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Life expectancy in sub-Saharan Africa (SSA) has increased owing to economic growth and improvements in medical care. An increased representation of older people among orthopaedic trauma victims is a significant consequence of population ageing, as shown in previous studies, including few in SSA. This retrospective review in Nigeria aims to corroborate previous studies and highlight the emergence of geriatric orthopaedic trauma (GOT) as a public health concern in SSA. Among 241 orthopaedic trauma in-patients aged ≥ 60, the mortality rate was 3.7%. They made up 21.2% of adult orthopaedic trauma admissions. The incidence of GOT increased steadily over the five-year study period with a spike during COVID-19 lockdown. Males constituted 51%. Mean age was 72.5 years (range, 60–105 years). Mean distance to the hospital was 35.8 km and 50.6% lived farther than 10 km. The main causes of injury were falls (50.6%) and traffic crashes (48.1%). Fractures were the predominant (91.7%) injuries. Univariate analyses revealed significant differences along age and gender stratifications. Longer distance to the hospital significantly delayed presentation. The study supports previous studies and shows that GOT is evolving as a public health concern in SSA. The 2030 Sustainable Development agenda is apt to stem the trend.
Life expectancy in sub-Saharan Africa (SSA) has increased owing to economic growth and improvements in medical care. An increased representation of older people among orthopaedic trauma victims is a significant consequence of population ageing, as shown in previous studies, including few in SSA. This retrospective review in Nigeria aims to corroborate previous studies and highlight the emergence of geriatric orthopaedic trauma (GOT) as a public health concern in SSA. Among 241 orthopaedic trauma in-patients aged ≥ 60, the mortality rate was 3.7%. They made up 21.2% of adult orthopaedic trauma admissions. The incidence of GOT increased steadily over the five-year study period with a spike during COVID-19 lockdown. Males constituted 51%. Mean age was 72.5 years (range, 60–105 years). Mean distance to the hospital was 35.8 km and 50.6% lived farther than 10 km. The main causes of injury were falls (50.6%) and traffic crashes (48.1%). Fractures were the predominant (91.7%) injuries. Univariate analyses revealed significant differences along age and gender stratifications. Longer distance to the hospital significantly delayed presentation. The study supports previous studies and shows that GOT is evolving as a public health concern in SSA. The 2030 Sustainable Development agenda is apt to stem the trend.
Global warming, the increase in heatwaves and periods of intense heat, is a major problem across the world, including in South Africa. Heat exposure has adverse health impacts, ranging from dehydration and heat stroke to death. The transport sector and its users are vulnerable to heat exposure both in vehicles and in places where they wait for transport. We investigated the heat perceptions and experiences of minibus commuters and the minibus taxi industry in minibus taxis and minibus taxi ranks to inform an intervention to prevent adverse health impacts from heat exposure in the City of Tshwane. Commuters (n = 279), drivers and marshals (n = 46) reported feeling hot in minibus taxis and minibus taxi ranks, experiencing sweating, headaches, exhaustion and dizziness. Some participants reported opening windows and doors, drinking water/cold drinks, removing a jersey and fanning themselves to try and cool down. All participants suggested solutions to address heat exposure in minibus taxis and minibus taxi ranks, including more shelters and trees for shade, the provision of water, benches and potentially an air-conditioned building for waiting/holding periods between trips. In consultation with our stakeholders, we prepared educational awareness materials about heat risks to health and actions to take when it is hot, and these were distributed through the minibus taxi sector in the City of Tshwane. Future research needs include measuring temperatures in these settings and rolling out large-scale interventions to protect health and well-being in a changing climate.
Kataegis, the focal hypermutation of single base substitutions (SBS) in tumour genomes, has received little attention with respect to prostate cancer (PCa) associated molecular and clinical features. Most notably, data is lacking with regards to this tumour evolutionary phenomenon and PCa racial disparities, with African men disproportionately impacted. Here through comparison between African (n = 109) and non-African (n = 79) whole genome sequenced treatment naïve primary tumours, using a single analytical workflow we assessed for shared and unique features of kataegis. Linking kataegis to aggressive presentation, structural variant burden and copy number loss, we attributed APOBEC3 activity through higher rates of SBS2 to high-risk African tumours. While kataegis positive African patients presented with elevated prostate specific antigen levels, their tumours showed evolutionary unique trajectories marked by increased subclonal and structural variant-independent kataegis. The potential to exacerbate tumour heterogeneity emphases the significance of continued exploration of biological behaviours and environmental exposures for African patients.
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