The World Health Organization welcomes such applications. The designations employed and the presentation of the material in this publication do not imply the expression of any opinion whatsoever on the part of the Secretariat of the World Health Organization concerning the legal status of any country, territory, city or area or of its authorities. or concerning the delimitation of its frontiers or boundaries.

The cumulative results and long-term follow-up of all patients with Burkitt's lymphoma treated at the Uganda cancer Institute Kampala are reported. The annual admission rate is 29. The tumor patients commonly present with jaw swelling (72%), abdominal swelling (56%) and central nervous system involvement (30%). Complete response rate is achieved in a high proportion of patients (81%). About 50% of these relapse, equal numbers relapsing before and after 3 months. The most important factor influencing remission duration and survival is disease stage. Other important factors are treatment protocols and, to a lesser extent, the type of relapse. Central nervous system relapse does not necessarily augur poor prognosis as second remissions and long-term survival can be achieved with appropriate therapy. Presently 25% of all treated patients have survived free of disease well beyond 5 years.

The presence of several infections was determined in tissue and serum samples from 34 cases and 23 controls seen in 1984-85 at Mulago Hospital in Kampala, Uganda. When assessing single infections, association with cervical cancer could be shown for 5 agents, namely by Southern blot assay for human papillomavirus types 16 and 18 (HPV), and by serological tests at varying levels of antibody titres, for herpes simplex virus type I and/or 2 (HSV), cytomegalovirus (CMV), Epstein-Barr virus, viral capsid antigen (EBV-VCA), and Chlamydia trachomatis (CLT). Due to interaction, HSV and CMV were associated with cervical cancer only when infection by both of these agents was demonstrable. In the assessment of the simultaneous presence of these 5 infections, moderately high antibody titres were taken as the cut-off point for infection by HSV, CMV, EBV-VCA, and CLT. This showed that 3 and 4 infections at a time were seen in the majority of the cases in contrast to the controls with essentially no more than 2 such infections. A linear trend in the rise of risk for cervical cancer was noted with increasing number of infections.

A Monte Carlo simulation study was designed to evaluate the sample survey technique currently used by the Expanded Programme on Immunization (EPI) of the World Health Organization. Of particular interest was how the EPI strategy compared to a more traditional sampling strategy with respect to bias and variability of estimates. It was also of interest to investigate whether the estimates of population vaccination coverage were accurate to within 10 percentage points of the actual levels. It was found that within particular clusters, the EPI method was particularly sensitive to pocketing of vaccinated individuals, but the more traditional method gave more accurate and less variable results under a variety of conditions. However, the stated goal of the EPI, of being able to produce population estimates accurate to within 10 percentage points of the true levels in the population, was satisfied in the artificially created populations studied.The Expanded Programme on Immunization (EPI) of the World Health Organization continually faces the problem of documenting disease-specific morbidity, mortality and immunization coverage rates in developing countries. Since this information is not readily available to local health managers, EPI has worked to develop a method which could obtain accurate information quickly and cheaply and, in addition, could be implemented in a relatively standardized manner from one country to another.The sampling scheme used by EPI may be characterized as a probability proportionate to size (PPS) cluster sample. Contrary to classical statistical theory, however, and because of logistic and managerial constraints in field operations, the EPI strategy is to select only the first household within a cluster at random. This household (HH) is visited to determine if any children in the target age group live there and, if so, to collect the required information. If no child of the right age lives in the first HH visited, the interviewer

Between 1967 and 1977, 48 patients with Hodgkin's disease under 16-years-old were treated with MOPP chemotherapy alone at the Uganda Cancer Institute because radiotherapy facilities are not available. Thirty-eight percent had early stage disease (stages I-IIIA). Prolonged first remissions were achieved in 74% of 42 complete responders. Of 11 patients who relapsed , 5 had prolonged second remissions induced by MOPP. Three patients were lost to follow-up and 15 of the remaining 45 died: 12 of these from progressive Hodgkin's disease, 2 from unrelated causes and 1 from Burkitt's lymphoma after 4 months remission from Hodgkin's disease. Acturial survival for all patients is 67% (75% for stages I-IIIA and 60% for stages IIIB-1V). Treatment complications included Herpes roster and gynaecomastia. The latter is probably related to gonadal dysfunction. All stages of childhood Hodgkin's disease can be successfully managed with MOPP chemotherapy alone. Cancer 42:787-792, 1978.