NRU :: Browsing by Author "Weiderpass, Elisabete"

Browsing by Author "Weiderpass, Elisabete"

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Agreement between Diagnoses of Childhood Lymphoma assigned in Uganda and by an International Reference Laboratory
(Clinical epidemiology, 2012) Orem, Jackson; Sandin, Sven; Odida, Michael; Wabinga, Henry; Mbidde, Edward; Wabwire-Mangen, Fred; Meijer, Chris JLM; Middeldorp, Jaap M.; Weiderpass, Elisabete
Correct diagnosis is key to appropriate treatment of cancer in children. However, diagnostic challenges are common in low-income and middle-income countries. The objective of the present study was to assess the agreement between a clinical diagnosis of childhood non- Hodgkin lymphoma (NHL) assigned in Uganda, a pathological diagnosis assigned in Uganda, and a pathological diagnosis assigned in The Netherlands. The study included children with suspected NHL referred to the Mulago National Referral Hospital, Kampala, Uganda, between 2004 and 2008. A clinical diagnosis was assigned at the Mulago National Referral Hospital, where tissue samples were also obtained. Hematoxylin and eosin-stained slides were used for histological diagnosis in Uganda, and were re-examined in a pathology laboratory in The Netherlands, where additional pathological, virological and serological testing was also carried out. Agreement between diagnostic sites was compared using kappa statistics.
Burkitt’s Lymphoma In Africa, A Review Of The Epidemiology And Etiology
(African health sciences, 2007) Orem, Jackson; Mbidde, Edward Katongole; Lambert, Bo; Sanjose, Silvia de; Weiderpass, Elisabete
Burkitt\'s lymphoma (BL) was first described in Eastern Africa, initially thought to be a sarcoma of the jaw. Shortly it became well known that this was a distinct form of Non Hodgkin\'s lymphoma.The disease has given insight in all aspects of cancer research and care. Its peculiar epidemiology has led to the discovery of Epstein Barr virus (EBV) and its importance in the cause of several viral illnesses and malignancies.The highest incidence and mortality rates of BL are seen in Eastern Africa. BL affects mainly children, and boys are more susceptible than girls. Evidence for a causal relationship between EBV and BL in the endemic form is fairly strong. Frequency of association between EBV and BL varies between different patient groups and different parts of the world. EBV may play a role in the pathogenesis of BL by deregulation of the oncogene c-MYC by chromosomal translocation.Although several studies suggest an association between malaria and BL, there has never been a conclusive population study in support of a direct role of malaria in causation of BL.The emergence of HIV and a distinct subtype of BL in HIV infected have brought a new dimension to the disease particularly in areas where both HIV and BL are endemic. BL has been reported as a common neoplasmin HIV infected patients, but not in other forms of immuno-depression, and the occurrence of BL seems to be higher amongst HIV positive adults, while the evidence of an association amongst children is still disputed.The role of other possible risk factors such as low socio-economical status, exposure to a plant species common in Africa called Euphorbiaceae, exposure to pesticies and to other infections such as schistosomiasis and arbovirus (an RNA virus transmitted by insect vectors) remain to be elucidated.
Clinical characteristics, treatment and outcome of childhood Burkitt’s lymphoma at the Uganda Cancer Institute
(Transactions of the Royal Society of Tropical Medicine and Hygiene, 2011) Orem, Jackson; Mulumba, Yusuf; Algeri, Sara; Bellocco, Rino; Mangen, Fred Wabwire; Mbidde, Edward Katongole; Weiderpass, Elisabete
Burkitt's lymphoma (BL) is a major cause of death among Ugandan children. We studied clinical characteristics and outcomes of childhood BL over time at the Uganda Cancer Institute (UCI). A total of 1217 children (766 boys, 451 girls, mean age 6.69 years) diagnosed with BL between 1985 and 2005 were included. There were no significant changes in the proportion of boys and girls diagnosed, or in mean age at diagnosis. Facial tumor (n = 945, 77.65%) and abdominal disease (n = 842, 69.19%) were the most common presentations. The proportion of children presenting with hepatic mass, malignant pleocytosis, and advanced-stage (stage C and D) BL increased during the study period (P < 0.01). A total of 1085 children out of 1206 (89.97%) received at least one cycle of chemotherapy, and 832 of 1099 (75.71%) demonstrated objective response (i.e. complete or partial remission). The most common symptoms at BL diagnosis were fever (n = 621, 51.03%), anemia (n = 593, 48.73%), and weight loss (n = 588, 48.32%). Significant increases in the proportion of children with fever, and significant changes in the proportion of children with anemia, night sweats and severe infection were observed. HIV positivity was 3.87%, but no substantial differences in the proportion of HIV-positive children were observed. Mortality was not significantly different over time: it was similar in boys and girls, higher in older children (compared with younger ones), in those with advanced-stage BL, and HIV-positive children, but lower in children with facial tumors compared with other tumor presentations, and among those who received chemotherapy.
Comparison of Human Papillomavirus Detection between Freshly Frozen Tissue and Paraffin Embedded Tissue of Invasive Cervical Cancer
(Infectious agents and cancer, 2010) Odida, Michael; Sanjose, Silvia de; Quiros, Beatriz; Alemany, Laia; Lloveras, Belen; Alejo, Maria; Weiderpass, Elisabete
Human Papillomavirus (HPV) detection results comparing paraffin embedded cervical tissue and other cervical specimens have been done with varying degrees of agreement. However, studies comparing freshly frozen specimens and paraffin embedded specimens of invasive cervical carcinomas are lacking. The aim of the study was to compare HPV detection using SPF10 broad-spectrum primers PCR followed by DEIA and genotyping by LiPA25 (version 1) between freshly frozen cervical tissue samples and paraffin embedded blocks of cervical tissue from the same patient. There were 171 pairs of paraffin embedded and freshly frozen samples analyzed from cervical carcinoma cases from Kampala, Uganda.
Current Investigations And Treatment Of Burkitt’s Lymphoma In Africa
(Tropical doctor, 2008) Orem, Jackson; Mbidde, Edward Katongole; Weiderpass, Elisabete
We reviewed the scientific literature on Burkitt's lymphoma (BL) in Africa in order to provide information on the current status of clinical care and the existing research challenges. BL epidemiology led to the discovery of the Epstein Barr virus, an important cause of several viral illnesses and malignancies. The incidence of BL has increased in the endemic areas of Africa, overlapping with the epidemic of HIV and increase of malaria. The impact of this on the clinical care of BL in the region is therefore of interest, especially in HIV-infected children. Rapid methods must be developed which enable the correct diagnosis to be made. It is important to improve supportive care to allow fairly aggressive treatment, to research into salvage therapy for those who fail first-line treatment, and to develop less toxic drug combinations for HIV-infected patients. Documentation of HIV status through counselling should be offered to all patients.
Evaluation of 'see-see and treat' strategy and role of HIV on cervical cancer prevention in Uganda
(Reproductive Health, 2010) Mutyaba, Twaha; Mirembe, Florence; Sandin, Sven; Weiderpass, Elisabete
There is scant information on whether Human Immunodeficiency Virus (HIV) seropositivity has an influence on the outcome of treatment of precancerous cervical lesions using cryotherapy. We studied the prevalence of cervical abnormalities detectable by visual inspection and cervical lesions diagnosed by colposcopy according to HIV serostatus and described the outcomes of cryotherapy treatment. Trained nurses examined women not previously screened for cervical cancer using visual inspection with acetic acid (VIA) and Lugol's iodine (VILI) in two family planning/post natal clinics in Kampala, Uganda, from February 2007 to August 2008. Women with abnormal visual inspection findings were referred for colposcopic evaluation and HIV testing. Women with precancerous cervical lesions detected at colposcopy were treated mainly by cryotherapy, and were evaluated for treatment outcome after 3 months by a second colposcopy.
HPV types, HIV and invasive cervical carcinoma risk in Kampala, Uganda: a case-control study
(Infectious Agents and Cancer, 2018) Odida, Michael; Sandin, Sven; Mirembe, Florence; Kleter, Bernhard; Quint, Wim; Weiderpass, Elisabete
While the association of human papillomavirus (HPV) with cervical cancer is well established, the influence of HIV on the risk of this disease in sub-Saharan Africa remains unclear. To assess the risk of invasive cervical carcinoma (ICC) associated with HIV and HPV types, a hospital-based case-control study was performed between September 2004 and December 2006 in Kampala, Uganda. Incident cases of histologically-confirmed ICC (N=316) and control women (N=314), who were visitors or care-takers of ICC cases in the hospital, were recruited. Blood samples were obtained for HIV serology and CD4 count, as well as cervical samples for HPV testing. HPV DNA detection and genotyping was performed using the SPF10/DEIA/LiPA25 technique which detects all mucosal HPV types by DEIA and identifies 25 HPV genotypes by LiPA version 1. Samples that tested positive but could not be genotyped were designated HPVX. Odds ratios (OR) and 95% confidence intervals (CI) were calculated by logistic regression, adjusting for possible confounding factors.
Human Papillomavirus Type Distribution in Invasive Cervical Cancer in Uganda
(BMC infectious diseases, 2008) Odida, Michael; Sanjosé, Silvia de; Bosch, Xavier F.; Weiderpass, Elisabete
We conducted a study aiming to describe Human Papillomavirus (HPV) type distribution in invasive cervical carcinoma in Uganda. 191 archival cervical carcinoma samples diagnosed in the Department of Pathology, Makerere University in Kampala between 1968 and 1992 were analysed using a sensitive PCR-Reverse Hybridization Line Probe Assay. Out of the 186 cases of confirmed invasive cervical cancer in the study paraffin blocks, 114 were positive for HPV DNA. Specific HPV genotypes were identifiable in 109 cases: HPV 16, 18, 31, 35, 39, 44, 45, 51, 52 and 70. These occurred as single infections in 105 cases (96.3%) and as multiple infections in 4 cases (3.7%). HPV 16 or 18 accounted for 80% (84/105) of cases with single infection. The results of this study confirm the role of HPV 16 and 18 in cervical cancer pathogenesis in the Ugandan population. The results suggest that the currently available HPV vaccines against HPV 16 and 18 could possibly prevent the majority of invasive cervical cancers in Uganda.
Influences on uptake of reproductive health services in Nsangi community of Uganda and their implications for cervical cancer screening
(Reproductive Health, 2007) Mutyaba, Twaha; Faxelid, Elisabeth; Mirembe, Florence; Weiderpass, Elisabete
Cervical cancer is the most common female cancer in Uganda. Over 80% of women diagnosed or referred with cervical cancer in Mulago national referral and teaching hospital have advanced disease. Plans are underway for systematic screening programmes based on visual inspection, as Pap smear screening is not feasible for this low resource country. Effectiveness of population screening programmes requires high uptake and for cervical cancer, minimal loss to follow up. Uganda has poor indicators of reproductive health (RH) services uptake; 10% postnatal care attendance, 23% contraceptive prevalence, and 38% skilled attendance at delivery. For antenatal attendance, attendance to one visit is 90%, but less than 50% for completion of care, i.e. three or more visits.
Male partner involvement in reducing loss to follow-up after cervical cancer screening in Uganda
(International Journal of Gynecology & Obstetrics, 2009) Mutyaba, Twaha; Mirembe, Florence; Sandin, Sven; Weiderpass, Elisabete
To evaluate the efficacy of male partner involvement in reducing loss to follow-up among women in Uganda referred for colposcopy after a positive cervical cancer-screening test. Methods: In 2 familyplanning/ postnatal clinics at Mulago Hospital, Kampala, Uganda, 5094 women were screened for cervical lesions. Those who screened positive were referred for colposcopy; half were allocated to the intervention group and half to the control group. In the intervention group, information about the screening findings and a request to assist their partner in attending the next examination were sent to male partners. In the control group, a standard service was provided, which did not include a letter to the male partner. Logistic regression models were applied to calculate the probability of women returning for colposcopy. Results: Of the 834 women referred, 209 (25%) did not return for colposcopy: 143/419 (34%) from the control group and 66/415 (16%) from the intervention group. Women in the intervention group were more likely to return (odds ratio 2.8; 95% confidence interval, 1.9–3.9). Conclusion: Male partner involvement significantly reduced loss to follow-up among women referred for colposcopy.
Type-specific incidence, clearance and predictors of cervical human papillomavirus infections (HPV) among young women: a prospective study in Uganda
(Infectious Agents and Cancer, 2010-04-09) Banura, Cecily; Sandin, Sven; van Doorn, Leen-Jan; Quint, Wim,; Kleter, Bernhard; Wabwire-Mangen, Fred; K Mbidde, Edward; Weiderpass, Elisabete
While infections with human papillomavirus (HPV) are highly prevalent among sexually active young women in Uganda, information on incidence, clearance and their associated risk factors is sparse. To estimate the incidence, prevalence and determinants of HPV infections, we conducted a prospective follow-up study among 1,275 women aged 12-24 years at the time of recruitment. Women answered a questionnaire and underwent a pelvic examination at each visit to collect exfoliated cervical cells. The presence of 42 HPV types was evaluated in exfoliated cervical cells by a polymerase chain based (PCR) assay (SPF10-DEIA LiPA).
The Usefulness of Immunohistochemistry in Tissue Microarrays of Human Papillomavirus Negative Adenocarcinoma of the Uterine Cervix
(BMC Research Notes, 2010) Odida, Michael; Lloveras, Belen; Guimera, Nuria; Weiderpass, Elisabete
The origin of adenocarcinomas presenting on the cervix uteri may be doubtful, i.e. whether it is of cervical or endometrial origin, due to the overlapping morphological features. In HPV negative samples, further tests may be needed to ascertain the nature of the tumours. We aimed to explore the use of immunohistochemistry profiles in tissue microarrays in archived samples of adenocarcinoma (ADC) of the cervix from Uganda that tested negative for HPV DNA.

Browsing by Author "Weiderpass, Elisabete"

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