subjects are constructed, mostly in the aspect of their relations to the non-human beings: animals, monsters, plants and personalized natural phenomena. It is argued that Świrszczyńska refers to indigenous beliefs (animism, totemism, fetishism, magic) in order to question Western anthropocentrism and propose alternative perspectives, emphasizing fierce and unconscious human motivations. In the poems the radical otherness of black Africans is highlighted, but nonetheless the collection expresses a sense of solidarity, especially with black women and elderly people. [ABSTRACT FROM AUTHOR]

Background: The prevalence of hypertension among black African patients is high, and these patients usually need two or more medications for blood-pressure control. However, the most effective two-drug combination that is currently available for blood-pressure control in these patients has not been established.Methods: In this randomized, single-blind, three-group trial conducted in six countries in sub-Saharan Africa, we randomly assigned 728 black patients with uncontrolled hypertension (≥140/90 mm Hg while the patient was not being treated or was taking only one antihypertensive drug) to receive a daily regimen of 5 mg of amlodipine plus 12.5 mg of hydrochlorothiazide, 5 mg of amlodipine plus 4 mg of perindopril, or 4 mg of perindopril plus 12.5 mg of hydrochlorothiazide for 2 months. Doses were then doubled (10 and 25 mg, 10 and 8 mg, and 8 and 25 mg, respectively) for an additional 4 months. The primary end point was the change in the 24-hour ambulatory systolic blood pressure between baseline and 6 months.Results: The mean age of the patients was 51 years, and 63% were women. Among the 621 patients who underwent 24-hour blood-pressure monitoring at baseline and at 6 months, those receiving amlodipine plus hydrochlorothiazide and those receiving amlodipine plus perindopril had a lower 24-hour ambulatory systolic blood pressure than those receiving perindopril plus hydrochlorothiazide (between-group difference in the change from baseline, -3.14 mm Hg; 95% confidence interval [CI], -5.90 to -0.38; P = 0.03; and -3.00 mm Hg; 95% CI, -5.8 to -0.20; P = 0.04, respectively). The difference between the group receiving amlodipine plus hydrochlorothiazide and the group receiving amlodipine plus perindopril was -0.14 mm Hg (95% CI, -2.90 to 2.61; P=0.92). Similar differential effects on office and ambulatory diastolic blood pressures, along with blood-pressure control and response rates, were apparent among the three groups.Conclusions: These findings suggest that in black patients in sub-Saharan Africa, amlodipine plus either hydrochlorothiazide or perindopril was more effective than perindopril plus hydrochlorothiazide at lowering blood pressure at 6 months. (Funded by GlaxoSmithKline Africa Noncommunicable Disease Open Lab; CREOLE ClinicalTrials.gov number, NCT02742467.). [ABSTRACT FROM AUTHOR]

George Best employs racial rhetoric in his exploration narrative to contemplate and order human difference. This essay examines the ways in which that racial rhetoric, informed by prior English understandings of sub-Saharan Africa, disrupts the narrative as Best grapples with cosmographical quandaries, not the least of which is how and where American indigenous groups fit into a larger world order. Close reading of the textual and rhetorical features of Best's narrative reveals the manner in which black Africans function as an essential but problematic mediating presence through which Best contemplates cultural differences, in particular the features of the Inuit, and attempts to reconcile moments of cognitive dissonance in which his expectations do not align with his experiences. Ultimately, the narrative suggests larger questions about how racial discourse and stereotypes about West Africa affected Englishmen's encounters with and representations of Native peoples in early Atlantic contact zones. [ABSTRACT FROM AUTHOR]

Abstract: Background: Few studies assessed arterial stiffness in Black hypertensive patients born and living in sub-Saharan Africa, where cardiovascular disease reaches epidemic proportions. Methods: The Newer versus Older Antihypertensive Agents in African Hypertensive Patients (NOAAH) trial is currently recruiting native African patients to compare the efficacy of various antihypertensive drugs given once daily as single-pill combinations. Two centres engaged in pulse wave analysis and measured carotid–femoral pulse wave velocity (PWV). Statistical methods included single and multiple linear regressions. Results: Of 172 patients screened, 116 entered the ancillary study on central haemodynamics (51.3% women; mean age 52.7 years; untreated blood pressure 147.6/87.1mmHg). The augmentation indexes were higher (p <0.0001) in women than men, both peripherally (pAI, 11.1 vs. −10.6%) and centrally (cAI, 39.0 vs. 28.0%). PWV (8.91m/s) and central pulse pressure (cPP, 48.7mmHg) were similar (p >0.844) in both sexes. pAI and cAI increased with female sex and mean arterial pressure, but decreased with heart rate and body mass index. cPP increased with age and mean arterial pressure. PWV increased with age and mean arterial pressure. Patients with measurements above the age-specific thresholds determined in healthy Black South Africans amounted to 0 for cAI, 1 (1.2%) for cPP, and 11 (18.3%) for PWV. Conclusion: NOAAH patients have measures of arterial stiffness similar to those of a healthy Black reference population with determinants as reported in the literature. Our observations highlight the potential for the prevention of irreversible arterial damage by timely treating sub-Saharan hypertensive patients to target blood pressure levels. [Copyright &y& Elsevier]

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The article focuses on communication training in Black Africa. According to Okwudiba Nnoli, one of Nigeria's foremost political scientists, self-reliance is a strategy of production that focuses attention on domestic priorities and resources for the national objectives accomplishment. It mentions that Black African have realized the urgent need for circulating the under-utilized of their countries domestic potential together with their need in assuring responsibility for their own fate. It adds that Black African states moves towards self-reliance on collective and national basis should be an effort in reducing economic dependence on advanced industrial states to encourage their self-respect and fuller independence.

Background: Fanconi-Bickel syndrome is an autosomal recessive disorder of glucose metabolism. It is an extremely rare disorder. Most cases have been reported in consanguineous communities. None of the cases have been reported in Black Africans in sub-Saharan Africa. This case was diagnosed 3 years after initial presentation due to diagnostic challenges and limited awareness of similar metabolic syndromes in our setting.Case Presentation: We report the case of a 4-year-old boy, born to non-consanguineous Black African parents, who presented with failure to thrive and rachitic features in infancy. Clinical, laboratory, and radiological features were indicative of Fanconi-Bickel syndrome. No genetic testing was done. The diagnosis was made 3 years after the initial presentation due to diagnostic challenges. He showed clinical improvement with the institution of a galactose-free diet.Conclusion: Fanconi-Bickel syndrome occurs even in non-consanguineous Black African populations. Therefore, clinicians in resource-poor settings should raise their index of suspicion for such metabolic disorders in settings with a high prevalence of failure to thrive among children. [ABSTRACT FROM AUTHOR]