This study associated Ki-67, p53, and BCL-2 markers with clinical histopathological (CH) features using currently available limited data on these markers in Tanzania. Retrospective chart review study was conducted among females with confirmed breast cancer (BC) at Muhimbili National Hospital in Tanzania between 2016 and 2017. Inclusion criteria were met by 76 patients with a mean age of 51.32 ± 14.28 years. Of these, 86.4% were stage III and IV, whereas 83.5% cases had grade 2 and grade 3. Upon immunostaining, 85.5% and 57.9% were Ki-67 and BCL-2 positive respectively. Log-linear analysis showed no statistically significant association among biomarkers expression and CH features. However, multinomial linear regression showed higher possibility for association between high expression of Ki-67, low expression of p53 and high expression of BCL-2 with age, grade, stage and tumor (T) stage. BCL-2 was positively correlated with Ki-67 expression contrary to p53, which was negatively correlated with BCL-2. Conclusively, there is evidence of correlation between the studied markers with CH features. However, studies with larger sample sizes will likely reveal significant associations that will validate the role of these markers as tools for evaluating treatment response in individualized therapeutic schemes in Tanzania.
Background Recent epidemiological studies suggest that reproductive factors are associated with breast cancer (BC) molecular subtypes. However, these associations have not been thoroughly studied in the African populations. The present study aimed to investigate the prevalence of BC molecular subtypes and assess their association with reproductive factors in Tanzanian BC patients. Methods This hospital-based case-only cross-sectional study consisted of 263 histologically confirmed BC patients in Tanzania. Clinico-pathological data, socio-demographic characteristics, anthropometric measurements, and reproductive risk factors were examined using the Chi-square test and one-way ANOVA. The association among reproductive factors and BC molecular subtypes was analyzed using multinomial logistic regression. The heterogeneity of the associations was assessed using the Wald test. Results We found evident subtype heterogeneity for reproductive factors. We observed that post-menopausal status was more prevalent in luminal-A subtype, while compared to luminal-A subtype, luminal-B and HER-2 enriched subtypes were less likely to be found in post-menopausal women (OR: 0.21, 95%CI 0.10–0.41, p = 0.001; OR: 0.39, 95%CI 0.17–0.89, p = 0.026, respectively). Also, the luminal-B subtype was more likely to be diagnosed in patients aged ≤ 40 years than the luminal-A subtype (OR: 2.80, 95%CI 1.46–5.32, p = 0.002). Women who had their first full-term pregnancy at < 30 years were more likely to be of luminal-B (OR: 2.71, 95%CI 1.18–4.17, p = 0.018), and triple-negative (OR: 2.28, 95%CI 1.02–4.07, p = 0.044) subtypes relative to luminal-A subtype. Furthermore, we observed that breastfeeding might have reduced odds of developing luminal-A, luminal-B and triple-negative subtypes. Women who never breastfed were more likely to be diagnosed with luminal-B and triple-negative subtypes when compared to luminal-A subtype (OR: 0.46, 95%CI 0.22–0.95, p = 0.035; OR: 0.41, 95%CI 0.20–0.85, p = 0.017, respectively). . Conclusion Our results are the first data reporting reproductive factors heterogeneity among BC molecular subtypes in Tanzania. Our findings suggest that breast-feeding may reduce the likelihood of developing luminal-A, luminal-B, and triple-negative subtypes. Meanwhile, the first full-term pregnancy after 30 years of age could increase the chance of developing luminal-A subtype, a highly prevalent subtype in Tanzania. More interventions to promote modifiable risk factors across multiple levels may most successfully reduce BC incidence in Africa.
This book contains the abstracts of the papers/posters presented at the Tanzania Health Summit 2020 (THS-2020) Organized by the Ministry of Health Community Development, Gender, Elderly and Children (MoHCDGEC); President Office Regional Administration and Local Government (PORALG); Ministry of Health, Social Welfare, Elderly, Gender, and Children Zanzibar; Association of Private Health Facilities in Tanzania (APHFTA); National Muslim Council of Tanzania (BAKWATA); Christian Social Services Commission (CSSC); & Tindwa Medical and Health Services (TMHS) held on 25–26 November 2020. The Tanzania Health Summit is the annual largest healthcare platform in Tanzania that attracts more than 1000 participants, national and international experts, from policymakers, health researchers, public health professionals, health insurers, medical doctors, nurses, pharmacists, private health investors, supply chain experts, and the civil society. During the three-day summit, stakeholders and decision-makers from every field in healthcare work together to find solutions to the country’s and regional health challenges and set the agenda for a healthier future.
Background: Male infertility is a frequent reproductive health problem in the world. It is usually related to abnormal spermproduction or function and these abnormalities can occur anywhere in the production of sperm including hormonal regulation, storage andtransport of sperm. Various factors are known to be responsible for seminal fluid abnormalities. Usually the first step in evaluating for maleinfertility is semen analysis. Setting: The study was conducted at Muhimbili National Hospital mainly in the department of Pathology laboratory,cytology unit. Study design: The study was a hospital based cross-sectional type. Objective: To determine semen pH in patients presenting withinfertility complains and relate how pH of seminal fluid and other semen parameters influence each other. Material and methods: Beforesemen collection, patients were instructed to abstain from sexual intercourse for a minimum of 48 hours to 7 days and collect semen bymasturbation and transport it to the laboratory through shirt pocket. Semen was to reach the laboratory for examination in not more than onehour from time of collection. Semen was examined macroscopically for volume, colour, viscosity and pH by using a pH meter (Consort C830)followed by microscopic examination which included motility of spermatozoa and sperm count by using Neuber counting chamber. The smearwas made on glass slides, fixed in 95% ethyl alcohol for 30 minutes then stained by using Papanicolaou’s staining technique and then analyzedmicroscopically for morphological examination. Results: In the analysis of the influence of semen parameters on semen pH, there wasdecrease in seminal fluid pH with age whereby as age increased the pH of seminal fluid decreased.. The general trend observed was that thepH of seminal fluid tended to decrease with an increase in the days of abstinence. pH tended to decrease with an increase of seminal fluidvolume. The pH of seminal fluid also increased with an increase in viscosity (Hyperviscosity >Hypoviscosity). The pH of seminal fluid in patientswith less than 50% forward progressive movement of spermatozoa was higher when compared to those with more than 50% forwardprogressive movement. pH had an influence on the motility of spermatozoa. Conclusions and recommendation: pH and other parameterstended to have an influence each other during seminal analysis in our study. There is a variation of pH in different parts of the World according tothe studies done. It is recommended that pH should be included during seminal analysis because our study has shown that it affects most of theseminal fluid parameters in and contribute to the problem of infertility.
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