Igboeli P, Walker W, McHugh A, Sultan A, Al-Hendy A
University of Nigeria Teaching Hospital, Department of Obstetrics and Gynaecology, Enugu, Nigeria.
Department of Obstetrics and Gynecology, Augusta University, Augusta, GA 30912, USA.
Curr Opin Gynecol Obstet. 2019;2(1):287-294. doi: 10.18314/cogo.v2i1.1701. Epub 2019 Aug 11.
Black women carry the burden of uterine fibroids, (AKA uterine leiomyomas), at a much higher rate than their racial counterparts. Thus, increasing awareness and discovering a solution to an endemic problem that plagues Sub-Saharan Africa is of critical importance, not only for the region itself, but also for the medical community globally. A collaborative, patient oriented, cost effective, and culturally sensitive approach must be at the forefront of this endeavor. While the exact pathogenesis of uterine fibroid development remains elusive, the racial disparity is well documented. Moreover, in the developed world, women are able to seek treatment through surgical and non-surgical means; however, sub-Saharan regions face their own challenges that, if not addressed, can ultimately extinguish the lives of many suffering women. Unfortunately, the literature is scarce on how to prevent fibroid development, which may be critical for women who do not have access to effective interventions. Recent research from our group and others has shown that vitamin D deficiency plays an important role in fibroid development and may be a preventable risk factor. Daily vitamin D supplementation is a low cost, effective intervention that could be implemented throughout the Sub-Saharan region. Similarly, education and increased awareness as to the nature and symptoms of uterine fibroids could improve the quality of life, remove negative social stigma, and reduce morbidity and mortality rates in women who seek medical care with advanced uterine fibroids.
黑人女性患子宫肌瘤(又称子宫平滑肌瘤)的比例远高于其他种族的女性。因此,提高人们对这个困扰撒哈拉以南非洲地区的地方性问题的认识并找到解决方案至关重要,这不仅对该地区本身,而且对全球医学界来说都意义重大。一种协作性的、以患者为导向的、具有成本效益且对文化敏感的方法必须处于这项工作的前沿。虽然子宫肌瘤发展的确切发病机制仍然不明,但种族差异已得到充分记载。此外,在发达国家,女性能够通过手术和非手术手段寻求治疗;然而,撒哈拉以南地区面临着自身的挑战,如果这些挑战得不到解决,最终可能会夺走许多患病女性的生命。不幸的是,关于如何预防肌瘤发展的文献很少,而这对于无法获得有效干预措施的女性来说可能至关重要。我们团队和其他团队最近的研究表明,维生素D缺乏在肌瘤发展中起重要作用,可能是一个可预防的风险因素。每日补充维生素D是一种低成本、有效的干预措施,可以在撒哈拉以南地区全面实施。同样,对子宫肌瘤的性质和症状进行教育并提高认识,可以改善生活质量,消除负面的社会污名,并降低患有晚期子宫肌瘤而寻求医疗护理的女性的发病率和死亡率。