Incidence of Endemic Burkitt Lymphoma in Three Regions of Mozambique

O’Callaghan-Gordo, Cristina; Casabonne, Delphine; Carrilho, Carla; Ferro, Josefo; Lorenzoni, Cesaltina; Zaqueu, Clésio; Nhabomba, Augusto; Aguilar, Ruth; Bassat, Quique; Sanjosé, Sílvia de; Dobaño, Carlota; Kogevinas, Manolis

doi:10.4269/ajtmh.16-0424

Cited by 4 publications

(10 citation statements)

References 17 publications

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“…Contemporary studies in SSA have also reported increased BL risk in areas with hyperendemic P. falciparum transmission, 1,2,14–16 corroborating Dr. Burkitt's early findings. In Kenya, children in areas with chronic P. falciparum transmission were found to be 3.48–7.30 times more likely to develop BL than those living in low P. falciparum transmission areas 1,16 .…”

Section: Introductionsupporting

confidence: 62%

“…1,16 In Mozambique, higher rates of BL were observed in the northern region where malaria transmission is elevated. 2 However, studies in Uganda and Cameroon observed increased BL risk in both high P. falciparum endemicity areas and low P. falciparum endemicity areas. 14,[17][18][19][20] In Malawi, a 1993 study by van den Bosch et al 21 identified timespace clusters for BL cases diagnosed between 1987 and 1989.…”

Section: Introductionmentioning

confidence: 99%

“…In Kenya, children in areas with chronic P. falciparum transmission were found to be 3.48–7.30 times more likely to develop BL than those living in low P. falciparum transmission areas 1,16 . In Mozambique, higher rates of BL were observed in the northern region where malaria transmission is elevated 2 . However, studies in Uganda and Cameroon observed increased BL risk in both high P. falciparum endemicity areas and low P. falciparum endemicity areas 14,17–20 …”

Section: Introductionmentioning

confidence: 99%

“…Burkitt lymphoma (BL), an aggressive B-cell non-Hodgkin lymphoma is the most common pediatric cancer in sub-Saharan Africa (SSA), 1 accounting for up to 90% of pediatric lymphomas in the region. 2 In the early 1960s, Dr. Dennis Burkitt published a map displaying the geographic distribution of documented BL cases in SSA. 3,4 The map showed that BL cases originated in areas with climatic and topographic characteristics favoring endemic Plasmodium falciparum malaria transmission.…”

Section: Introductionmentioning

confidence: 99%

“…Burkitt lymphoma (BL), an aggressive B‐cell non‐Hodgkin lymphoma is the most common pediatric cancer in sub‐Saharan Africa (SSA), 1 accounting for up to 90% of pediatric lymphomas in the region 2 . In the early 1960s, Dr. Dennis Burkitt published a map displaying the geographic distribution of documented BL cases in SSA 3,4 .…”

Section: Introductionmentioning

confidence: 99%

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Spatial distribution of incident pediatric Burkitt lymphoma in central and northern Malawi and association with malaria prevalence

Gondwe

Salima

Manda

et al. 2022

Pediatric Blood & Cancer

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Background: Burkitt lymphoma (BL) accounts for 90% of pediatric lymphomas in sub-Saharan Africa. Plasmodium falciparum malaria is considered an etiological factor of BL.We describe the geographic distribution of pediatric BL in Malawi and association with P. falciparum malaria prevalence rate (PfPR). Methods: We enrolled 220 pathologically confirmed incident pediatric BL cases (2013-2018) into an observational clinical cohort at Kamuzu Central Hospital (KCH) in Lilongwe district. KCH is the main tertiary cancer referral center serving the central and northern regions of Malawi. Using an ecological study design, we calculated district-level annual BL incidence rate using census population estimates. District-level PfPR was extracted from the National Malaria Control Program 2010 report. BL incidence and PfPR maps were constructed in QGIS. Moran's I test was used to identify BL spatial clusters. Pearson's correlation and multiple linear regression analyses were used to statistically examine the relationship between PfPR and BL.Results: BL incidence was higher in central region districts (8.2 cases per million) than northern districts (2.9 cases per million) and was elevated in lakeshore districts. Districts with elevated PfPR tended to have elevated BL incidence. A low-risk BL cluster was detected in the north. Statistically, BL incidence was positively correlated with PfPR (r = .77, p < .01). A 1% increase in PfPR predicted an increase in BL incidence of 0.2 cases per million (p = .03), when controlling for travel time from referral district hospital to KCH. Conclusion:Our study supports evidence for an association between P. falciparum and BL and highlights a need to improve geographic accessibility to tertiary cancer services in Malawi's northern region.

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Section: Introductionsupporting

confidence: 62%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Spatial distribution of incident pediatric Burkitt lymphoma in central and northern Malawi and association with malaria prevalence

Gondwe

Salima

Manda

et al. 2022

Pediatric Blood & Cancer

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Mosquito Bed Net Use and Burkitt Lymphoma Incidence in Sub-Saharan Africa

Schmit,

Kaur,

Aglago

2024

JAMA Netw Open

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ImportanceBurkitt lymphoma (BL) is one of the most common childhood cancers in sub-Saharan Africa and is etiologically linked to malaria. However, evidence for an effect of malaria interventions on BL is limited.ObjectiveTo investigate the potential population-level association between large-scale rollout of insecticide-treated bed nets (ITNs) in sub-Saharan Africa in the 2000s and BL incidence.Data SourcesIn this systematic review and meta-analysis, a search was conducted in the Embase, Global Health, and Medline databases and in cancer registry publications between January 1, 1990, and February 27, 2023.Study SelectionAll epidemiologic studies on BL incidence rates in children and adolescents aged 0 to 15 years in sub-Saharan African countries where malaria is endemic were identified by 2 reviewers blinded to each other’s decision.Data Extraction and SynthesisThe systematic review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-analyses reporting guideline. Data were extracted independently by 2 reviewers, and quality was scored based on 3 predefined criteria: data collection, case ascertainment, and calculation of person-time at risk.Main Outcomes and MeasuresIncidence rates of BL during childhood and mean ITN use in the population. Data were analyzed using a random-effects negative binomial regression model.ResultsOf 2333 studies meeting selection criteria, 23 comprising 66 data points on BL incidence were included based on 5226 BL cases from locations with large-scale ITN use in 17 countries. Rates of BL were 44% (95% CI, 12%-64%) lower in the period after ITN introduction compared with before. The adjusted pooled incidence rates of BL were 1.36 (95% CI, 0.88-2.10) and 0.76 (95% CI, 0.50-1.16) per 100 000 person-years before and after introduction of ITNs, respectively. After adjusting for potential confounders, a 1–percentage point increase in mean ITN use in the population in the 10 years before BL data collection was associated with a 2% (95% CI, 1%-4%) reduction in BL incidence.Conclusions and RelevanceIn this systematic review and meta-analysis, large-scale rollout of ITNs in the 2000s was associated with a reduction in BL burden among children in sub-Saharan Africa. Although published data may not be representative of all incidence rates across sub-Saharan Africa, this study highlights a potential additional benefit of malaria control programs.

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Cancer in Mozambique: Results from two population‐based cancer registries

Lorenzoni

Ferro

Carrilho

et al. 2020

Intl Journal of Cancer

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Results from two recently established population‐based registries in Mozambique are reported: Beira in the central region (2014–2017) and Maputo, the capital city, in the South (2015–2017). The results are compared to those from Maputo (Lourenço Marques at the time) in 1956–1960 (appearing Cancer Incidence in Five Continents Vol 1), and with estimated incidence rates from other regions of Africa. The elevated prevalence of HIV infection (12.6% of adults in 2018) results in high rates for HIV‐related cancers, and the greater prevalence in central Mozambique, compared to the south, largely explains the rather higher rates of Kaposi sarcoma (males), non‐Hodgkin lymphoma, squamous cell carcinoma of conjunctiva and cervical cancer in Beira than in Maputo. Burkitt lymphoma is the commonest childhood cancer in Beira, with high rates typical of East Africa, while the low rates in Maputo are more typical of Southern Africa. Overall, 44% of cancers in Maputo and 52% in Beira are estimated to be caused by infectious agents. In the last 60 years, cancers more frequent in developed countries, such as breast and prostate, are emerging in Mozambique. The incidence of the former in Maputo has increased fivefold since 1956–1960, that of prostate cancer 2.5‐fold, and that of large bowel cancer doubled. The results reported here were used to make national estimates of incidence, mortality and prevalence in Globocan 2018. The two registries were important in providing data to establish priority actions in the National Cancer Control Plan, and are a valuable resource to monitor progress toward its goals.

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Incidence of Endemic Burkitt Lymphoma in Three Regions of Mozambique

Cited by 4 publications

References 17 publications

Spatial distribution of incident pediatric Burkitt lymphoma in central and northern Malawi and association with malaria prevalence

Spatial distribution of incident pediatric Burkitt lymphoma in central and northern Malawi and association with malaria prevalence

Mosquito Bed Net Use and Burkitt Lymphoma Incidence in Sub-Saharan Africa

Cancer in Mozambique: Results from two population‐based cancer registries

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