Spatio-temporal Description of AIDS-related Cancers Incidence in North and Sub-Saharan Africa and of Mortality in HIV-infected Patients in Algeria and Hepatitis C Prevalence in Patients with Non-Hodgkin Lymphoma in Algeria PDF Download
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Author: Karima Chaabna
Publisher:
ISBN:
Category :
Languages : en
Pages : 0
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Background: In Africa, the prevalence of HIV/AIDS and hepatitis C virus (HCV) has been the highest in the world. Furthermore, cancer incidence is increasing. Objective: This thesis work presents a part of the impact of these infections on the cancer burden in northern and sub-Saharan Africa. AIDS-related cancers, namely Kaposi sarcoma (KS), non-Hodgkin lymphoma (NHL), and cervical cancer, were described to assess the impact of HIV/AIDS on cancer epidemiology in Algerian, Tunisian, Egyptian, Ugandan, and Zimbabwean populations. Furthermore, for the impact of HCV infection, the epidemiology of NHL as an extra-hepatic HCV-related cancer was also studied. Results: Ugandan HIV/AIDS prevalence has declined since the early 1990s, and in Zimbabwe, after an increase until the end of the 1990s, rates have gone down. In Algeria, the retrospective study performed during this thesis work showed that risk of death and standardized mortality ratio, comparing the mortality of HIV-positive patients with that of the general population, have decreased after the introduction of highly active antiretroviral therapy (HAART) in 1998 in Algeria. However, the late stage of the disease among HIV/AIDS patients at diagnosis warns of the high risk of HIV/AIDS transmission. These observations suggest that Algeria needs to couple HAART use with a more effective prevention programme to fight the increase in the number of HIV/AIDS cases. KS incidence was higher in the sub-Saharan African populations studied than in the northern African populations; however, among women it was similar in Uganda and Zimbabwe. With the emergence of the HIV/AIDS epidemic, KS incidence increased dramatically in both sub-Saharan African populations studied, and it has followed the HIV/AIDS time trend in Zimbabwe. However, in Uganda although HIV/AIDS prevalence has decreased, KS incidence has remained stable among women and elderly men (>50 years old). The decrease in KS incidence was observed only in young Ugandan men (
Author: Karima Chaabna
Publisher:
ISBN:
Category :
Languages : en
Pages : 0
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Background: In Africa, the prevalence of HIV/AIDS and hepatitis C virus (HCV) has been the highest in the world. Furthermore, cancer incidence is increasing. Objective: This thesis work presents a part of the impact of these infections on the cancer burden in northern and sub-Saharan Africa. AIDS-related cancers, namely Kaposi sarcoma (KS), non-Hodgkin lymphoma (NHL), and cervical cancer, were described to assess the impact of HIV/AIDS on cancer epidemiology in Algerian, Tunisian, Egyptian, Ugandan, and Zimbabwean populations. Furthermore, for the impact of HCV infection, the epidemiology of NHL as an extra-hepatic HCV-related cancer was also studied. Results: Ugandan HIV/AIDS prevalence has declined since the early 1990s, and in Zimbabwe, after an increase until the end of the 1990s, rates have gone down. In Algeria, the retrospective study performed during this thesis work showed that risk of death and standardized mortality ratio, comparing the mortality of HIV-positive patients with that of the general population, have decreased after the introduction of highly active antiretroviral therapy (HAART) in 1998 in Algeria. However, the late stage of the disease among HIV/AIDS patients at diagnosis warns of the high risk of HIV/AIDS transmission. These observations suggest that Algeria needs to couple HAART use with a more effective prevention programme to fight the increase in the number of HIV/AIDS cases. KS incidence was higher in the sub-Saharan African populations studied than in the northern African populations; however, among women it was similar in Uganda and Zimbabwe. With the emergence of the HIV/AIDS epidemic, KS incidence increased dramatically in both sub-Saharan African populations studied, and it has followed the HIV/AIDS time trend in Zimbabwe. However, in Uganda although HIV/AIDS prevalence has decreased, KS incidence has remained stable among women and elderly men (>50 years old). The decrease in KS incidence was observed only in young Ugandan men (
Author: Edgar P. Simard
Publisher:
ISBN:
Category : AIDS (Disease)
Languages : en
Pages : 115
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Context: Profound immune suppression is the hallmark of infection with the human immunodeficiency virus (HIV) and the principal sequela of chronic HIV disease is progression to acquired immunodeficiency syndrome (AIDS). There are over half a million people living with AIDS in the U.S. today and many more with HIV infection who have yet to develop AIDS. HIV-associated immune deficiency, coinfection with oncogenic viruses and elevated prevalences of smoking and alcohol use, place persons with HIV/AIDS at increased risk for a number of cancers. Highly active antiretroviral therapy (HAART), widely available since 1996, results in partial immune restoration among persons with HIV/AIDS. Concurrent with increased HAART use, declines in AIDS-related mortality and in the incidence of some cancers have been observed. However, as survival increases among persons with AIDS, little is known about their long-term cancer risk. Further, as rates of AIDS-related deaths decline, cancers may emerge increasingly important sources of mortality in this aging population. Specific Aims: The aims of this dissertation were to: (1) determine cancer risk among persons with longstanding AIDS in years 3-5 and years 6-10 after AIDS onset, (2) to evaluate the impact of HAART on cancer incidence in years 3-10 after AIDS onset, (3) to quantify the cumulative incidence of AIDS-defining cancer and non-AIDS-defining cancer, controlling for trends in mortality, and (4) to determine the fraction of deaths among persons with AIDS attributable to cancer. Design, Setting, and Patients: Data from the population-based U.S. HIV/AIDS Cancer Match Study (HACM) were used to address the aims of this dissertation. Records of persons with HIV/AIDS in surveillance registries from 9 states and 6 metropolitan areas (diagnosed during 1980-2008) were linked to corresponding cancer registry records using a probabilistic matching algorithm. Records were linked on demographic characteristics which were assigned a weight to represent their importance. AIDS onset date was recorded according to the 1993 Centers for Disease Control and Prevention surveillance case definition. Incident, invasive cancers were coded according to the International Classification for Diseases for Oncology (third edition). Subsequent to the match, all identifying information was removed. For Aims 1 and 2, we constructed a cohort of 263,254 adults and adolescents with AIDS (diagnosed during 1980-2004) and evaluated incident cancers occurring during years 3-5 and 6-10 after AIDS onset. Standardized incidence ratios (SIRs) assessed risks relative to the general population. Rate ratios (RRs) derived from Poisson regression compared cancer incidence before and after 1996 to assess the impact of HAART. For Aims 3 and 4, we constructed a cohort of 372,364 adults and adolescents with AIDS who were alive, caner-free, and under follow-up for cancer at the start of the fourth month after AIDS onset. We used competing risk methods to determine cumulative incidence of cancer (AIDS-defining cancers [ADCs] and non-AIDS-defining cancers [NADCs]) and Cox regression to estimate cancer-attributable mortality across 3 calendar periods (AIDS onset in 1980-1989, 1990-1995, and 1996-2006). Results: Aims 1 and 2 demonstrated risks of ADCs (Kaposi sarcoma, non-Hodgkin lymphoma, cervical cancer) were significantly elevated during 3-5 and 6-10 years after AIDS, and incidence of Kaposi sarcoma and non-Hodgkin lymphoma declined significantly between the pre-HAART (1990-1995) and HAART era (1996-2006). Other cancers with elevated risks in the 3-5 and 6-10 year periods, respectively, were cancers of the oral cavity/pharynx (SIR 1.9 95%CI 1.6-2.1, and SIR 1.8 95%CI 1.5-2.1) and anus (SIR 27 95%CI 24-31, and SIR 40 95%CI 35-45), and Hodgkin lymphoma (SIR 9.1 95%CI 7.8-11, and SIR 12 95%CI 9.7-14). Between 1990-1995 and 1996-2006, incidence increased for anal cancer (RR 2.9 95%CI 2.1-4.0) and Hodgkin lymphoma (RR 2.0 95%CI 1.3-2.9). Aims 3 and 4 demonstrated cumulative incidence of ADCs declined across AIDS calendar periods (from 8.7% among persons diagnosed with AIDS during 1980-1989 to 6.4% among persons diagnosed with AIDS during 1990-1995 to 2.1% among persons diagnosed with AIDS during 1996-2006). Cumulative incidence of NADCs increased from 0.86% in 1980-1989 to 1.1% in 1990-1995 with little change thereafter (1.0%, 1996-2006). However, the cumulative incidence of some site-specific NADCs (anal cancer, Hodgkin lymphoma, liver cancer and lung cancer) increased. Among those with AIDS and cancer, cancer-attributable mortality increased to 88.3% (ADC) and 87.1% (NADC) during 1996-2006, and population-attributable NADC mortality increased to 2.3% (1996-2006). Population-attributable ADC mortality decreased from 6.3% (1990-1995) to 3.9% (1996-2006). Conclusions: Among people who survived an AIDS diagnosis for several years or more, we observed continuing risks of ADCs and elevated long-term risks for selected NADCs, notably anal cancer and Hodgkin lymphoma. We also noted dramatically declining incidence of ADCs and increases in some NADCs, while controlling for temporal trends in mortality using competing risk methods. Among people with AIDS who develop cancer, their malignancy is the predominant cause of death, pointing to the need for more effective cancer treatment in this population. Further, NADCs account for a growing fraction of all deaths among persons diagnosed with AIDS in the HAART era. Continued monitoring of long-term cancer risk among persons with AIDS is warranted and should be extended to include persons with HIV infection alone. As HIV infection is increasingly considered with chronic disease management paradigms, greater attention should be focused on cancer screening and prevention strategies among person with HIV/AIDS.
Author:
Publisher: Lulu.com
ISBN: 1105103668
Category :
Languages : en
Pages : 188
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Author: International Atomic Energy Agency
Publisher:
ISBN: 9789201150134
Category : Medical
Languages : en
Pages : 544
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Cancer treatment is complex and calls for a diverse set of services. Radiation therapy is recognized as an essential tool in the cure and palliation of cancer. Currently, access to radiation treatment is limited in many countries and non-existent in some. This lack of radiation therapy resources exacerbates the burden of disease and underscores the continuing health care disparity among States. Closing this gap represents an essential measure in addressing this global health equity problem. This publication presents a comprehensive overview of the major topics and issues to be taken into consideration when planning a strategy to address this problem, in particular in low and middle income countries. With contributions from leaders in the field, it provides an introduction to the achievements and issues of radiation therapy as a cancer treatment modality around the world. Dedicated chapters focus on the new radiotherapy technologies, proton beams, carbon ion, intraoperative radiotherapy, radiotherapy for children, treatment of HIV-AIDS malignancies, and costing and quality management issues.
Author: Ellen F. M. 't Hoen
Publisher:
ISBN: 9789079700851
Category :
Languages : en
Pages : 181
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Millions of people around the world do not have access to the medicines they need to treat disease or alleviate suffering. Strict patent regimes introduced following the establishment of the World Trade Organization in 1995 interfere with widespread access to medicines by creating monopolies that keep medicines prices well out of reach for many. 0The AIDS crisis in the late nineties brought access to medicines challenges to the public?s attention, when millions of people in developing countries died from an illness for which medicines existed, but were not available or affordable. Faced with an unprecedented health crisis ? 8,000 people dying daily ? the public health community launched an unprecedented global effort that eventually resulted in the large-scale availability of low-priced generic HIV medicines. 0But now, high prices of new medicines - for example, for cancer, tuberculosis and hepatitis C - are limiting access to treatment in low-, middle and high-income countries alike. Patent-based monopolies affect almost all medicines developed since 1995 in most countries, and global health policy is now at a critical juncture if the world is to avoid new access to medicines crises. 0This book discusses lessons learned from the HIV/AIDS crisis, and asks whether actions taken to extend access and save lives are exclusive to HIV or can be applied more broadly to new global access challenges.
Author: Mohamed E. Abd El Bagi
Publisher: Springer Science & Business Media
ISBN: 3540493549
Category : Medical
Languages : en
Pages : 202
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Book Description
With parasitic diseases increasing worldwide it’s vitally important that radiologists in particular stay up to date with developments. In this brilliantly useful volume, the authors cover the imaging findings for parasitic diseases that can affect the human body using modern imaging equipments. Every chapter consists of a short description of causative agent, epidemiology, clinical manifestations, laboratory tests, and imaging findings with illustrative examples of parasitic diseases.
Author: World Health Organization
Publisher: World Health Organization
ISBN: 9241565152
Category : Medical
Languages : en
Pages : 283
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Book Description
The World Malaria Report 2015assesses global malaria disease trends and changes in the coverage and financing of malaria control programs between 2000 and 2015. It also summarizes progress towards international targets, and provides regional and country profiles that summarize trends in each WHO region and each country with malaria. The report is produced with the help of WHO regional and country offices, ministries of health in endemic countries, and a broad range of other partners. The data presented are assembled from the 96 countries and territories with ongoing malaria transmission, and a further five countries that have recently eliminated malaria. Most data are those reported for 2014 and 2015, although in some cases projections have been made into 2015, to assess progress towards targets for 2015.
Author: Nir Eyal
Publisher: Oxford University Press, USA
ISBN: 0190082542
Category : Medical
Languages : en
Pages : 345
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"In this volume, a group of leading philosophers, economists, epidemiologists, and policy scholars continue a twenty-year discussion of philosophical questions connected to the Global Burden of Disease Study (GBD), one of the largest-scale research collaborations in global health. Chapters explore issues in ethics, political philosophy, metaphysics, the philosophy of economics, and the philosophy of medicine. Some chapters identify previously-unappreciated aspects of the GBD, including the way it handles causation and aggregates complex data; while others offer fresh perspectives on frequently-discussed topics such as discounting, age-weighting, and the valuation of health states. The volume concludes with a set of chapters discussing how epidemiological data should and shouldn't be used"--
Author: Olufunso Adebola Adedeji
Publisher: Springer
ISBN: 9783319849348
Category : Medical
Languages : en
Pages : 0
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Book Description
This book discusses the current state of cancer pathway as it is relevant to sub-Saharan Africa and highlights differences in epidemiology and the underlying problems with management. It outlines the current practice and opinions in all forms of cancer, also highlighting future prospects. Starting by providing background information on the epidemiology and genomic variations, the book then goes on to look at Infection-related cancers and continues to prostate GI, breast cancer and ovarian and cervical cancer. The last part of the book focuses on delivery of affordable and accessible care. Palliative services and primary and transnational research, as well as clinical trials are also discussed. Written by a team of authors based in the UK, Nigeria, South Africa and the US. this book offers an overview of the current state and challenges of cancer care in sub-Saharan Africa, and it would be valuable to policy makers, researchers, funding organisations, and can be an adjunct to standard text books for students, residents and established doctors.
Author: Sauro Longhi
Publisher: Springer Nature
ISBN: 3030338797
Category : Science
Languages : en
Pages : 212
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Book Description
The book describes significant multidisciplinary research findings at the Università Politecnica delle Marche and the expected future advances. It addresses some of the most dramatic challenges posed by today’s fast-growing, global society and the changes it has caused, while also discussing solutions to improve the wellbeing of human beings. The book covers the main research achievements made in the social sciences and humanities, and includes chapters that focus on understanding mechanisms that are relevant to all aspects of economic and social interactions among individuals. In line with Giorgio Fuà’s contribution, the interdisciplinary research being pursued at the Faculty of Economics of Università Politecnica delle Marche is aimed at interpreting the process of economic development in all of its facets, both at the national and local level, with a particular focus on profit and non-profit organizations. Various disciplines are covered, from economics to sociology, history, statistics, mathematics, law, accounting, finance and management.
