| dc.description.abstract |
Endemic Burkitt lymphoma (eBL) is the most common childhood cancer in sub-Saharan African countries, however, few
epidemiologic studies have been undertaken and none attempted enrolling cases from multiple countries. We therefore
conducted a population-based case–control study of eBL in children aged 0–15 years old in six regions in Northern Uganda,
Northern Tanzania and Western Kenya, enrolling 862 suspected cases and 2,934 population controls (response rates
98.5–100%), and processing ~40,000 vials of samples using standardized protocols. Risk factor questionnaires were
administered, and malaria period prevalence was measured using rapid diagnostic tests (RDTs). A total of 80.9% of the recruited
cases were diagnosed as eBL; 61.4%confirmed by histology. Associations with eBL risk were computed using logistic regression
models adjusted for relevant confounders. Associations common in at least two countries were emphasized. eBL risk was
decreased with higher maternal income and paternal education and elevated with history of inpatient malaria treatment
>12 months before enrollment. Reporting malaria-attributed fever up to 6 months before enrollment and malaria-RDT positivity at
enrollment were associated with decreased eBL risk. Conversely, reporting exposure to mass malaria suppression programs
(e.g., indoor residual insecticide) was associated with elevated risk. HIV seropositivity was associated with elevated eBL risk, but
the relative impact was small. The study shows that it is feasible to conduct networked, multisite population-based studies of
eBL in Africa. eBL was inversely associated with socioeconomic status, positively associated with inpatient malaria treatment
12 months ago and with living in areas targeted for malaria suppression, which support a role of malaria in eBL. |
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