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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
Associations between Burkitt lymphoma among children in Malawi and infection with HIV, EBV and malaria: Results from a case-control study
PLoS ONE, Volume 3, No. 6, Article e2505, Year 2008
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Description
Background: Burkitt lymphoma, a childhood cancer common in parts of sub-Saharan Africa, has been associated with Epstein Barr Virus (EBV) and malaria, but its association with human immunodeficiency virus (HIV) is not clear. Methodology/Principal Findings: We conducted a case-control study of Burkitt lymphoma among children (aged ≤ 15 years) admitted to the pediatric oncology unit in Blantyre, Malawi between July 2005 and July 2006. Cases were 148 children diagnosed with Burkitt lymphoma and controls were 104 children admitted with non-malignant conditions or cancers other than hematological malignancies and Kaposi sarcoma. Interviews were conducted and serological samples tested for antibodies against HIV, EBV and malaria. Odds ratios for Burkitt lymphoma were estimated using unconditional logistic regression adjusting for sex, age, and residential district. Cases had a mean age of 7.1 years and 60% were male. Cases were more likely than controls to be HIV positive (Odds ratio (OR)) = 12.4, 95% Confidence Interval (CI) 1.3 to 116.2, p = 0.03). ORs for Burkitt lymphoma increased with increasing antibody titers against EBV (p = 0.001) and malaria (p = 0.01). Among HIV negative participants, cases were thirteen times more likely than controls to have raised levels of both EBV and malaria antibodies (OR = 13.2; 95% CI 3.8 to 46.6; p = 0.001). Reported use of mosquito nets was associated with a lower risk of Burkitt lymphoma (OR = 0.2, 95% CI, 0.03 to 0.9, p = 0.04). Conclusions: Our findings support prior evidence that EBV and malaria act jointly in the pathogenesis of Burkitt lymphoma, suggesting that malaria prevention may decrease the risk of Burkitt lymphoma. HIV may also play a role in the etiology of this childhood tumor. © 2008 Mutalima et al.
Authors & Co-Authors
Mutalima, Nora
United Kingdom, Oxford
University of Oxford
Molyneux, Elizabeth M.
Malawi, Zomba
University of Malawi
Jaffe, Harold W.
United Kingdom, Oxford
University of Oxford
Kamiza, Steve B.
Malawi, Zomba
University of Malawi
Borgstein, Eric S.
Malawi, Zomba
University of Malawi
Mkandawire, Nyengo C.
Malawi, Zomba
University of Malawi
Liomba, George N.
Malawi, Zomba
University of Malawi
Batumba, Mkume
Malawi, Zomba
University of Malawi
Lagos, Dimitris
United Kingdom, London
Ucl Wolfson Institute for Biomedical Research
Gratrix, Fiona
United Kingdom, London
Ucl Wolfson Institute for Biomedical Research
Boshoff, Chris H.
United Kingdom, London
Ucl Wolfson Institute for Biomedical Research
Casabonne, Delphine
United Kingdom, Oxford
University of Oxford Medical Sciences Division
Carpenter, Lucy J.
United Kingdom, Oxford
University of Oxford
Newton, Robert A.
United Kingdom, York
University of York
Statistics
Citations: 148
Authors: 14
Affiliations: 5
Identifiers
Doi:
10.1371/journal.pone.0002505
e-ISSN:
19326203
Research Areas
Cancer
Infectious Diseases
Maternal And Child Health
Study Design
Case-Control Study
Study Locations
Malawi
Participants Gender
Male