Double-dipping: When your research answers unintended questions

A Unger,M Reis,A.I Ko

doi:10.1016/j.aogh.2014.08.124

Abstract

Structure/Method/Design: This was a descriptive retrospective study of histologically confirmed cases of esophageal cancer diagnosed at the Kilimanjaro Christian Medical Centre, and identified through its Cancer Registry and/or endoscopy unity, from 1998 to 2008. Demographic data (age, sex, village) were obtained from hospital records and a risk-factor questionnaire was administered to patient’s relatives. Results (Scientific Abstract)/Collaborative Partners (Programmatic Abstract): 802 patients were diagnosed with esophageal cancer during the study period, the majority of which was squamous cell carcinoma. 59% of cases were male. Mean age at diagnosis was 60 years (inter-quartile range 50-70). The age-standardized incidence rates (ASR to world population per 100,000) were 6.8 and 3.8 in men and women respectively. Large geographical variations were observed. ASRs were over 9 inmen inMoshi Urban,Moshi Rural, andHai and less than 3 in Rombo, Mwanga and Same districts. 96% of male cases and 92% of female cases had drank alcohol regularly; 38% and 5% had consumed strong illicit moonshine spirits (gongo). Amongst drinkers, drinking started at mean age of 13 years, with 25% having started by age 8 and mean lifetime years of drinking was 50 (SD 15.6). 87% ofmale and 36% of female cases had smoked tobacco regularly. Summary/Conclusion: Within the high esophageal cancer area of the Kilimanjaro region, the south and western districts adjacent to the Kilimanjaro mountain peak have over 3-fold higher incidence rates than other districts in the region. Prevalence of alcohol and tobacco consumption is higher among cases than in previous population surveys. These findings need further investigation in a broader analytical study.

Highlights

Botswana’s HIV prevalence is 19%, with antiretroviral drugs available to all eligible citizens
The data supports growing evidence that Botswana faces a double-burden of infectious and noninfectious diseases. Given this epidemiologic transition, leveraging President’s Emergency Plan for AIDS Relief (PEPFAR) funded HIV-programing to expand access to care for patients with noncommunicable diseases (NCDs) is increasingly important
Little data exists on how PEPFAR programming in Africa impacts on the care for NCDs

Summary

From Communicable to Noncommunicable Diseases and Injuries

Summary/Conclusion: While laypersons and hospital personnel may receive and feel comfortable administering basic resuscitation techniques, further data must be collected to see if this intervention improves mortality. Structure/Method/Design: This was a descriptive retrospective study of histologically confirmed cases of esophageal cancer diagnosed at the Kilimanjaro Christian Medical Centre, and identified through its Cancer Registry and/or endoscopy unity, from 1998 to 2008. Prevalence of alcohol and tobacco consumption is higher among cases than in previous population surveys These findings need further investigation in a broader analytical study. Structure/Method/Design: We collected data on patients seen by HIV specialists on outreach to nine hospitals in southern Botswana. Most patients were not HIV-infected and the most frequent conditions seen by physicians were hypertension, diabetes, and congestive cardiac failure. The data supports growing evidence that Botswana faces a double-burden of infectious and noninfectious diseases Given this epidemiologic transition, leveraging PEPFAR funded HIV-programing to expand access to care for patients with NCDs is increasingly important.

Background

Hypertension in an urban slum in northeastern Brazil

Findings