Lymphomas and multiple myeloma in rural Kenya: A cross-sectional survey

Abstract

17558 Background: Prevalence of lymphomas and multiple myeloma in rural referral centers and far isolated district hospitals in Kenya was unknown apart from the teaching hospital, the Kenyatta National Hospital in Nairobi. Methods: A questionnaire on which disease code according to the WHO international diagnostic index (IDIC) numbers was used for data collection for a ten year period from 1991 to 2000. Care was taken to avoid double entry of patients who might have been seen in more than one center. Disease codes were entered for Burkit Lymphoma (BL), Hodgkin’s Lymphoma (HL), Non-Hodgkin’s Lymphoma (NHL), Unclassified Lymphomas and Other Lymphomas (OL) and Multiple Myeloma (MM). Seven rural referral centers, known as Provincial Hospitals (PGH), namely Coast, Nyanza, Western, Central, Eastern, North Eastern and Rift Valley were used for data collection. Results: There were no data from the semi-arid North Eastern province. A total of 1,027 lymphomas were recorded from the six remaining centers. 40.7% were BL, 36% NHL, 12.6% HL and 10.7% UL. There were 133 cases of MM. 87% of BL were from oceano-lacustrine centers. The same applied to 61% of NHL. 43.4% of HL were from Rift Valley, the rest being spread over the other five centers. The same applied to 69% of UL. 81.2% of MM cases were from the high altitude areas of Rift Valley and the mountain region. Conclusions: Although predominance of BL in oceano-lacustrince regions is accouneted for in association with malaria endemicity, we cannot so far account for high prevalence of MM in high altitude regions of Kenya. We also cannot fully account for the absence of any case from the semi-arid North Eastern Province. [Table: see text]