Journal of Global Medicine

Mitigating the healthcare exodus: pathways to retention and brain gain in Nigeria

Emmanuel Oladipo Otolorin — 2026-03-30

The ongoing emigration of healthcare professionals from Nigeria – commonly referred to as ‘brain drain’ or the ‘Japa syndrome’ – poses a significant threat to the nation’s public health infrastructure and broader developmental objectives. This perspective article contends that, while the immediate effects of this phenomenon are profoundly adverse, there is a critical need for a paradigm shift: from perceiving brain drain solely as a detrimental loss to strategically reimagining it as an opportunity for ‘brain gain’. Drawing on findings from an online survey of 155 members of the Ibadan College of Medicine Alumni Association (ICOMAA Worldwide), this perspective article examines the multifactorial drivers of health professional migration and articulates actionable, evidence-based recommendations for the Nigerian government and healthcare stakeholders. These recommendations focus on enhancing working conditions, cultivating innovative frameworks for diaspora engagement, and prioritising sustained investment in health workforce development. Ultimately, the article advocates for policies that not only stem the outflow of talent but also leverage the expertise, resources, and networks of the Nigerian health diaspora to strengthen the domestic healthcare system.

Rising prostate cancer incidence in Africa: socioeconomic impact implications and 25-year projection

Adedeji Fatuga — 2026-03-11

Background: Prostate cancer is the most common male malignancy globally, with a disproportionately high burden in Africa and negative quality of life and economic consequences, as well as premature mortality.

Methods: This study uses Global Cancer Observatory 2022 data on prostate cancer (International classification of diseases [ICD]-10 C61) from 48 African countries to estimate incidence and mortality and to project future trends to 2050. Incidence and mortality predictions were based on constant 2022 national rates applied to population growth projections. Economic productivity losses were calculated using International Labour Organisation statistics and remaining years of productive life before age 65.

Results: In 2022, there were an estimated 103,050 new prostate cancer cases and 58,890 deaths in Africa, accounting for 8.7% of all cancers. Age-standardised incidence and mortality rates were 30.3 and 17.3 per 100,000, respectively, with the highest rates observed in Southern, Middle, and West Africa. By 2050, prostate cancer cases are projected to increase by 173.7%, reaching 282,005 new cases annually, with the steepest rise in countries such as Equatorial Guinea, Zambia, and Cape Verde. Prostate cancer was among the top cancers contributing to economic productivity loss in four of five African regions, with West Africa recording an average of 32.2 years of productive life lost compared to a world average of 9.4 years.

Conclusions: Prostate cancer burden in Africa is expected to nearly triple by 2050, driven by demographic expansion and ageing. Strengthening early detection, access to care, and targeted health policies are required to address this growing challenge and mitigate productivity losses.

The metal fingerprint of preeclampsia: evaluating the copper-to-zinc ratio in Nigerian pregnant mothers

Mathias A. Emokpae — 2026-03-23

Background: Preeclampsia poses serious medical risks to pregnant women in the world, especially those in developing countries like Nigeria. This study aimed to identify specific levels of zinc, copper, and selenium and to determine the relationship between the copper-to-zinc ratio and preeclampsia in pregnant mothers.

Materials and Methods: Serum levels of zinc, copper, and selenium were analysed using atomic absorption spectrophotometry (AAS). The copper-to-zinc ratio was calculated, and a paired t-test was used to analyse the data; P-values less than 0.05 were considered statistically significant.

Results: Serum levels of zinc and selenium in pregnant women with preeclampsia were significantly lower (P < 0.001) than those of the normotensive pregnant women. Conversely, the serum copper level and copper-to-zinc ratio of pregnant women with preeclampsia were markedly higher (P < 0.001) when compared to those of the normotensive pregnant women. After adjusting for age and body mass index (BMI), the mean Cu/Zn ratio was 2.86 (95% confidence interval of 2.85–2.87, P < 0.01) and remained independently associated with pre-eclampsia in a multivariate regression. The Area Under the Receiver Operating Characteristic curve was excellent at 0.9.

Conclusion: The findings provide evidence of an imbalance in essential trace elements, resulting in a significantly elevated Cu/Zn ratio, which could serve as a metal fingerprint linked to preeclampsia in the examined group of Nigerian mothers. The finding is promising as a novel, cost-effective, and easily measurable biomarker for risk evaluation of preeclampsia in resource-limited settings.

Modulation of nitric oxide synthase activity by Burantashi (pausinystalia yohimbe) extract in Wistar rats

Christabel A. Omogiade — 2026-03-09

Introduction: Yohimbine-containing herbs (pausinystalia yohimbe, ‘Burantashi’) are traditionally used as aphrodisiacs and may alter nitric oxide synthase (NOS) pathways. NOS is essential for nitric oxide (NO) generation, which facilitates penile smooth muscle relaxation and vasodilation.

Aim and objectives: To examine the impact of sildenafil and the methanolic stem-bark extract of pausinystalia yohimbe (Burantashi) on NOS mRNA expression in male Wistar rats. The goals were to: (1) give graded extract dosages for 28 days; (2) measure NOS gene expression using semi-quantitative densitometry and RT-PCR; and (3) compare expression between groups.

Materials and methods: For 28 days, 25 adult male Wistar rats (n = 5 per group) were given either Burantashi extract (50, 100, or 200 mg/kg), sildenafil (5 mg/kg), or distilled water (control). Following euthanasia, NOS PCR was performed using agarose gel electrophoresis, and blood/tissue RNA was collected and reverse-transcribed. Tukey’s post hoc test was used to analyse the results of a one-way analysis of variance (ANOVA).

Results: Comparing the Burantashi-treated groups to the control, semi-quantitative densitometry showed dose-dependent elevation of NOS mRNA; sildenafil induced a strong upregulation. One-way ANOVA F(4,20) p < 0.001; Tukey’s post hoc: sildenafil and 200 mg significantly higher versus control, p < 0.01) showed the following representative (reconstructed) fold-change in NOS expression (mean ± standard error of mean) normalised to control (1.00): control 1.00 ± 0.05, sildenafil 2.10 ± 0.12, Burantashi 50 mg/kg 1.25 ± 0.08, 100 mg/kg 1.78 ± 0.09, and 200 mg/kg 2.45 ± 0.11).

Conclusion: In male Wistar rats, burantashi methanolic extract dose-dependently increases NOS gene expression, indicating that increased NO production is a likely explanation for its traditional aphrodisiac usage. The source data showed no concurrent rise in serum testosterone. Quantifying functional NO generation, hemodynamic outcomes, and safety will require additional effort.

Your Health As The Climate Changes: Death and Disease on a Warming Planet

Samuel Teale Chadwick — 2026-03-13

The neglected stepchild at risk: reimagining global surgery of shifting priorities

Cynthia de Carvalho Fischer — 2026-04-20

Living with Cancer

Meg Orr — 2026-03-02