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    Spatial clustering of endemic Burkitt's lymphoma in high-risk regions of Kenya

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    Authors
    Rainey, Jeanette J.
    Omenah, Dorine
    Sumba, Peter Odada
    Moormann, Ann M.
    Rochford, Rosemary A.
    Wilson, Mark L.
    UMass Chan Affiliations
    Department of Pediatrics
    Department of Quantitative Health Sciences
    Document Type
    Journal Article
    Publication Date
    2006-10-05
    Keywords
    Adolescent
    Animals
    Burkitt Lymphoma
    Child
    Child, Preschool
    Cluster Analysis
    *Endemic Diseases
    Female
    Humans
    Incidence
    Kenya
    Male
    Risk Factors
    Biostatistics
    Epidemiology
    Health Services Research
    Immunology and Infectious Disease
    Pediatrics
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    Link to Full Text
    http://dx.doi.org/10.1002/ijc.22179
    Abstract
    Endemic Burkitt's lymphoma (eBL), the most common childhood cancer in sub-Saharan Africa, occurs at a high incidence in western Kenya, a region that also experiences holoendemic malaria. Holoendemic malaria has been identified as a co-factor in the etiology of this cancer. We hypothesized that eBL may cluster spatially within this region. Medical records for all eBL cases diagnosed from 1999 through 2004 at Nyanza Provincial General Hospital were reviewed for case residential information to examine this hypothesis. Two cluster detection methods, Anselin's Local Moran test for spatial autocorrelation and a spatial scan test statistic, were applied to this residential data to determine whether statistically significant high- and low-risk areas were present in the Province. During the 6-year study period, 272 children were diagnosed with eBL, with an average annual incidence of 2.15 cases per 100,000 children. Using Empirical Bayes smoothed rates, the Local Moran test identified 1 large multi-centered area of low eBL risk (p-values < 0.01) and 2 significant multi-centered clusters of high eBL risk (p-values < 0.001). The spatial scan detected 3 small independent low-risk areas (p-values < 0.02) and 2 high-risk clusters (p-values = 0.001), both similar in location to those identified from the Local Moran analysis. Significant spatial clustering of elevated eBL risk in high-malaria transmission regions and of reduced incidence where malaria is infrequent suggests that malaria plays a role in the complex eBL etiology, but that additional factors are also likely involved.
    Source
    Int J Cancer. 2007 Jan 1;120(1):121-7. Link to article on publisher's site
    DOI
    10.1002/ijc.22179
    Permanent Link to this Item
    http://hdl.handle.net/20.500.14038/47253
    PubMed ID
    17019706
    Related Resources
    Link to Article in PubMed
    ae974a485f413a2113503eed53cd6c53
    10.1002/ijc.22179
    Scopus Count
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    Population and Quantitative Health Sciences Publications

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