Lagos University Teaching Hospital (LUTH) is a tertiary hospital established in 1961 and is located in Idi-Araba, Surulere, Lagos State, the administrative division of Nigeria. The teaching hospital affiliated with the University of Lagos College of Medicine established in 1962. The University of Lagos College of Medicine educates students and LUTH provides them with experience through placement and work experience.
BACKGROUND:Type III female genital mutilation (FGM) is corrected by the scar tissue removal of the vaginal opening, known as deinfibulation. OBJECTIVES:To determine the current evidence on whether deinfibulation leads to improved obstetric, neonatal, gynecologic, and sexual health outcomes. SEARCH STRATEGY:The following databases were searched from inception to May 18, 2023: CINAHL Plus (EBSCOhost), MEDLINE (Ovid), PsycINFO (EBSCOhost), SCOPUS, and Web of Science. SELECTION CRITERIA:Two review authors independently screened the titles and abstracts, extracted data, and performed the risk of bias assessment. DATA COLLECTION AND ANALYSIS:Meta-analysis was conducted with RevMan, and the quality of evidence was assessed using the GRADE approach. MAIN RESULTS:Eight studies with serious risk of bias involving 3166 women were included. Very low-certainty evidence indicates that deinfibulation for women with type III FGM reduced the odds of an emergency cesarean birth (odds ratio [OR] 0.16, 95% confidence interval [CI] 0.06-0.42) and genital tract lacerations (OR 0.48, 95% CI 0.29-0.79) when compared to women with type III FGM without deinfibulation. Reduced odds of an emergency cesarean birth apply when compared to women without FGM (OR 0.59, 95% CI 0.37-0.93). Antepartum deinfibulation, compared to intrapartum deinfibulation, may lead to a reduction in the duration of labor, with little or no difference in the risk of prolonged labor (low-certainty evidence). Antepartum deinfibulation may increase the likelihood of postpartum hemorrhage and cesarean births in pregnant women with type III FGM (low-certainty evidence). We found no studies for inclusion on gynecologic, urologic, and sexual health outcomes for this update. CONCLUSIONS:The evidence of deinfibulation for women with type III FGM is available only for obstetrics outcomes. Larger observational studies in settings where type III FGM is predominantly practiced are required to improve the certainty of the evidence in these findings.
Background:Automated brain tumor segmentation on multi-parametric magnetic resonance imaging (mpMRI) is crucial in assessing patient outcomes and remains a challenge across Sub-Saharan Africa (SSA). Since 2012, the Brain Tumor Segmentation (BraTS) Challenge has evaluated state-of-the-art artificial intelligence (AI) methods to detect, characterize, and classify tumors. However, it is unclear if these methods can generalize, and hence be widely implemented, in SSA populations. To address this, the BraTS-Africa challenge was conducted in 2023 and 2024 to evaluate population-specific AI models for automated segmentation of brain tumors on mpMRI from the region. Methods:Preoperative T1-weighted, T1-contrast enhanced, T2-weighted, and T2-FLAIR brain MRI scans of 115 patients diagnosed with adult diffuse glioma were curated, annotated, and utilized for the Challenge. Participants were invited to develop and validate their methods. The participating teams were evaluated using weighted Dice Score Coefficient (DSC) and 95% Hausdorff Distance (HD95). Results:In the 2023 challenge a total of 9 teams with participants from 12 countries met the submission criteria and were ranked. The 2024 challenge featured 6 teams from 7 countries. Compared to 2023, the six top ranked methods from 2024 had higher DSC (9.4%) and lower HD95 (57.21%). Conclusions:Together, the 2023 and 2024 challenges provided a unique opportunity to include brain mpMRI glioma cases from SSA in global efforts to develop and evaluate AI methods for the detection of glioma boundaries and their quantification, where the potential of AI solutions to transform healthcare into resource-limited settings is more likely.
PURPOSEHepatocellular carcinoma (HCC) is the third leading cause of cancer-related deaths worldwide. The higher incidence and earlier onset of HCC in sub-Saharan Africa suggest a potential role for a genetic predisposition. This study evaluated the association of TERT-rs2242652-(A), a variant linked to lower HCC risk, with HCC in populations from Ghana, Nigeria, and Cameroon, compared with a population from the United States.METHODSThe study included 537 patients with HCC: United States (n = 348), Ghana (n = 79), Nigeria (n = 43), and Cameroon (n = 67). The control group had 2,872 cancer-free individuals: United States (n = 2,399), Ghana (n = 323), Nigeria (n = 85), and Cameroon (n = 65). Whole-exome sequencing was conducted using germline DNA, and data for TERT-rs2242652 were analyzed. Odds ratios (ORs) and 95% CIs were calculated using unconditional logistic regression. Chi-square tests assessed protective allele frequencies.RESULTSIn the US cohort, TERT-rs2242652 was significantly associated with lower HCC risk (OR, 0.75 [95% CI, 0.58 to 0.96]; P = .02), with an allele frequency of 18.8% (15.4% in HCC cases v 19.3% in controls). In the combined sub-Saharan African population, no significant association was observed, but there was a trend toward decreased HCC risk (OR, 0.80 [95% CI, 0.53 to 1.22]; P = .29), with an allele frequency of 12.2% (10.6% in HCC cases v 12.9% in controls). Separate analyses of Ghanaian, Nigerian, and Cameroonian populations showed similar nonsignificant trends. The protective allele frequency in the combined African populations was significantly lower than in the US cohort (P < .0001).CONCLUSIONIn sub-Saharan African populations, there was a lower frequency of the HCC protective allele TERT-rs2242652 compared with European Americans. These findings underscore the importance of multiethnic genetic studies in understanding population differences in HCC risk and developing prevention strategies.
Abstract Background: Pediatric osteosarcoma remains a major cause of cancer-related morbidity and mortality among children and adolescents in sub-Saharan Africa, where late presentation, limited diagnostic resources, and restricted access to multimodal therapy significantly affect outcomes. There is a lack of region-specific data describing the epidemiology, clinical characteristics, and treatment patterns of this disease in low-resource settings. Methods: We conducted a retrospective descriptive study of pediatric patients (≤21 years) diagnosed with osteosarcoma at a sub-Saharan African cancer centre between September 2019 and May 2025. Data were extracted from medical records and institutional databases. The Cox proportional hazards model and Kaplan-Meier survival analysis were used to predict survival. Results: 45 pediatric patients were identified. The median age at diagnosis was 15 years (range: 5-21), with a male predominance (55.6%). The majority of patients presented with advanced (66.7% ≥ stage III) or metastatic disease (51%), most commonly involving the lungs (82.6%). The long bones of the lower extremity (62.2%), particularly the distal femur (28.9%) and proximal tibia (22.2%), were the most frequently affected primary sites. Delayed presentation was common, with prolonged symptom duration prior to diagnosis (average 290 days). Surgery was performed in 31.1% (n=14). Chemotherapy formed the backbone of management, with 34 (75.6%) patients receiving systemic therapy in neoadjuvant (21, 46.7%), adjuvant (12, 26.7%), or concurrent chemotherapy (11, 24.4%) settings. Radiotherapy (RT) was administered to 27 patients (60%), functioning mostly as a curative modality in 71.1% (20/27), mainly with 3DCRT in 55.6% and IMRT in 44.4%. RT treatment completion was achieved in 26 patients (96.3%). The 1-year survival rate was 58.2%. The mean and median overall survival (OS) were 52.8 months (95% CI: 33.6-72.0) and 16.6 months (95% CI: 11.8-21.4), respectively. Survival did not differ significantly by age, sex, laterality, stage, or treatment type. Conclusion: Pediatric osteosarcoma in this cohort was characterized by prolonged diagnostic intervals, advanced-stage disease, and high metastatic burden at presentation, reflecting persistent systemic gaps in timely cancer diagnosis and access to comprehensive sarcoma care. High radiotherapy completion rates and the delivery of multimodal treatment in a proportion of patients, however, demonstrate the feasibility of structured oncologic care within resource-limited settings. These findings re-emphasize the impact of system-level constraints and the need for strengthened early diagnosis and referral pathways, diagnostic capacity, and access to multidisciplinary treatment in order to improve survival for pediatric osteosarcoma across sub-Saharan Africa. Citation Format: Adedayo Joseph, Adeseye M. Akinsete, Adewunmi Alabi, Ayodeji O. Ojetunde, Asepeoreoluwa Adeyemi. Pediatric osteosarcoma in a resource-limited setting: Data from a sub-Saharan African centre in Nigeria [abstract]. In: Proceedings of the AACR Special Conference in Cancer Research: Bridging Discovery and Clinical Impact in Pediatric Cancer; 2026 Sep 22-25; Philadelphia, PA. Philadelphia (PA): AACR; Cancer Res 2026;86(18_Suppl_1):Abstract nr B028.
BACKGROUND:Human papillomavirus (HPV) infection is a major etiological factor in cervical cancer, with increased burden among women living with human immunodeficiency virus (HIV). This study compared the prevalence and genotype distribution of HPV infection among HIV-positive and HIV-negative women in Lagos University Teaching Hospital (LUTH), Lagos, Nigeria. METHODS:A comparative cross-sectional study was conducted among 441 asymptomatic women (232 HIV-positive women attending the AIDS Prevention Initiative in Nigeria clinic and 209 HIV-negative women attending the General Outpatient Department clinic) selected using systematic random sampling. HPV DNA testing was performed to detect the presence and genotypes of HPV. Data were collected using interviewer-administered questionnaires and analyzed using chi-square or Fisher's exact tests, with statistical significance set at p < 0.05. RESULTS:The mean age ± standard deviation (SD) of the respondents was 42.47 ± 8.05 years. The overall prevalence of HPV infection was 38.8%. HIV-positive women had a significantly higher prevalence of HPV infection (50.4%) compared to HIV-negative women (25.8%) (p < 0.001). High-risk HPV genotypes were more prevalent among HIV-positive women (91.5%) than HIV-negative women (68.5%) (p < 0.001). HPV 52 was the most common genotype overall. Multiple HPV infections were more frequent among HIV-positive women, though not statistically significant. Several high-risk genotypes, including HPV 18, 45, 52, 53, 58, and 68, were significantly more prevalent among HIV-positive women. CONCLUSION:HIV-positive women bear a significantly higher burden of HPV infection, particularly high-risk genotypes. The predominance of non-HPV 16/18 genotypes highlights the need for broader vaccine coverage and strengthened cervical cancer prevention strategies.
