Approximately 50% of subjects with cancer have been treated with ionizing radiation (IR) either as a curative, adjuvant, neoadjuvant or as a palliative agent, at some point during the clinical course of their disease. IR kills cancer cells directly by injuring their DNA, and indirectly by inducing immunogenic cell killing mediated by cytotoxic T cells; but it can also induce harmful biological responses to non-irradiated neighbouring cells (bystander effect) and to more distant cells (abscopal effect) outside the primary tumour field of irradiation.Although IR can upregulate anti-tumour immune reactions, it can also promote an immunosuppressive tumour microenvironment. Consequently, radiotherapy by itself is seldom sufficient to generate an effective long lasting immune response that is capable to control growth of metastasis, recurrence of primary tumours and development of second primary cancers. Therefore, combining radiotherapy with the use of immunoadjuvants such as immune checkpoint inhibitors, can potentiate IR-mediated anti-tumour immune reactions, bringing about a synergic immunogenic cell killing effect.The purpose of this narrative review is to discuss some aspects of IR-induced biological responses, including factors that contributes to tumour radiosensitivity/radioresistance, immunogenic cell killing, and the abscopal effect.

Chronic kidney disease is increasing in prevalence sub-Saharan Africa, largely driven by the growing burden of hypertension, obesity, diabetes, and HIV infection. Underlying common and rare genetic variants may add to this risk at both the individual and population levels.Here we explore the advances and challenges in the translation of genetic discovery to personalized medicine for chronic kidney disease (CKD) in children and adults living in sub-Saharan Africa. The review discusses monogenic and polygenic causes of CKD with a focus on the African-specific APOL1 and NPHS2 variants. In summary, advances in genomics research capacity herald improvement in health outcomes through personalized medicine, precision molecular diagnosis of diseases, and through public health initiatives targeting high-risk populations.

Most of the health systems in developing countries are dysfunctional and hardly responsive to the needs and demands of patients. Access to a plural healthcare system and reports of patients abandoning western medicine for indigenous medicine are signs of nonresponsive health system. The major contributing factors are the failures of the allopathic health system to recognize that indigenous medicine is a living and practised science, with its own philosophy, beliefs and practices developed over centuries. Indigenous communities and the patient's worldviews are intertwined with indigenous traditions, practices and beliefs. While the two health systems, allopathic and indigenous, coexist in Africa, they must collaborate in the management of patients. The two systems assign different etiological explanations and meanings to health, disease and illness based on worldviews, epistemologies and methodologies developed over time. Change of mindset, attitudes and practices through decolonization will lead to sustainable collaboration.