학술논문
Burkitt lymphoma risk shows geographic and temporal associations with Plasmodium falciparum infections in Uganda, Tanzania, and Kenya.
Document Type
Academic Journal
Author
Broen K; Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, MI 48109.; Center for Social Epidemiology and Population Health, School of Public Health, University of Michigan, Ann Arbor, MI 48109.; Dickens J; Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, MI 48109.; Center for Social Epidemiology and Population Health, School of Public Health, University of Michigan, Ann Arbor, MI 48109.; Trangucci R; Department of Statistics, University of Michigan, Ann Arbor, MI 48109.; Ogwang MD; EMBLEM Study, St. Mary's Hospital, Lacor, Gulu.; African Field Epidemiology Network, Kampala, Uganda.; Tenge CN; EMBLEM Study, Moi University College of Health Sciences, Eldoret, Kenya.; Academic Model Providing Access To Healthcare, Eldoret, Kenya.; Masalu N; EMBLEM Study, Bugando Medical Center, Mwanza, Tanzania.; Reynolds SJ; Division of Intramural Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD 20892.; Kawira E; Epidemiology of Burkitt Lymphoma in East-African Children and Minors (EMBLEM) Study, Shirati Health and Educational Foundation, Shirati, Tanzania.; Kerchan P; African Field Epidemiology Network, Kampala, Uganda.; EMBLEM Study, Kuluva Hospital, Arua, Uganda.; Were PA; EMBLEM Study, Moi University College of Health Sciences, Eldoret, Kenya.; Academic Model Providing Access To Healthcare, Eldoret, Kenya.; Kuremu RT; EMBLEM Study, Moi University College of Health Sciences, Eldoret, Kenya.; Academic Model Providing Access To Healthcare, Eldoret, Kenya.; Wekesa WN; EMBLEM Study, Moi University College of Health Sciences, Eldoret, Kenya.; Academic Model Providing Access To Healthcare, Eldoret, Kenya.; Kinyera T; EMBLEM Study, St. Mary's Hospital, Lacor, Gulu.; African Field Epidemiology Network, Kampala, Uganda.; Otim I; EMBLEM Study, St. Mary's Hospital, Lacor, Gulu.; African Field Epidemiology Network, Kampala, Uganda.; Legason ID; African Field Epidemiology Network, Kampala, Uganda.; EMBLEM Study, Kuluva Hospital, Arua, Uganda.; Nabalende H; EMBLEM Study, St. Mary's Hospital, Lacor, Gulu.; African Field Epidemiology Network, Kampala, Uganda.; Buller ID; Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD 20892.; Cancer Prevention Fellowship Program, Division of Cancer Prevention, National Cancer Institute, National Institutes of Health, Bethesda, MD 20892.; Ayers LW; Department of Pathology,The Ohio State University, Columbus, OH 43210.; Bhatia K; Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD 20892.; Biggar RJ; Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD 20892.; Goedert JJ; Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD 20892.; Wilson ML; Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, MI 48109.; Mbulaiteye SM; Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD 20892.; Zelner J; Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, MI 48109.; Center for Social Epidemiology and Population Health, School of Public Health, University of Michigan, Ann Arbor, MI 48109.
Source
Publisher: National Academy of Sciences Country of Publication: United States NLM ID: 7505876 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1091-6490 (Electronic) Linking ISSN: 00278424 NLM ISO Abbreviation: Proc Natl Acad Sci U S A Subsets: MEDLINE
Subject
Language
English
Abstract
Endemic Burkitt lymphoma (eBL) is a pediatric cancer coendemic with malaria in sub-Saharan Africa, suggesting an etiological link between them. However, previous cross-sectional studies of limited geographic areas have not found a convincing association. We used spatially detailed data from the Epidemiology of Burkitt Lymphoma in East African Children and Minors (EMBLEM) study to assess this relationship. EMBLEM is a case-control study of eBL from 2010 through 2016 in six regions of Kenya, Uganda, and Tanzania. To measure the intensity of exposure to the malaria parasite, Plasmodium falciparum , among children in these regions, we used high-resolution spatial data from the Malaria Atlas Project to estimate the annual number of P. falciparum infections from 2000 through 2016 for each of 49 districts within the study region. Cumulative P. falciparum exposure, calculated as the sum of annual infections by birth cohort, varied widely, with a median of 47 estimated infections per child by age 10, ranging from 4 to 315 infections. eBL incidence increased 39% for each 100 additional lifetime P. falciparum infections (95% CI: 6.10 to 81.04%) with the risk peaking among children aged 5 to 11 and declining thereafter. Alternative models using estimated annual P. falciparum infections 0 to 10 y before eBL onset were inconclusive, suggesting that eBL risk is a function of cumulative rather than recent cross-sectional exposure. Our findings provide population-level evidence that eBL is a phenotype related to heavy lifetime exposure to P. falciparum malaria and support emphasizing the link between malaria and eBL.