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We previously showed that Erythromycin, Retapamulin, Pyridoxine, Folic acid and Ivermectin inhibit SARS-COV-2 induced cytopathic effect (CPE) in Vero cells. In this study and using validated quantitative neutral red assay, we show that the inhibition of CPE is concentration dependent with Inhibitory Concentration-50(IC50) of 3.27 μM, 4.23 μM, 9.29 μM, 3.19 μM and 84.31 μM respectively. Furthermore, Erythromycin, Retapamulin, Pyridoxine, Folic acid and Ivermectin dose dependently inhibit SARS-CoV-2 Papain-like Protease with IC50of 0.94 μM, 0.88 μM, 1.14 μM, 1.07 μM, 1.51 μM respectively and the main protease(MPRO) with IC50of 1.35 μM, 1.25 μM, 7.36 μM, 1.15 μM and 2.44 μM respectively. The IC50for all the drugs, except ivermectin, are at the clinically achievable plasma concentration in human, which supports a possible role for the drugs in the management of COVID-19. The lack of inhibition of CPE by Ivermectin at clinical concentrations could be part of the explanation for its lack of effectiveness in clinical trials.

Background Upsurge in cardiopulmonary dysfunctions in Enugu, Nigeria, involved mainly cement workers, automobile spray painters, woodworkers, and civil servants (cleaners) and was worsened in the dry season, suggesting the need for an occupation-specific characterization of the disease features and seasonal evaluation of air quality for prevention and management. Methods We conducted a randomized cross-sectional study of eighty consenting participants (in Achara Layout, Enugu), comprising 20 cement workers (39.50 ± 14.95years), 20 automobile painters (40.75 ± 9.85years), 20 woodworkers (52.20 ± 9.77years), and 20 cleaners (42.30 ± 9.06years). The air quality, some hematological (fibrinogen-Fc, and C-reactive protein-CRP), and cardiopulmonary parameters were measured and analyzed using ANCOVA, at p 10 = 541.17 ± 258.72µg.m− 3; PM2.5=72.92 ± 25.81µg.m− 3] and the university campus [PM10 = 244 ± 74.79µg.m− 3 ; PM2.5=30.33 ± 16.10µg.m− 3], but the former was twice higher. The PM differed significantly (p 1) (F = 6.128, p = 0.001), and Peak expiratory flow rate (PEFR) (F = 5.523, p = 0.002), differed significantly across the groups. FEV1/FVC% was 1 and work duration were significantly and negatively related in cement workers (r=-0.46, r2 = 0.2116, p = 0.041, one-tailed). CRP (normal range ≤ 3.0mg/L) and FC (normal range-1.5-3.0g/L) varied in cement workers (3.32 ± 0.93mg/L versus 3.01 ± 0.85g/L), automobile painters (2.90 ± 1.19mg/L versus 2.54 ± 0.99g/), woodworkers (2.79 ± 1.10mg/L versus 2.37 ± 0.92g/L) and cleaners (3.06 ± 0.82mg/L versus 2.54 ± 0.70g/L). Conclusion(s): Poor air quality was evident at the study sites, especially in the dry season. Cement workers and spray painters showed significant risks of obstructive pulmonary diseases while woodworkers had restrictive lung diseases. Cement workers and cleaners recorded the highest risk of coronary heart disease (CRP ≥ 3.0mg/L). The similarity in Fc and CRP trends suggests a role for the inflammation-sensitive proteins in the determination of cardiovascular risk in cement workers and cleaners. Therefore, there are occupation-specific disease endpoints of public health interest that likewise warrant specific preventive and management approaches among the workers.

Graft survival after kidney transplantation may be influenced by both donors' and recipients' Apoprotein 1 (APOL1) risk variant status. There are several conflicting reports on screening, eligibility, and inclusion of APOL1 risk variant testing in the Kidney donor risk index. We developed a search strategy that included medical subject headings (MeSH), text words, and entry terms in order to search nine databases. The primary measurable outcome is the recipient's post-transplant graft survival time from APOL1 high-risk variant donors. The secondary outcomes are the proportion of APOL1 high-risk variants in end-stage kidney disease requiring a kidney transplant, the proportion in graft recipients and kidney donors; the effect of APOL1 high-risk variant on donor's kidney function post-kidney donation, recipient kidney allograft survival in APOL1 low and high-risk recipients. Confidence and comprehensive meta-analysis software will be used for the meta-analysis. Methodological, clinical, and statistical heterogeneity will be assessed. Publication bias will be visually assessed using the funnel plot. Results will be presented in forest plots with pooled survival time, standard error, and variance. Sub-group analysis will be performed using moderators such as sociodemographic characteristics, hypertension, HIV status, forms of rejection and other environmental factors. The primary outcome effect size is the standardized mean difference in survival time for APOL1 high risk variants in kidney transplants. The differences in kidney function between donors and recipients before and after transplantation would be examined. The suitability of donors with APOL1 high risk variants will be explored in terms of graft survival time, donor kidney function, and the aforementioned moderators.

INTRODUCTION The Prostate Cancer Transatlantic Consortium (CaPTC) has the goal of better understanding the burden of prostate cancer among Black men of West African descent. While prostate cancer disproportionately affects Blacks around the world, little research is done to understand what mental health and social support play a role in prostate cancer risk factors. The purpose of this 10-year longitudinal study is to establish a cohort of U.S.-born Black men, West African-born Black men who reside in the U.S, and West African Black men in Africa who would be prospectively and longitudinally followed to better understand the cause of prostate cancer and how different factors might influence it. METHODS Study staff partnered with community-based organizations, events, and stakeholders to engage with the priority population. Snowball sampling was also used for recruitment. All participants were made aware of the longitudinal nature of the study and that they would be contacted every two years for follow-up. Informed consent was done in community settings electronically and on paper. Once consent was received, participants completed the survey with a unique identifier and filled out a Cohort Contact sheet. They were given the option to complete this on their own or with the help of the study staff. Study Staff would then measure participants’ weight, height, and waistline, to be recorded on the survey form. After this, participant saliva was collected and tracked with the unique identifier. All collected data was stored on RedCap and a Chi-squared test was utilized to identify statistical significance. RESULTS 803 participants are included in this data with 77 in Cameroon, 663 in Nigeria, and 59 in the United States. When asked about emotional support, 13.6% (US) 11.8% (Nigeria), and 14.3% (Cameroon) indicated never or rarely having emotional support. 5.8% of those in the United States, 5.6% of those in Nigeria, and 7.8% of those in Cameroon felt dissatisfied or very dissatisfied with their lives. The p-value for both was found to be Citation Format: Jessica Otero, Emeka Iweala, Ademola Popoola, Paul Jibrin, Mohammed Faruk, Anthonia Sowumi, Omolara Fatiregun, Nkegoum Blaise, Catherine Oladoyinbo, Ifeoma Okoye, Abdulkadir Ayo Salako, Abidemi Omonisi, Iya Eze Bassey, Kayode Adenji, Nggada Haruna Asura, Ernest Kaninjing, Oluwole Kukoyi, Parisa Fathi, Ruth Enuka, Oluwaseyi Toye, Jennifer Crook, Folakemi Odedina. Quality of life indicators including mental health factors in CaPTC prostate cancer familial cohort study of men of African Ancestry in Nigeria, Cameroon, and United States [abstract]. In: Proceedings of the 15th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2022 Sep 16-19; Philadelphia, PA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2022;31(1 Suppl):Abstract nr B073.

BACKGROUND Black populations are disproportionately affected by prostate cancer globally. The leading countries in prostate cancer mortality are found in Africa and the Caribbean. This data is being presented as part of the Prostate Cancer Transatlantic Consortium (CaPTC) Prostate Cancer Familial Cohort Study of African Ancestry study with the purpose of identifying the various factors that influence prostate cancer risk factors. Access to care, a known cancer risk factor, not only affects a person’s ability to receive treatment but to receive accurate health information, preventative care, diagnoses, and more. Researching exactly how different social determinants, such as this one, affect cancer risk factors for specific populations is imperative to reducing their cancer burden. METHODS: This ten-year prospective study started in 2017 and has been conducted in Nigeria, Cameroon, and the United States. Participants have been recruited in clinics and different community settings. Upon consent, participants were asked to complete a validated survey with a unique identifier on epidemiological, behavioral, clinical, and anthropometric variables. They were then asked to provide a saliva sample that was also given a unique identifier. Associations of characteristics from the survey were evaluated using logistic regression models. Others were tested for statistical significance using a Chi-Squared test. RESULTS: A total of 803 responses are included in this dataset. Of these participants, 9.6% were from Cameroon, 82.6% from Nigeria, and 7.3% from the United States. More than half of the participants (54.9%) shared they did not have healthcare coverage. In addition, a chi-squared test showed 10.2% in the United States, 13.9% in Nigeria and 35.1% in Cameroon were unable to see a physician due to cost with a p-value of less than .001 indicating statistical significance. While participants in the United States did not report any cancer diagnoses, logistical regression found a significant inverse relationship between health literacy and increased risk of a cancer diagnosis. CONCLUSION Research shows a relationship between health access factors and cancer risk factors, but little research is done for specific populations. Further research should be done to measure the exact impact access to care has on cancer diagnoses for specific communities. It is very important that health equity researchers assess exactly how these factors affect the specific populations they work with to tailor evidence-based interventions to their needs. Citation Format: Jessica Otero, Emeka Iweala, Ademola Popoola, Paul Jibrin, Mohammed Faruk, Anthonia Sowumi, Omolara Fatiregun, Nkegoum Blaise, Catherine Oladoyinbo, Ifeoma Okoye, Abdulkadir Ayo Salako, Abidemi Omonisi, Iya Eze Bassey, Kayode Adenji, Nggada Haruna Asura, Ernest Kaninjing, Oluwole Kukoyi, Parisa Fathi, Ruth Enuka, Oluwaseyi Toye, Jennifer Crook, Folakemi Odedina. Influence of access to care on cancer diagnoses in the CaPTC Prostate Cancer Familial Cohort Study of African Ancestry in Nigeria, Cameroon, and the United States [abstract]. In: Proceedings of the 15th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2022 Sep 16-19; Philadelphia, PA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2022;31(1 Suppl):Abstract nr B072.

Background Evidence exists as to the criticality of the first 24 h in the management of cerebral malaria. The morbidity and the mortality rate (35%) with the current intravenous monotherapy for the initial treatment of cerebral malaria are unacceptably high. Combination therapy and a shorter course of effective medication have been shown to improve outcomes in human participants in the treatment of other diseases. This study outlines a protocol to conduct a triple blinded parallel randomized controlled trial on cerebral malaria using dual intravenous medications compared to the current standard of monotherapy. Methods This is a parallel multi-site randomized controlled superiority triple blinded trial consisting of intravenous artesunate plus quinine and a control arm of intravenous artesunate only. Eligible and assenting children aged 6 months to 17 years will be recruited from 4 tertiary hospitals by random selection from the list of tertiary hospitals in Nigeria. Participants will be randomized and assigned in parallel into two arms using random numbers generated from GraphPad Prism (version 9) by a clinical pharmacologist who has no link with the investigators, the patients, or the statistician. The primary measurable outcome is survival at 12, 24, and 48 h post-randomization. A composite secondary outcome consists of the number of children that regained consciousness, parasitaemia and defervescence at 12 and 24 h post-randomization and haematological and inflammatory markers at 24 and 48 h post-randomization. Adverse events both solicited and unsolicited are recorded all through the study post-randomization. The study is approved by the State Research Ethics Review Committee. Data analysis will be performed in GraphPad Prism version 9. Discussion The outcome of this analysis will give insight into the efficacy and safety of dual intravenous antimalaria in the treatment of cerebral malaria among Nigerian children compared with the standard of care. The safety profile of this intervention will also be highlighted. This may help inform physicians on the optimal treatment for cerebral malaria to improve outcomes and reduce recrudescence and treatment failure. Trial registration Pan Africa Clinical Trial Registry PACTR202102893629864. 23/02/2021.

Oncology clinical trials are requisite for testing the safety and effectiveness of promising treatments and deciphering new knowledge into concrete benefits for patients. They present opportunities to innovate promising, novel cancer remedies. A dearth of local evidence to guide cancer treatment in Africans is creating an increased interest in oncology clinical trials to improve patient care. This is primarily because of limitations in pathology, surgery, medical oncology, radiation, and palliation that are leading to worse cancer outcomes on the continent. Investment in oversight of Human Research Ethics committees and Medicines Regulatory Authorities in Africa has improved the potential for many countries to host clinical trials. However, the distribution of cancer trials remains poor across the continent, resulting in inadequate treatment options for patients with cancer. There are some initiatives aimed at developing research capacity to host trials in Africa. However, there is now a need to establish strategic partnerships whose aim should be to achieve harmonized, accredited Clinical Trials Units capable of running trials to meet Good Clinical Practice standards. This article discusses what has been achieved and proposes a model for quality oversight of Clinical Trials Units in Africa.

Background Graft survival post-kidney transplant may be influenced by APOL1 risk variant status of both donors and recipients. There are several conflicting reports on screening, eligibility and inclusion of APOL1 risk variant testing in the Kidney Donor Risk Index. We aimed to produce a protocol for synthesizing evidence from available data on Apoprotein L1 risk variants and kidney transplantation.Methods We developed a search strategy using MeSH, text words and entry terms. Nine databases will be searched: PubMed, Embase, CINAHL, AJOL, Google Scholar, Web of Science, Cochrane Library, Research gate and Scopus. Only observational studies retrievable in the English Language will be included. The primary measurable outcome is the recipient’s post-transplant graft survival time from APOL1 high-risk variant donors. The secondary outcomes are the proportion of APOL1 high-risk variants in End-Stage Kidney Disease requiring kidney transplant, the proportion in graft recipients and kidney donors; effect of APOL1 high-risk variant on donor's kidney function post-kidney donation, recipient kidney allograft survival in APOL1 low and high-risk recipients. Deduplication, screening and selection of identified studies will be done using Covidence software while CMA software version 3 will be used for meta-analysis. All studies will be assessed for methodological, clinical and statistical heterogeneity. Publication bias will be visually assessed using the funnel plot. Results will be presented in forest plots with pooled survival time, standard error and variance. Subgroup analysis will be performed using moderators such as socio-demographics: race, age, gender and socio-economic status; hypertension, HIV status, forms of rejection and other environmental factors.Discussion: The effect size for primary outcome is standardized mean difference in survival time for APOL1 high risk variants in kidney transplants. The changes in kidney functions of donors and recipients pre and post-transplantation would be examined. The suitability of donors who have APOL1 high risk variants will explored in relation to graft survival time, donors kidney function and moderating effects of socio-demographics and environmental determinants. Trial Registration Number: This protocol is registered in PROSPERO, with registration number CRD42021230358

Background: About 1.35 million people die annually worldwide due to road traffic accidents. Road traffic injuries cause considerable economic losses to individuals, their families, and to nations as a whole. About 93% of the world's fatalities on the roads occur in low-and middle-income countries, even though these countries have approximately 60% of the world's vehicles. Road Traffic Accidents constitute the third leading cause of trauma related deaths in Nigeria. It is a substantial public health problem that deserves a systematic review.Methods and Analysis: We developed a search strategy using MeSH, text words and entry terms. Nine databases will be searched, including PubMed, African Journal Online, Embase, Google Scholar, Scopus, Cochrane Library, CINAHL, Web of Science and ResearchGate. Only observational studies, retrievable in the English language will be included. The primary outcome is prevalence of road traffic injuries in Nigeria. The secondary outcomes include proportion of road traffic accidents in Nigeria, patterns, predictors and consequences of road traffic accidents in Nigeria. Identified studies will be screened and selected based on inclusion criteria using Rayyan QCRI screening tool, by independent reviewers with dual blinding. Data items will be extracted into predefined forms in Microsoft Excel before exporting to CMA version 3 for analysis. Every selected study will have their NIH quality scores and Cochrane risk of bias reported. Studies will be assessed for methodological and statistical heterogeneity. Publication bias will be assessed using Funnel Plots and test of asymmetry. Results will include forest plots, pooled prevalence with standard error, variance, relative weights assigned to studies and heterogeneity test. Further analysis will include subgroup analysis and meta-regression using both categorical and quantitative variables.Discussion: This protocol will enable a transparent, accurate and reliable method for determining pooled prevalence, standard error and 95% CI of road traffic injuries in Nigeria. Patterns and outcomes of RTA in Nigeria will also be assessed. Evidence generated by this protocol will likely inform policy on prevention of RTA in NigeriaTrial Registration Number: This protocol is registered with PROSPERO, with registration number CRD42021226956.

Background Granulocyte Colony-stimulating factors (G-CSF) biosimilars are recombinant biologics that are similar to a reference product, neupogen, a 175 amino acid recombinant human G-CSF. Characteristically, biosimilars are produced from living cells as high molecular weight, heterogenous compounds that are highly immunogenic. They are primarily used to treat febrile and severe neutropenia in oncology patients as well as mobilize peripheral stem cells in transplant donors. However, as biosimilars are produced by biological processes rather than chemical synthesis, their comparable effectiveness and safety are very paramount to clinical uses. We aimed to produce a protocol for consistent and accurate systematic review and meta-analysis of G-CSF biosimilars.Methods We developed a search strategy using MeSH terms, key words and entry terms to search 9 databases: PubMed, AJOL, Embase, Google Scholar, Scopus, Cochrane Library, CINAHL, Web of Science and ResearchGate. Only randomized controlled trials retreivable in the English language will be included in this study. The primary measurable outcomes in this study are uses, effectiveness and safety of G-CSF biosimilars. Identified primary studies will be screened, deduplicated and selected based on study design, inclusion/exclusion criteria and outcome measures using DistillerSR software. Studies will be assessed for methodological, clinical and statistical heterogeneity. Extractable data items for effectiveness measure are: i) proportion of patients with 50% increase in absolute neutrophil count within 3–7 days; ii) resolution of fever within 3–7 days, iii) resolution of intra-oral mucosa ulcers within 7–10 days and iv) resoluton of difficulty in swallowing within 7–10 days. Measures of safety are i) proportion of patients with immunologic reactions, ii) any other documented adverse events. Quality scores and risk of bias for individual studies will be reported. Funnel Plots will be used for assessing publication bias in selected studies. Effect size, variance, SE and % CI and heterogeneity tests will be reported on forest plots using the CMA software version 3. Subgroup analysis and meta-regression will also be included using secondary outcomes as moderators and explanatory variables. The systematic review and meta-analysis will be reported according to PRISMA 2015 Statement.Discussion Ethical approval will not be required since this study will be based on published data. G-CSF biosimilars will be compared with the reference product, neupogen (filgrastin). The uses, effectiveness and safety of the biosimilars will be discussed. The study will also examine short and long acting biosimilars and compare their overall effectiveness. The strength of evidence from this study will be assessed using the NIH Quality assessment for systematic review and meta-analysis.Trial Registration Number The study is registered with PROSPERO, with registration number CRD42021232375

Background: Currently in Nigeria, SARS CoV-2 infection control measures rely solely on RT-PCR testing of cases with high index of suspicion for COVID-19. The sero-prevalence of SARS-CoV-2-specific antibodies in the populations remains unknown. We aimed to determine the sero-prevalence of SARS CoV-2 IgM and IgG in screened blood donors in two selected cities in Nigeria. Methods: A total of 113 blood samples from screened and accepted blood donors were tested for both SARS CoV-2 IgM and IgG antibodies using NOVATECH ELISA kits from Eurofins Germany. Results: The age range of donor was 21-48 years. Males were 96 %. Of the 113 blood donors 42% were positive for SARS CoV-2 IgG while 41% were positive for SARS CoV-2 IgM respectively. Only 11% and 19% of blood donors had equivocal test result for IgG and IgM respectively.Conclusions: Nearly a half of accepted blood donors in Nigeria had been exposed to SARS CoV-2 infection. Although it is not a blood transmissible infection, the blood banks must take adequate preventive measures to prevent spread amongst the bank staff and potential donors. It also implies a wider spread of the infection in Nigeria.Trial Registration: The study does not require registration.

Introduction: Human Immunodeficiency Virus (HIV) infection remains prevalent co-morbidity, and among fracture patients. Few studies have investigated the role of exercise interventions in preventing bone demineralization in people who have fractures and HIV. If exercise exposed, HIV-infected individuals may experience improved bone health outcomes (BMD), function, quality of life (QoL). The study will aim to assess the impact of home based exercises on bone mineral density, functional capacity, QoL, and some serological markers of health in HIV infection among Nigerians and South Africans. Methods and design: The study is an assessor-blinded randomized controlled trial. Patients managed with internal and external fixation for femoral shaft fracture at the study sites will be recruited to participate in the study. The participants will be recruited 2 weeks post-discharge at the follow-up clinic with the orthopaedic surgeon. The study population will consist of all persons with femoral fracture and HIV-positive and negative (HIV-positive medically confirmed) aged 18 to 60 years attending the above-named health facilities. For the HIV-positive participants, a documented positive HIV result, as well as a history of being followed-up at the HIV treatment and care center. A developed home based exercise programme will be implemented in the experimental group while the control group continues with the usual rehabilitation programme. The primary outcome measures will be function, gait, bone mineral density, physical activity, and QoL. Discussion: The proposed trial will compare the effect of a home-based physical exercise-training programme in the management of femoral fracture to the usual physiotherapy management programmes with specific outcomes of bone mineral density, function, and inflammatory markers. Trial registration: The study was prospectively registered with the Pan African Clinical Trials Registry (Reference number – PACTR201910562118957) on October 21, 2019. (https://pactr.samrc.ac.za/TrialDisplay.aspx?TrialID=9425).

BackgroundOne in every four men will be affected by prostate cancer. Choice of treatment depends on factors including grade and stage of the disease, age of the patient, availability of treatment options and socioeconomic status. We aimed to develop a protocol to assess the impact of socioeconomic status on prostate cancer outcomes globally.Methods A search strategy is developed using MeSH, text words, and entry terms. Nine databases will be searched, including PubMed, African Journals Online (AJOL), Google Scholar, Scopus, Cochrane Library, CINAHL, Web of Science, Embase and ResearchGate.Only observational studies, retrievable in the English language will be included. The primary outcome of this study is the socioeconomic status of prostate cancer patients. Secondary outcomes include mortality due to prostate cancer, health related quality of life, prostate cancer recurrence, need for secondary treatment, time to return to work, treatment choice regret and hospice enrollment. Identified studies will be screened and selected based on inclusion criteria. Data items will be managed in Zotero software, Microsoft Excel and CMA software. Both quality scores and the risk of bias for individual studies will be reported. Studies will be assessed for methodological, clinical, and statistical heterogeneity. Funnel Plots will be used for assessing publication bias. DiscussionThis protocol will enable a transparent, reliable and accurate method for assessing the impact of socioeconomic status on the global prostate cancer outcomes. It will allow discussions on outcomes such as mortality due to prostate cancer and how income disparity and availability of treatment options can influence prostate cancer outcomes. The final report of this study will be published in a peer-reviewed journal and the findings will be made available to health authorities.Systematic review RegistrationThis protocol has been registered in PROSPERO, with registration number CRD42020213700

Background: The effect of antidepressants on the foetus is of great public concern on account of teratogenicity. However, evidence on this is quite controversial. This study aims to determine the risk of congenital malformations in offsprings of pregnant women placed on Selective Serotonin Reuptake Inhibitors (SSRIs) during pregnancy compared to the offsprings of pregnant women not on SSRIs. It also aims to assess if significant increase in risk occurs across trimesters. METHODS AND ANALYSIS:A search strategy is developed using MeSH, text words and entry terms. Nine databases will be searched: PubMed, Embase, CINAHL, AJOL, Google Scholar, Web of Science, Cochrane Library, Research gate and Scopus. Only Observational studies from 2009-2020, retrievable in the English Language will be included. The primary measurable outcome is risk of teratogenicity with SSRI use in pregnancy. All identified studies, imported into End note version 9, will be screened based on the inclusion/exclusion criteria; data will be exported into Microsoft excel. Extractable data will include first author’s name and year of publication, proportion of congenital malformations in women on SSRIs and women without SSRIs, trimester, time of initiation and duration of treatment. Pedro quality scores and Cochrane risk of bias for individual study will be reported. All studies will be assessed for methodological, clinical and statistical heterogeneity. Publication bias will be assessed using the funnel plot. Subgroup analysis will be performed. The different trimesters and time of initiation of treatment will be used as moderators. Meta-regression will be done using duration of treatment. The CMA version 3 will be used for statistical analysis and forest plots. Discussion:The study will require no ethical approval, it is based on published data. The results obtained from this review will provide relevant information on the use of SSRIs in pregnancy and the risk of congenital malformations. Furthermore, it will provide vital information on the levels and trend of risk at each trimester. The final report will be made available to mental health experts providing care to pregnant women.Trial Registration Number: This protocol is registered in PROSPERO, with number CRD42020213505

BackgroundNephrotic syndrome (NS) is one of the most common childhood renal disorders globally, with an incidence of 2 to 7 cases per 100,000 children. A characteristic feature is massive proteinuria which may rapidly progress to end stage kidney failure, if uncontrolled. Most of the cases in children are steroid sensitive but associated with frequent relapses. Levamisole, a cheap antihelminthic has been used as steroid sparing agent in steroid sensitive NS (SSNS). This study assesses the efficacy and safety of Levamisole in African children with idiopathic nephrotic syndrome.MethodsWe will conduct a systematic review and meta-analysis of all Randomised controlled trials which reported African children with Idiopathic nephrotic syndrome who were on Levamisole compared to other drugs. Ten databases including PubMed, African Journals Online, Google Scholar, Cumulative Index to Nursing and Allied Health Literature, EMBASE, Cochrane Library, Web of Science, Scopus, Clinicaltrial.gov and Research Gate will be searched using a search strategy. The search will have no time restrictions, but studies must have been conducted among African children residing in Africa and are retrievable in the English Language. Studies will be selected based on inclusion and exclusion criteria by two independent reviewers without blinding. The study quality will be assessed using the Pedro scale and risk of bias evaluated using the Cochrane Risk of Bias tool. Eligible screened studies will be inlcuded for meta-analysis using the CMA Software. Statistical, clinical and methodological heterogeneity will be tested. Subgroup analyses and meta-regression will be performed on rate of relapses, adverse event and drug dose.DiscussionThe primary outcome will be the proportion of children with remissions and or relapses within 6 -12 months post initiation of levamisole or comparators with effect size being the relative risk. Safety of Levamisole will be measured using reported adverse events. Moderating effects of age, gender, duration of illness, and dosage of Levamisole on the duration of remission, frequency of relapses and adverse events will be examined.Systematic Review RegistrationThis protocol has been registered in PROSPERO, with registration number CRD42020213327.

Introduction One of the confirmed risk factors for prostate cancer (CaP) is race, with Black men (BM) more likely to get and die from CaP globally. Although CaP affects BM globally, little is known about CaP and its risk factors in foreign-born BM and the source population of US BM in Africa. The Prostate Cancer Transatlantic Consortium (CaPTC) studies CaP in BM globally and has an ongoing familial cohort study of West African men in the US, Nigeria and Cameroon. The CaPTC cohort data provides an opportunity to examine the impact of migration on CaP behavioral risk factors. This study focuses on oxidative stress, which has been linked to CaP. The primary objective was to examine nutrients and supplements that inhibit oxidative stress among West African men. Methods The CaPTC cohort study is a prospective, longitudinal study of West African men, between ages 35 -70. Participants were recruited from diverse community settings and clinics. Data collection included the use of structured survey for behavioral and epidemiological data, and saliva samples for biological data. For this study, the variables were: known foods with high levels of antioxidants (vitamins); and dietary polyphenols such as berries, beans, leafy vegetables and tea. Descriptive statistics was used to summarize the study results while ANOVA was used to compare study variables among West African men in the US, Nigeria and Cameroon. Results A total of 704 West African men (WAm) participated in the study, with 9% recruited in the US, 81% in Nigeria and 10% in Cameroon. Most of the participants were married (93%) and in the middle-income SES. Participants in Cameroon were older with a mean age of 53, followed by those in Nigeria (48) and participants in the US (47). WAm in Nigeria were more likely to have prostatitis compared to the other two groups. There was no differences among the three groups with respect to history of CaP and BPH. The three groups were significantly different statistically for the following food groups: (1) sweet potato, mostly consumed by WAm in Cameroon; (2) beans, mostly consumed by WAm in Nigeria; and (3) berries, mostly consumed by WAm in the US. There was no differences among the groups with respect to leafy greens, grape, tea and Vitamin E. The most popular food reported by the WAm were: beans in Nigeria and berries in the US. In Cameroon, the most popular food tied between beans and sweet potatoes. Conclusion Dietary intake of foods rich with antioxidants and polyphenols have been known to be associated with decreased risk of chronic diseases such as CaP. It is interesting to note that the WAm in the different countries consume different types of food groups rich in antioxidants. More research is needed on the antioxidant content of the food as the preparation of the meals may affect content. Also, there needs to be an emphasis on increasing these nutrient rich foods in diets of WAm, given that they are also disproportionately affected by CaP. Citation Format: Folakemi Odedina, Adaora Ezeani, Ernest Kaninjing, Malcom Ingraham, Catherine Badejo, Anthonia Sowunmi, Omolara Fatiregun, Ayo Salako, A.A. Popoola, Mohammed Faruk, Emeka Iweala, Iya Bassey, Chidiebere Ogo, O.P. Oluwole, H.A. Nggada, Jubrin Paul, Oluwole Kukoyi, Ifeoma Okoye, Abidemi Omonisi, Iheanyi Okpala, Lasebikan Nwamaka, Adeniji Adebanji, Ruth Agaba, Toye Adeniji, Yaseen Elhag. Oxidative stress-inhibiting nutrients and supplements among West African men: The CaPTC prostate cancer cohort study [abstract]. In: Proceedings of the Twelfth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2019 Sep 20-23; San Francisco, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(6 Suppl_2):Abstract nr C028.

INTRODUCTION Prostate Cancer (CaP) disproportionately overburden men of African ancestry, especially Black men (BM). Unfortunately, few CaP studies have focused on the heterogeneity of BM within the US as well as the source population of US BM in Africa. The Prostate Cancer Transatlantic Consortium (CaPTC) team has documented differences in CaP-related behavioral factors, health-seeking behaviors and experiences between US-born and foreign-born Blacks since 2005. The CaPTC familial cohort study was developed to understand the genetic, environmental and behavioral etiology of CaP in West African men (WAm). This presentation focuses on the impact of migration on prostate health factors among WAm. Methodology The CaPTC cohort study in a longitudinal study and is still ongoing. The inclusion criteria are WAm, age 35-70 years, and residing in the US, Nigeria and Cameroon. Participants were recruited in diverse community settings. Data were collected from participants who provided informed consent using the CaPTC-AC3 Global Prostate Cancer Measure. The variables included in this presentation are general demographics, cultural beliefs and values, health beliefs, sun exposure, vitamins, body shape, and baldness. In addition, self-reported measures of prostate health were assessed. In addition to descriptive analyses, ANOVA/comparative analyses was used to examine differences among WAm in the US, Nigeria and Cameroon. Results The scales employed for the construct were highly reliable (alpha over 0.80). By December 2018, the sample size was 704 WAm with 81% recruited in Nigeria, 10% recruited in Cameroon and 9% recruited in the US. The average age was 48. Most of the WAm live in Nigeria, are married, middle-income level, Christian by faith and had never been screened for CaP. There was statistically significant differences among the WAm based on their country of residence with respect to CaP history (Nigeria), skin color (darker skin color in Cameroun), vitamin use (mostly by WAm in US), and pattern of baldness at age 30 (WAm in Nigeria). In addition, there was statistically significantly differences relative to cultural beliefs and values (cancer fatalism, religiosity, temporal orientation) and health beliefs (perceived barrier, perceived benefit). Cancer fatalism was lowest among WAm in US; religiosity was highest among WAm in Nigeria; WAm in the US were more future-oriented and WAm in Cameroun more present-oriented; perceived barrier was lowest for WAm in US; and perceived benefit highest for WAm in the US. Conclusion The increasing number of the African immigrant group in the US underscores the need to study within group difference among Blacks in the US. Unfortunately, this group is understudied and may offer a novel approach to fully understand cancer disparities in Blacks. Studying the impact of migration on CaP burden in this population provides several advantages, including identification of CaP risk factors. Our study confirms that migration impacts prostate health factors among WAm. Note: This abstract was not presented at the conference. Citation Format: Folakemi Odedina, Getachew Dagne, Adaora Ezeani, Ernest Kaninjing, Catherine Badejo, Anthonia Sowunmi, Omolara Fatiregun, Ayo Salako, Ademola Popoola, Mohammed Faruk, Emeka Iweala, Iya Bassey, Chidiebere Ogo, HA Nggada, Paul Jibrin, Oluwole Kukoyi, Ifeoma Okoye, Abidemi Omonisi, Iheanyi Okpala, Kayode Adeniji, Ruth Agaba, Oluwaseyi Adeniji, Desiree Rivers, Renee Reams, Clayton Yates. Impact of migration on prostate health factors among West African men in US, Nigeria and Cameroon: Findings from the CaPTC familial cohort study [abstract]. In: Proceedings of the Twelfth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2019 Sep 20-23; San Francisco, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(6 Suppl_2):Abstract nr C024.

Background Healthcare disparities among racial and ethnic groups have been well documented across all aspects of clinical healthcare, and disparities in attainment of preventive services are particularly prevalent. African immigrants may be particularly susceptible to factors that contribute to healthcare disparities but little is known about this population. The purpose of this study was to assess patient-provider concordance and trust of health care providers among West African immigrants in the US. In addition, we explored the relationship between these variables and the prostate cancer (CaP) screening behavior of participants. Methods Data collection was part of a global study of prostate cancer in West African men. A study questionnaire was used to collect data from West African male immigrants in the US between the ages of 35 and 70 years. Survey scales for this study included country of birth, years since immigration, patient–provider concordance, trust of healthcare provider, attitude and cues towards CaP screening (PSA and DRE), and CaP screening history. Results There were 38 African immigrants from Cameroon, Nigeria, Sierra Leone, and Ghana. Participants’ average age was 46.2 years and they had spent an average of 13.9 years in the US. Most of the participants (over 60%) stated that they had no preference in regards to their provider race, ethnicity or gender. Over 70% indicated that their physician was of different ethnicity and race while 50% indicated that their physician was of a different gender. Furthermore, most respondents noted that they trusted their physicians with health decisions. However, 61% and 68% of participants did not complete PSA or DRE testing, respectively. Most stated that they did not discuss the advantages or disadvantages of prostate cancer screening with their physicians, noting they mostly received cues to getting tested from reading information, radio, and/or TV. Conclusion Although health disparities can be explained by socioeconomic status such as lack of insurance and various other observable impediments to accessing health care, others barriers persist. It is important to explore other contributing factors such as patient-physician relationships. This study suggests that patient-provider concordance may not be a priority. Emphasis should be placed on encouraging physician-initiated discussion on CaP screening. Unfortunately, current physician guidelines do not stress CaP screening and fail to account for the documented increased risk and early onset of CaP in Black men. Citation Format: Nissa Askins, Ruth Agaba, Oluwaseyi Adeniji, Adaora Ezeani, Ernest Kaninjing, Folakemi Odedina, Catherine Badejo, Anthonia Sowunmi, Omolara Fatiregun, Ayo Salako, A. A Popoola, Mohammed Faruk, Emeka Iweala, Iya Bassey, Chidiebere Ogo, O. P. Oluwole, H. A. Nggada, Paul Jibrin, Ifeoma Okoye, Abidemi Omonisi, Iheanyi Okpala, A Adeniji, Toye Adeniji. Patient and provider concordance and trust in providers among West African Immigrants: Findings from the CaPTC Familial Cohort Study [abstract]. In: Proceedings of the Twelfth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2019 Sep 20-23; San Francisco, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(6 Suppl_2):Abstract nr D034.

Background African immigrants represent one of the fastest growing groups of immigrants in the US, resulting in increased diversity of Blacks in the US. Therefore, there is a growing need to assess the healthcare needs and practices of this population. The main public health concern has been on infectious disease but priority should also focus on chronic disease. Specifically, the literature has yet to provide consistent results regarding the “healthy immigrant effect”, specifically that immigrants are in relatively better health on arrival before their health converges with native-born levels after time. Using the data collected by the Prostate Cancer Transatlantic Consortium (CaPTC), this study explores chronic disease history and healthy behaviors of male immigrants from West Africa with length of residence in the US. Methods A study questionnaire was used to collect data on West African (WA) Black men residing in Nigeria, Cameroon, and the United States. Data from 709 respondents, Black men between the ages of 35-70 years, recruited from community settings, was collected. Variables analyzed included age, education level, income, smoking and alcohol use, weight, height, physical activity levels, country of birth, country of residence, years since immigration, chronic disease history, and health insurance status. Descriptive analysis was used to determine the frequency of each condition among participants. Results There were 37 respondents, WA males, residing in the US; 26 born in Cameroon, 10 born in Nigeria, 1 born in Sierra Leone, 1 born in Ghana. The average age was 46.2 years and the average length of residency was 13.9 years. Participants were placed in two groups: length of residence in the US of less than or equal to 10 years (LT10Y) and greater than 10 years (GT10Y). This study focused on the most common chronic diseases in the US: high blood pressure (HB), high cholesterol (HC), diabetes (D), stroke/transient ischemic attack (ST), COPD, Alzheimer’s (AZ), and arthritis (AT). Although there was no statistical significant differences between participants who lived greater than 10 years in the US compared to those who resided 10 years or less, there was practical differences. For example, 39% in the LT10Y group had been diagnosed with HBP versus 42% in the GT10Y group. With larger sample size, it is likely that there may be statistical differences. There was statistical significant differences in HC diagnosis with 5% in LT10Y and 22.2% in GT10Y. The GT10Y group showed decreased alcohol use, increased frequency of physical activity, and frequent annual physician visits and had higher income and education level. Conclusion Based on our results, we found length of stay of WA Black males in the US to impact HC diagnosis, alcohol use, physical activity, and physician visits. The “healthy immigrant” phenomenon is likely to be moderated by several factors and need to be studied more among African immigrants. Citation Format: Adaora Ezeani, Ernest Kaninjing, Folakemi Odedina, Catherine Badejo, Anthonia Sowunmi, Omolara Fatiregun, Ayo Salako, A. A. Popoola, Mohammed Faruk, Emeka Iweala, Iya Bassey, Chidiebere Ogo, O. P. Oluwole, H. A Nggada, Paul Jibrin, Oluwole Kukoyi, Ifeoma Okoye, Abidemi Omonisi, Iheanyi Okpala, Lasebikan Nwamaka, A. Adeniji, Nissa Askins, Ruth Agaba, Oluwaseyi Adeniji. The effect of length of residence in the US on risk of developing chronic disease in West African male immigrants [abstract]. In: Proceedings of the Twelfth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2019 Sep 20-23; San Francisco, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(6 Suppl_2):Abstract nr C086.

Background Infant mortality in rural areas of Nigeria can be minimized if childhood febrile conditions are treated by trained health personnel, deployed to primary healthcare centres (PHCs) rather than the observed preference of mothers for patent medicine dealers (PMDs). However, health service utilization/patronage is driven by consumer satisfaction and perception of services/product value. The objective of this study was to determine ‘mothers’ perception of recovery’ and ‘mothers’ satisfaction’ after PMD treatment of childhood febrile conditions, as likely drivers of mothers’ health-seeking behaviour, which must be targeted to reverse the trend. Methods Ugwuogo-Nike, in Enugu, Nigeria, has many PMDs/PHCs, and was selected based on high prevalence of childhood febrile conditions. In total, 385 consenting mothers (aged 15–45 years) were consecutively recruited at PMD shops, after purchasing drugs for childhood febrile conditions, in a cross-sectional observational study using a pre-tested instrument; 33 of them (aged 21–47 years) participated in focus group discussions (FGDs). Qualitative data were thematically analysed while a quantitative study was analysed with Z score and Chi square statistics, at p

Amount raised: #1,627,000 (Nigerian Naira) Background and context: With a large population and very limited resources, the economic burden of cancer in our country is enormous and cannot be tackled solely by the government. A high mortality rate among newly diagnosed patients is a direct result of poverty and lack of an effective health insurance coverage for cancer, among other reasons. Breast cancer accounts for two out of five women cancers, with a 70% mortality. Aim: To alleviate the financial burden of cancer treatment on indigent patients. Strategy/Tactics: We constituted the Cancer Patient Treatment Intervention Fund (CPTIF) board of partners and funders. We also inaugurated a fundraising event, the annual Go Pink Day Ball, and instituted crowd-funding schemes. Program process: Indigent patients diagnosed at BWS and designated health facilities are referred to CPTIF for financial support. The patient is reviewed for eligibility by the medical board. If approved by the CPTIF Board of Directors, the required funds are paid directly to the designated tertiary health facility where patient will be receiving the oncology services. Costs and returns: Between December 2017 and March 2018 a total of #1,627,000 (Nigerian Naira) was raised, a total of #750,950 has been spent on 7 patients at different levels of oncology services. The cost covered included laboratory tests, ultrasounds, biopsies chemotherapy and radiotherapy. What was learned: Financial assistance gave these patients a lifeline and zeal to go through the usually overwhelming cancer treatment process.

Background and context: Early detection and improved treatments are associated with a reduction in breast cancer mortality and morbidity. UNTH is a leading comprehensive cancer center in Nigeria with referrals from the entire southeast and south south regions. Our goal is to offer high quality comprehensive cancer care services across the cancer care continuum from public health awareness campaigns and provision of screening services all the way to palliative care and survivorship. This is the first attempt by any institution in the country to standardize and harmonize available treatment options for breast cancer. Aim: To optimize, standardize and harmonize treatment options and management strategies for breast cancer using a multidisciplinary approach by developing guidelines adapted to our peculiar infrastructure and health system. Strategy/Tactics: The practice guideline was specifically developed for UNTH using a multidisciplinary approach and taking into consideration circumstances peculiar to UNTH, including the following: UNTH's specific patient population; UNTH's services and structure; and UNTH's clinical information. Program/Policy process: The process used recognized methods that are robust, objective, scientifically valid, consistent and adaptable to UNTH and engaged all identified multisectoral and multidisciplinary stakeholders involved in the care of patients with breast cancer. Outcomes: We reviewed substantial evidence on documented and proven strategies for community screening and prevention, less expensive and only marginally less effective diagnostic tools, locoregional and systemic therapies for the management of breast cancer. The team also recommended all patients receive psycho-oncology support through a dedicated team and through the breast cancer support group. It was agreed that palliative care be incorporated within the first 8 weeks of commencing treatment in line with the current ASCO guidelines and receive consultation from the exercise immunology unit. What was learned: Institutionalized care offers better management strategies and standardized treatment in line with best global practices of care for patients with breast cancer across the cancer care continuum which will ultimately translate to better treatment outcomes.

Purpose Cancer diagnosis comes with many challenges. Diagnosis is a huge burden to the patient, family, and community that subjects them to financial crisis, emotional distress, a dearth of self-esteem, and physiologic deformations. From a patient’s perspective, the treatment of cancer is complex and complicated with a weak health care system, attitude of health care workers, lack of insurance, lack of trust in orthodox medicine, and stigmatization. Patients with cancer are constantly seeking solace, people to listen to them, and people who understand their state of mind and can be a source of inspiration. Studies have shown that peer cancer support groups result in psychological benefit and improve relationships. The 2016 World Cancer Congress patient’s pavilion inspired us to start cancer support group for patients with cancers, survivors, and caregivers, known as the Abuja Breast Cancer Support Group, through the Union for International Cancer Control SPARC Metastatic Breast Cancer Challenge project. The cancer support group was primarily founded for only patients with breast cancer, survivors, caregivers, and for peer support. As of today the group has transitioned from being a patient group to also being an advocacy group with a number of activities and programs that are aimed at guiding all patients with cancer from diagnosis to survivorship. Methods This study reviewed the 1 year activities of the Abuja Breast Cancer Support Group and surveyed the impact of peer support on the 36 members of the group using a mixed-methods approach. Results Cancer support groups have the potential to revolutionize cancer care in sub-Saharan Africa, as we have seen with HIV/AIDs support groups. Use of technological tools is helpful to build connectedness. Conclusion There was an improvement in the psychological states of patients as well as in their physiologic understanding of their diagnosis by meeting together, networking, and interacting through a WhatsApp group. Our qualitative findings also indicate that patients with cancer need platforms through which to speak out, to advocate, and to change the course of cancer care if provided with the necessary training and support. AUTHORS' DISCLOSURES OF POTENTIAL CONFLICTS OF INTEREST The following represents disclosure information provided by authors of this manuscript. All relationships are considered compensated. Relationships are self-held unless noted. I = Immediate Family Member, Inst = My Institution. Relationships may not relate to the subject matter of this manuscript. For more information about ASCO's conflict of interest policy, please refer to www.asco.org/rwc or ascopubs.org/jco/site/ifc . No COIs from the authors.

Background and context: Information is key. The Nigerian Communications Commission released a statement in December 2017 that 98.3 million people in Nigeria use the Internet. The increasing number of people that use social media and the unlimited access is a reason to do some level of awareness on these platforms. A huge opportunity to pass information and save lives in the process will be missed by not engaging social media. Aim: To increase awareness for prevention and early detection of cancer via social media and forming an online community in the process. Strategy/Tactics: Creation of cancer-related engaging contents with words, pictures and videos such as general information about cancer, preventive measures among others to get the attention of the audience and consistent posting of these contents. Informing the general public of our free screening exercises and activities. Program/Policy process: Creation of a content calendar for our posts on specific days and times, targeting of online audience through age, sex and location among others considering the campaign we want to push at a given time. Outcomes: After 3 months, we had 48,765 reach and 17,223 impressions on Facebook, 47,599 impressions on Twitter and 15,177 impressions on Instagram from 30 posts each. A very significant increase in the number of people that showed up to our vaccinations, screenings and other activities/programs. Positive response from people who were reached via social media, they were thankful for the basic information they got which they had no idea about. Dozens of people volunteered to work for our organization to help get rid of cancer. What was learned: Social media enabled us to reach a good number of people easily. Our target audience was very grateful for the information they got. In summary, the use of social media in raising awareness and passing information was very effective.

Background: Health-related quality of life is an important end point in breast cancer care. Assessing quality of life in breast cancer patients could contribute to improved treatment outcome and could even serve as monitor along with medical parameters. The need for psychosocial support is well established among breast cancer patients with levels of psychological distress and depression, particularly after diagnosis and treatment. Cancer support helps patients to cope with cancer by adjusting their attitudes, knowledge, and expectation about the disease. Aim: To determine the impact of support group intervention on quality of life of patients with advanced breast cancer To create awareness, educate, counsel and support as well as to mediate in the weaknesses of the medical care system in dealing with breast cancer patients. Methods: A prospective cohort study involving breast cancer patients using a system of breast cancer support group that organizes a two month period meeting for all breast patients in University of Nigeria Teaching Hospital Enugu. Educational information on breast cancer, nutritional needs, exercise and the need for regular follow-up in breast cancer care were given to them as well as the means of overcoming the psychosocial burden in cancer. QOL assessment evaluating the four domains (physical, social, psychological and environmental) on selected patients with advanced breast cancer using WHO BREF was administered. Results: A total of 113 breast cancer patients were involved in this study. At the end of the intervention, 14 women (12.4%) were censored due to death, while postassessment was carried out for only 99 women. Postintervention analysis showed that there was a significant positive correlation between availability of social support to respondents (FS score) and the four quality of life domains ( P < 0.05). Further analysis also showed that respondents' quality of life significantly increased across all domains at postintervention ( P < 0.05). Conclusion: Patients receiving support group intervention all had improved quality of life.

Background and context: Prostate cancer is the commonest cancer affecting Nigerian men, with worse outcome compared with men from the developed world. There is limited public awareness about prostate cancer in Nigeria. Oga Blue 4 Prostate Awareness (OB4PA) was created by a consortium of Nigerian nonprofits for prostate cancer advocacy (PCA). Aims: -Design PCA using videos, printed brochure and social media -Implement PCA in five Nigerian states -Evaluate the reach and impact of PCA campaign Program/Policy process: Community-based participatory process, involving the medical community, prostate cancer survivor, and the public was used. Multimedia teaching was used to enhance learning and retention; social media was used to engage groups and individuals. Content development involved iterative consultation among project leaders, medical experts and target audience, often on social media. High-quality teaching videos were recorded in English and Nigerian Pidgin languages. Videos ensured consistency and ease of broadcast. Videos were accessed by OB4PA partners through cloud computing (OneDrive). Facebook was used to promote the campaign, engage local audience, and for Facebook Live presentation. Local health professionals projected the video in appropriate language to audiences in religious and community groups. Brochure detailing clinical features and local service providers was distributed. Audience evaluation was obtained following each interaction. Outcomes: In 6 weeks, 20 presentations were made to 1800 persons. The Facebook Live presentation had 1500 views, reached 9302 people and was shared 107 times. A total of 25 Facebook posts were made, resulting in 628 like, 1908 video views, 160 shares, and reached 14,222 people. Almost all participants had positive feedback on the free and detailed advocacy. Most questions focused on the causes and prevention of prostate cancer, especially on the use of nutritional supplements. What was learned: Cloud computing enabled us to have one presenter; this eliminated the need to find a presenter for each organization. Audience appreciated simplified videos used in explaining the disease process and need for personalized early detection. Facebook live presentation attracted the most reactions on social media, with most comments showing that people liked the intervention. Audience feedback showed that adding advocacy cellphone video by a survivor helped demystify prostate cancer. Having the main presentation video in different file formats and sizes enhanced sharing on social media, as most Nigerians access the Internet on cell phones. Reliable access to projectors was challenging, especially in remote areas. Overall, use of cloud computing and social media were crucial in the success of the PCA project. Lessons from OB4PA informed the design of the current We Can, I Can Conquer Cervical Cancer Awareness project in Nigeria.

Background. About 65% of cancer deaths globally occur in low to middle income countries (LMICs) where prioritization and allocation of resources to cancer care are often quite poor. In the absence of governmental focus on this problem, public-private partnerships may be an avenue to provide effective cancer control. Methods. This manuscript highlights the establishment of a nongovernmental organization (NGO) to stimulate the development of partnerships between oncology professionals, private enterprise, and academic institutions, both locally and internationally. Examples of capacity building, grant support, establishment of collaborative networks, and the development of a facility to provide clinical care are highlighted. Results. Collaborations were established between oncology professionals at academic institutions in the US and Nigeria. Cancer control workshops were conducted in Nigeria with grant support from the Union for International Cancer Control (UICC). A monthly tumor board conference was established at LASUTH in Lagos, and further capacity building is underway with grant support from the United States NCI. An outpatient, privately funded oncology clinic in Lagos has been launched. Conclusion. In LMICs, effective partnership between public and private institutions can lead to tangible strides in cancer control. The use of creative healthcare financing models can also support positive change.

Objectives To determine the effect of music on the anxiety levels of patients undergoing a hysterosalpingography procedure. Patients and methods One hundred hysterosalpingography referrals were randomly assigned to either the experimental or control group. Music chosen earlier by the patients was played during the hysterosalpingography procedure for the experimental group. The control group was studied without music. Certain physiological parameters and the State-Trait Anxiety Inventory were used to assess the patients' anxiety levels before and during the investigation. Patient's willingness to have a repeat procedure, should it become necessary, was also assessed in both groups as a measure of acceptability of the investigation. The z-test was used to analyze the results for any statistically significant differences between the experimental and the control groups. Results The blood pressure (BP) monitored during the procedure was reduced in 31 (62%) of the patients in the experimental group compared to their pre-investigation values. Reduction in the pulse rate (PR) in 28 (56%) of the patients was also noted in the experimental group. On the other hand, the blood pressure of 37 (74%) of the patients and the pulse rate of 32 (64%) patients in the control group were increased from their pre-investigation values. The physiological parameters in the experimental group were significantly lower than the values in the control group during the investigation (p Conclusion Music reduces the physiological and cognitive responses of anxiety in patients undergoing hysterosalpingography and can be harnessed for clinical use. The use of music therapy made the procedure to be more acceptable by the patients.

A decline in the CD4 count is a common feature in HIV/AIDS, suggesting a compromise in immunity of patients. In response, highly active antiretroviral therapy (HAART) is prescribed to slow-down a diminution in the CD4 count and risk of AIDS-related malignancies. However, exercise may improve both the utility and population of innate immune cell components, and may be beneficial for patients with HIV infection. Comparing the effects of different exercises against HAART, on CD4 count, helps in understanding the role and evidence-based application of exercises to ameliorate immune deficiency.

Aims and Objectives : The purpose of this study is to present an experiential audit of initial data accumulated in 3 years since inception in 2007 of mammographic and sono-mammographic work at the Radiology Department of the University of Nigeria Teaching Hospital, Enugu. Materials and Methods In the three years under review 443 patient records were examined. Results : Majority of the women were in the mid-forties.Breast pain was the leading complaint (54.8%). This was followed by complaint of breast mass (34.5%). The predominant breast pattern encountered is the fibro-glandular type. Reduction in cost of imaging when combined with awareness campaign appeared encourage health-seeking behaviour. Beyond basic imaging, cases of suspicious nipple discharge unfortunately underwent no further radiologic work up like ductulography to establish definitive diagnosis. Conclusions : This paper concludes that the culture of breast imaging for diagnostic and screening purposes is evolving in South-East Nigeria where the breast imaging unit of the institution has played a pioneering role. Sensitization advocacy to the general public about breast diseases and the local availability of breast imaging services, followed by reduction of cost of access to such services impacts positively on service utilization. There is need to encourage earlier screening as most patients screened are close to the peak incidence of breast carcinoma in this environment. Key words : Mammography, Sono-mammography, Breast screening

This article describes in detail the Self-Directed Process Approach (SDPA) to teaching writing which has been used effectively in teaching Technical Report Writing to a large class of engineering students. What is unique about SDPA and what makes it particularly suitable for large classes is that students are taught, through the use of guidelines, checklists, a type of text analysis and detailed step-by-step instructions, how to be their own evaluator and how to take the responsibility of improving their own work. SDPA, which also uses peer feedback and is practice-oriented, reduces the teacher's marking load. By the time the students submit their work to the teacher, they will have improved it considerably, having checked by themselves most of the things a teacher usually checks in a student's written work.

Aim. The aim of the study was to determine the ultrasonic gallbladder wall thickness in normal adult Nigerians so as to create standards for defining gallbladder abnormalities in Nigerians. Method. Four hundred adults comprising 228 (57%) women and 172 (43%) men aged 16 - 78 years, who had normal clinical history and physical findings, were recruited. The gallbladder wall thickness was obtained in the supine, prone and right anterior oblique positions. Differences in gallbladder wall thickness were determined using the chisquare test, while the relationship between the ultrasound-measured gallbladder wall thickness and the subjects’ age, sex, height and weight were analysed using the Pearson product moment correlation. Normal ranges and related statistics were estimated and tabulated according to age group and sex. Results. The mean age of the subjects was 32±13.2 years. The mean gallbladder wall thickness range was 1.8 - 2.8 mm±0.5mm. The thickness range for females was 1.7 - 2.7 mm±0.5 mm, and that for males was 1.9 - 2.9 mm±0.5 mm. There was a statistically significant difference (p

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