Burkitt Lymphoma Risk Shows Geographic and Temporal Associations with Plasmodium falciparum Infections in Uganda, Tanzania, and Kenya

Details

• Personal Author:
  Ayers LW ; Bhatia K ; Biggar RJ ; Broen K ; Buller ID ; Dickens J ; Goedert JJ ; Kawira E ; Kerchan P ; Kinyera T ; Kuremu RT ; Legason ID ; Masalu N ; Mbulaiteye SM ; Nabalende H ; Ogwang MD ; Otim I ; Reynolds SJ ; Tenge CN ; Trangucci R ; Wekesa WN ; Were PA ; Wilson ML ; Zelner J
• Description:
  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. [Description provided by NIOSH]
• Subjects:
  Neoplasms Occupational Health Safety
• Keywords:
  Author Keywords: East Africa Cancer Children Endemic Burkitt's Lymphoma (eBL) Epidemiology Etiology Non-Hodgkin Lymphoma Parasitic Diseases Plasmodium Falciparum Malaria
• ISSN:
  0027-8424
• Document Type:
  Text
• Funding:
  Grant
• Genre:
  Journal Article
• Place as Subject:
  Maryland ; Michigan ; Ohio ; OSHA Region 3 ; OSHA Region 5
• CIO:
  National Institute for Occupational Safety and Health (NIOSH)
• Topic:
  Workplace Safety & Health
• Location:
  North America
• Volume:
  120
• Issue:
  2
• NIOSHTIC Number:
  nn:20066700
• Citation:
  Proc Natl Acad Sci U.S.A. 2023 Jan; 120(2):e2211055120
• Contact Point Address:
  Kelly Broen, Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, MI 48109
• Email:
  broenk@umich.edu
• Federal Fiscal Year:
  2023
• Performing Organization:
  University of Michigan, Ann Arbor
• Peer Reviewed:
  True
• Start Date:
  20050701
• Source Full Name:
  Proceedings of the National Academy of Sciences of the United States of America
• End Date:
  20280630
• Collection(s):
  National Institute for Occupational Safety and Health
• Main Document Checksum:
  urn:sha-512:8ac379294b77366458137c063283ce77b72b529798c32bb0a7163f9830aa4fa399ca200f3a49e3a075e002fd7ed8583da5cf7df7f0d7422ad21dfe03f24b4944
• Download URL:
  https://stacks.cdc.gov/view/cdc/231154/cdc_231154_DS1.pdf
• File Type:
  [PDF - 1.47 MB ]