Browsing by Author "Akello, Suzan Joan"

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    Biomass fuel as a risk factor for esophageal squamous cell carcinoma: a systematic review and meta-analysis
    (Environmental Health, 2019) Okello, Samson; Akello, Suzan Joan; Dwomoh, Emmanuel; Byaruhanga, Emmanuel; Opio, Christopher Kenneth; Zhang, Ruyang; Corey, Kathleen E.; Muyindike, Winnie R.; Ocama, Ponsiano; Christiani, David D.
    The link between use of solid biomass fuel (wood, charcoal, coal, dung, and crop residues) for cooking and/or heating and esophageal squamous cell carcinoma (ESCC) is inconclusive. Objective: We systematically reviewed the literature and performed a meta-analysis to determine whether cooking fuel type influences esophageal squamous cell carcinoma. Methods: We searched MEDLINE, EMBASE, Web of Knowledge and Cochrane Database of Systematic Reviews for studies investigating cooking fuel and ESCC from 2000 until March 2019. We performed random effects meta-analysis stratified by the continent, World Bank’s country income classifications and fuel type and calculated pooled odds ratios and 95% CIs for the risk of esophageal squamous cell carcinoma in biomass fuel users compared with non-users. Results: Our analysis included 16 studies (all case-control) with 16,189 participants (5233 cases and 10,956 controls) that compared risk of ESCC among those using nonsolid fuels and biomass fuels. We found use of biomass fuel was associated with Esophageal squamous cell carcinoma with a pooled odds ratio (OR) 3.02 (95% CI 2.22, 4.11, heterogeneity (I2) = 79%). In sub-group analyses by continent, Africa (OR 3.35, 95%CI 2.34, 4.80, I2 = 73.4%) and Asia (OR 3.08, 95%CI 1.27, 7.43, I2 = 81.7%) had the highest odds of ESCC. Use of wood as fuel had the highest odds of 3.90, 95% CI 2.25, 6.77, I2 = 63.5%). No significant publication bias was detected. Conclusions: Biomass fuel is associated with increased risk of Esophageal squamous cell carcinoma. Biomass fuel status should be considered in the risk assessment for Esophageal squamous cell carcinoma.
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    One-year Incidence and Standardized Mortality Rates for Esophageal Squamous Cell Carcinoma in Uganda
    (Research Square, 2021) Okello, Samson; Byaruhanga, Emmanuel B.; Lumori, Boniface Amanee Elias; Akello, Suzan Joan; Dwomoh, Emmanuel; Opio, Christopher Kenneth; Ocama, Ponsiano; Muyindike, Winnie R.; David, Christiani C.; Corey, Kathleen E.
    Little is known about the survival of patients with esophageal squamous cell cancer in resource limited settings. Objectives: We sought to determine the incidence of one-year all-cause mortality and age-standardized mortality rates for esophageal squamous cell carcinoma in Uganda. Methods: Prospective cohort of 92 participants with histologically confirmed esophageal squamous cell cancer at Mbarara Regional Referral Hospital, southwestern Uganda. Participants were enrolled between January 2018 and March 2020 and followed until death. We used Kaplan-Meier methods to determine allcause mortality and median survival time; Cox regression to determine predictors of survival; and determined age-standardized mortality rates (SMR) using the WHO standard population. Results: All 92 participants contributed a total 353.8 months at risk, 89 (96.7%) died representing an incidence rate of 251.5 (95% CI 204.3, 309.6) per 1000 person-months. The difference in the one-year risk of all-cause mortality among men and women was negative 6.4 percentage points. The overall SMR was 9.96 (95%CI 7.63, 12.29) per 100,000 and median survival time was 3.03 (95% CI 2.60, 3.47), shortest (1.77 months) among men younger than 45 and longest (7.77 months) among women aged 75 years or greater. In a fully adjusted model, high socioeconomic status predicted longer survival while increasing age and low socioeconomic status predicted shorter survival. Conclusion: After diagnosis, the one-year incidence rates of all-cause mortality and age-standardized mortality rates among ESCC patients in rural Uganda are high. Initiatives to improve access to oncology care for diagnosis and treatment should be prioritized to improve overall survival.