In the African esophageal squamous cell carcinoma (ESCC) corridor, recent work from Kenya found increased ESCC risk associated with poor oral health, including an ill‐understood association with dental fluorosis. We examined these associations in a Tanzanian study, which included examination of potential biases influencing the latter association. This age and sex frequency‐matched case‐control study included 310 ESCC cases and 313 hospital visitor/patient controls. Exposures included self‐reported oral hygiene and nondental observer assessed decayed+missing+filled tooth count (DMFT index) and the Thylstrup‐Fejerskov dental fluorosis index (TFI). Blind to this nondental observer TFI, a dentist independently assessed fluorosis on photographs of 75 participants. Odds ratios (ORs) are adjusted for demographic factors, alcohol and tobacco. ESCC risk was associated with using a chewed stick to brush teeth (OR 2.3 [95% CI: 1.3‐4.1]), using charcoal to whiten teeth (OR 2.13 [95% CI: 1.3, 4.1]) and linearly with the DMFT index (OR 3.3 95% CI: [1.8, 6.0] for ≥10 vs 0). Nondental observer‐assessed fluorosis was strongly associated with ESCC risk (OR 13.5 [95% CI: 5.7‐31.9] for TFI 5+ v 0). However, the professional dentist's assessment indicated that only 43% (10/23) of participants assessed as TFI 5+ actually had fluorosis. In summary, using oral charcoal, brushing with a chewed stick and missing/decayed teeth may be risk factors for ESCC in Tanzania, for which dose‐response and mechanistic research is needed. Links of ESCC with “dental fluorosis” suffered from severe exposure misclassification, rendering it impossible to disentangle any effects of fluorosis, extrinsic staining or reverse causality.

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A drug-related problem (DRP) is an event or circumstance involving drug therapy that actually or potentially interferes with desired outcome. The complexities in drug regimens used in cervical cancer chemotherapy has led to more serious problems. The aim of this study is to investigate DRPs in cervical cancer patients receiving chemotherapy. The study was a retrospective cross sectional study on patients receiving cervical cancer chemotherapy at Ahmadu Bello University Teaching Hospital Zaria (ABUTH). Patients' medication charts were reviewed from July, 2015 to June, 2016. Data were collected using the Pharmaceutical Care Network Europe (PCNE) Classification of DRP V 6.20. A total of 224 DRPs cases were identified from 65 cervical cancer patients. The DRPs were mostly on treatment effectiveness (28.1%), adverse reaction (29.0%), and cost (26.8%), while the causes were majorly drug selection (28.1%) and dose selection (29.0%). The risk factors for the DRPs were found to be comorbidities and polypharmacy. In conclusion, DRPs were common among cervical cancer patients receiving chemotherapy at ABUTH. Pharmacist interventions to achieve a better therapeutic outcome are necessary.

Background The contribution of alcohol to the large burden of oesophageal squamous cell carcinoma (ESCC) in east Africa remains uncertain and difficult to assess owing to complex consumption patterns of traditional and commercial drinks. We aimed to assess whether alcohol drinking, overall and at specific intake levels, contributes to ESCC risk in east Africa. MethodsWe did a hospital-based case-control study in Kenya, Tanzania, and Malawi, which included comprehensive assessment of a variety of locally consumed alcohol that we used to classify drinkers as exclusively low alcohol-byvolume (ABV; <30% ABV) drinkers or drinkers of some high-ABV drinks, as well as the number of drinks consumed, average weekly ethanol intake, and the contribution of each drink type to overall ethanol consumption. Cases were patients aged 18 years and older with incident primary ESCC, confirmed histologically for the majority of cases, and a clinical diagnosis for the remainder. Controls were frequency-matched on age and sex in a 1:1 ratio with cases. The controls were recruited from the same hospitals as cases and included outpatients, inpatients, and hospital visitors who did not have cancer or any other digestive disease. Consenting participants took part in face-to-face interviews in which they were asked whether they had ever consumed alcohol (the primary exposure variable); those who had were asked follow-up questions about their consumption habits for different alcoholic drinks. Findings 1279 cases and 1346 controls were recruited between Aug 5, 2013, and May 24, 2020, including 430 cases and 440 controls from Kenya, 310 cases and 313 controls from Tanzania, and 539 cases and 593 controls from Malawi. 65 (4•8%) of 1344 cases were excluded. Consistent positive associations with ESCC risk were found for ever having consumed alcohol in Kenyan men and Tanzanian men, and for daily number of drinks and estimated ethanol intake in Kenya, Tanzania (both sexes) and Malawian women. Corresponding population-attributable fractions of ESCC for those reporting ever drinking alcohol (vs never drinking) were 65% (95% CI 52-78) in Kenyan men and 23% (<1-45) in Kenyan women, and 56% (95% CI 36-76) in Tanzanian men and 5% (0-42) in Tanzanian women. Increased risk and population-attributable fractions were almost entirely due to risks in high-ABV drinkers.Interpretation Alcohol appears to be a substantial contributor to ESCC risk in east Africa, particularly among men, and a large fraction of ESCC could be prevented by cessation or reduction of alcohol consumption. Future studies should consider independent ascertainment of alcohol intake to assess the potential of under-reporting in Malawi.

Poor adherence to medication is a major public health concern, especially in patients with hypertension because it is sometimes difficult to convince them to take medication in the absence of symptoms. The aim of this study was to assess the relationship between patients' beliefs about their antihypertensive drugs and adherence to treatment. The study was a cross-sectional study on hypertensive patients in General Hospital Katsina State. The data were collected using patient administered questionnaires. Data were analyzed using SPSS version 20.0.The study recorded a total of 127 hypertensive patients, majority of whom were females (58%) and mostly above 40 years (76%). Significant number of the respondents (98%) agreed their antihypertensives were effective in protecting them from the effects of high blood pressure. All adherent patients (100%) were strongly concerned about possible future effects of their medication, suggesting a high counterbalancing effect of this belief on their adherence. Majority (77%) believed they were receiving the necessary advice about their medicines from the pharmacist. Overall adherence to treatment was excellent (80%). A statistically significant relationship (p<.05) was established between patient's beliefs and adherence. In conclusion, the study revealed that adherence to antihypertensive medication is attributed to patients' beliefs and the role of pharmacists cannot be overemphasized.