Prostate cancer incidence and the magnitude of the risk in our population may have been grossly underestimated. The clinical prostate cancer rate in Nigerians may be as great as that noted in black men in the United States, which may suggest a common enhancing genetic predisposition.

The prevalence and correlates of erectile dysfunction (ED) in developing countries are largely unknown. Our objectives were to determine the prevalence and associated factors of ED in three countries (Pakistan, Egypt, Nigeria) that represent very different cultures. Men 35-70 y of age seeking primary medical care answered a structured questionnaire adapted to reflect local cultures. Degree of ED was categorized as 'none,' 'mild,' 'moderate,' or 'complete.' The age-adjusted prevalence rates of ED among men attending primary care clinics was 57.4% in Nigeria, 63.6% in Egypt, and 80.8% in Pakistan. Older age, diabetes, peptic ulcers, prostate disease, depression-related symptoms, and caffeine consumption were independently associated with increased prevalence of ED, whereas being moderately active to very active at work (hard physical labor) and during leisure time (strenuous exercise) was associated with half the prevalence of moderate-to-complete ED. Our multicultural study demonstrates that in every country studied, high proportions of men older than age 35 have some degree of ED (57-81%). Both severity and prevalence increase consistently with age. Factors associated with ED are similar, but their distribution differs across countries.

In order to determine the role of cadmium and zinc in the very low incidence (10/100,000) of cancer of the prostate, in African blacks which contrasts with the very high incidence (100/100,000) in American blacks, the authors measured the serum and prostatic concentrations of these trace metals in healthy Nigerian men and those with benign prostatic hypertrophy (BPH) and prostatic cancer using atomic absorption spectrophotometric study. The mean plasma zinc concentration of healthy men was 14.9 mumol/l +/- 0.5 SEM, whereas those with BPH and malignant glands were 16.5 mumol/l +/- 0.6 SEM and 11 mumol/l +/- 0.7 SEM, respectively. The mean serum cadmium concentrations were 15.2 mumol/l +/- 0.6 SEM, 15.5 mumol/l +/- 0.7 SEM, and 24.2 +/- 0.9 SEM for normal, BPH, and cancer subjects, respectively. The mean prostatic tissue zinc concentration in normal gland was 12.1 mumol/g +/- 0.8 SEM, BPH 17.9 mumol/g +/- 0.6 SEM, and cancer gland 2.9 mumol/g +/- 0.4 SEM. The mean prostatic tissue cadmium concentration for normal BPH and malignant glands were 3.8 mumol/g +/- 0.6 SEM, 14.6 mumol/g +/- 0.37 SEM. The serum and prostatic tissue values of these trace metals in our controls, BPH, and cancer subjects compare with those from populations with higher prostatic cancer rates. This suggests that these metals do not primarily play any significant role in the reported low incidence rate of prostatic cancer in our community. Furthermore, in control subjects and those with BPH, cadmium/zinc ratio, whether evaluated for serum or prostatic tissue was one or less. In patients with cancer, however, this ratio was always greater than one. The possible clinical use of this ratio to diagnose cancer of the prostate gland and to follow-up such patients needs to be further evaluated through more studies.

Summary:In order to assess the role of the gonads and anterior pituitary gland in the production of poor quality semen of males with homozygous sickle cell disease (SCD) serum gonadotrophins, namely follicle stimulating hormone (FSH), luteinizing hormone (LH), prolactin and serum testosterone, were assayed radioimmunologically in 33 men with sickle cell disease and in 29 age-matched normal control subjects.Our results show a significantly lower mean serum testosterone, a higher mean FSH and prolactin in SCD subjects than in normal controls. No single SCD subject had significantly low serum testosterone associated with low FSH, LH or prolactin.The tendency for higher gonadotrophins associated with lower testosterone in subjects with SCD suggests that the hypothalamic/pituitary function in these patients is intact and that the primary fault leading to poor sperm production lies in the testes.

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