Abstract
BackgroundWe investigated the feasibility and appropriateness of enrolling controls for Burkitt lymphoma (BL) from local health facilities in two regions in Uganda.MethodsBL case data were compiled from two local hospitals with capacity to diagnose and treat BL in North-west and North-central regions of Uganda during 1997 to 2009. Local health facility data were compiled from children attending four representative local health facilities in the two regions over a two week period in May/June 2010. Age and sex patterns of BL cases and children at local facilities were compared and contrasted using frequency tables.ResultsThere were 999 BL cases diagnosed in the study area (92% of all BL cases treated at the hospitals): 64% were from North-central and 36% from North-west region. The mean age of BL cases was 7.0 years (standard deviation [SD] 3.0). Boys were younger than girls (6.6 years versus 7.2 years, P = 0.004) and cases from North-central region were younger than cases from North-west region (6.8 years versus 7.3 years, P = 0.014). There were 1012 children recorded at the four local health facilities: 91% at facilities in North-central region and 9% from facilities in North-west region. Daily attendance varied between 1 to 75 children per day. The mean age of children at health facilities was 2.2 years (SD 2.8); it did not differ by sex. Children at North-central region facilities were younger than children at North-west region facilities (1.8 years versus 6.6 years, P < 0.001).ConclusionsWhile many children attend local health facilities, confirming feasibility of obtaining controls, their mean age is much lower than BL cases. Health facilities may be suitable for obtaining young, but not older, controls.
Highlights
We investigated the feasibility and appropriateness of enrolling controls for Burkitt lymphoma (BL) from local health facilities in two regions in Uganda
Infection with Epstein-Barr virus (EBV) [1,2,3] and Plasmodium falciparum malaria [4,5,6,7,8,9] have been implicated in endemic Burkitt lymphoma (BL), a B cell non-Hodgkin lymphoma (NHL) described in African children by Denis Burkitt fifty years ago [10]
We investigated whether local health facilities might be an appropriate source of controls for BL cases by comparing and contrasting age and sex patterns of children at local facilities versus those of BL cases diagnosed at two participating hospitals in the study region in Uganda
Summary
We investigated the feasibility and appropriateness of enrolling controls for Burkitt lymphoma (BL) from local health facilities in two regions in Uganda. The. Because the risk of malaria is influenced by host genes [13], the link between malaria and BL may be investigated indirectly by evaluating the association between malariaresistance genes and BL. Because the risk of malaria is influenced by host genes [13], the link between malaria and BL may be investigated indirectly by evaluating the association between malariaresistance genes and BL This approach has the merit of being free from reverse causation bias, and genotypes can be measured reproducibly. Subgroup analysis of the third study focusing on another haemoglobin variant known as haemoglobin C (HBAC), which is linked with malaria resistance, noted a decreased frequency of that variant in children with BL. Our understanding of the role of genes in malaria resistance has increased vastly since these pioneering studies were conducted, and includes more than 50 implicated variants in 25 genes, no studies have investigated the role of these genes in BL
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