Malignant mesothelioma in Sub-Saharan Africa: A case report from Lubumbashi, DR Congo

Our plain-English summary of Malignant mesothelioma in Sub-Saharan Africa: A case report from Lubumbashi, DR Congo, by J. Pyana Kitenge, D. Kapinga Kayembe, M. Tshibangu Muamba, et al (Environmental Research, 2019).

The study

• Authors: J. Pyana Kitenge, D. Kapinga Kayembe, M. Tshibangu Muamba, H. Kachil Rubing, B. De Vos, J. Van Bouwel, B. Nemery
• Journal: Environmental Research
• Published: 2019;176:108556
• Type of article: Case report
• Cited by: 2 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

Abstract

Although asbestos has been used throughout Africa in the past decades, no reports of asbestos-related malignant mesothelioma are available from sub-Saharan Africa, except from South Africa and Zimbabwe. We present a case of a 39-year-old man who died from a histologically proven malignant mesothelioma of the peritoneum in Lubumbashi, DR Congo. No occupational exposure to asbestos could be found in his history. In view of his young age, we speculated that he had been exposed to asbestos as a child, which was highly plausible because he had grown up in one of the numerous mining estates of the region. The houses of these estates were often built with asbestos-containing materials, notably roofs made of corrugated asbestos-cement. The possibility of past domestic or environmental exposure to asbestos was substantiated by the identification of chrysotile and crocidolite fibres in samples of asbestos-cement collected from the home where the patient had lived as a child. To our knowledge, this is the first report of malignant mesothelioma from a country in the Central African region. We expect that heightened awareness and improved diagnosis will lead to the detection of more asbestos-related diseases in Africa.

Copyright © 2019 Elsevier Inc. All rights reserved.

In plain English

This short communication was a case report of one man from Lubumbashi, DR Congo. In April 2016 the 39-year-old man was referred for kidney dialysis. He died of cardiogenic shock within two days, and no autopsy was performed. He had been ill for about three years and was first treated for six months for suspected tuberculosis involving the abdomen. Biopsies of the omentum and peritoneum led to a diagnosis of malignant mesothelioma of the peritoneum. After his death, the authors interviewed his wife, mother and a close friend. They found no job with direct asbestos exposure; he had worked as a laboratory assistant at a mining company's medical centre. Until about age 20 he had lived in a copper mining company housing estate in Kambove. Pieces of a damaged roof sheet from that house contained chrysotile and crocidolite. The authors could not test his biopsies for asbestos fibres. They believed his exposure, if any, most likely took place in childhood or early adolescence. They described the case as, to their knowledge, the first report of malignant mesothelioma from the DR Congo.

We wrote this plain-English summary from the full article with the help of AI, and a second AI model checked each sentence against the article. It is not the authors' wording; the abstract and the article are their own account.

What the study did and found

• Design: case report (short communication) of a single patient
• Who was studied: One 39-year-old man in Lubumbashi, DR Congo, referred for renal dialysis in April 2016; ill since about age 36
• Exposure: No occupational asbestos exposure was found. Possible childhood domestic or environmental exposure: he lived until about age 20 in a copper mining company housing estate in Kambove, where the family house had an asbestos-cement roof
• Main results:
  • The patient died of cardiogenic shock within two days of admission, without having been dialyzed
  • No autopsy was performed
  • He had been ill for about three years
  • He was initially treated for six months for suspected tuberculosis with peritoneal involvement
  • On CT scans the lung bases appeared normal and no pleural plaques were visible
  • Biopsies of the omentum and peritoneum, with immunohistochemistry, allowed a diagnosis of malignant mesothelioma of the peritoneum
  • After the patient's death, the authors interviewed his wife, his mother and a close friend about possible asbestos exposure
  • He had worked as a laboratory assistant in a mining company's medical centre
  • He had never worked as a miner or as a blue-collar worker in industry or construction
  • Samples from a damaged asbestos-cement roof sheet of his childhood home contained both chrysotile and crocidolite
  • The authors judged there were no serious reasons to blame natural asbestos for this case; asbestos was never mined in Congo
• The authors' conclusion: The authors believed the patient's causal asbestos exposure, if any, most likely occurred in childhood or early adolescence. They stated that, to their knowledge, this was the first report of malignant mesothelioma from the DR Congo
• Limitations the authors state:
  • The authors could not test the biopsies for the presence of asbestos fibres or asbestos bodies
  • The authors stated the absence of a job with direct asbestos exposure only as far as they could ascertain

Topics

The National Library of Medicine indexes this study under subjects our site covers: Lung cancer, Mesothelioma.

Medical terms in this study, explained in our Lexicon: Malignant Mesothelioma, Peritoneum, Occupational Exposure, Asbestos-Containing Material (ACM), Asbestos-Cement, Environmental Exposure, Chrysotile, Crocidolite.

Related studies

• The mortality of amphibole miners in South Africa, 1946-80 — G.K. Sluis-Cremer, F.D. Liddell, et al. (1992)
• Excess mortality from stomach cancer, lung cancer, and asbestosis and/or mesothelioma in crocidolite mining districts in South Africa — J.L. Botha, L.M. Irwig, et al. (1986)
• Asbestosis in South Africa--certain geographical and environmental considerations — G.K. Sluis-Cremer (1965)
• Case-control study of mesothelioma in South Africa — D. Rees, J.E. Myers, et al. (1999)
• Asbestos-related disease in South Africa: the social production of an invisible epidemic — L. Braun, S. Kisting (2006)
• Asbestos and mesothelioma in South Africa — R.P. Abratt, D.A. Vorobiof, et al. (2004)

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