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dc.contributor.authorRainey, Jeanette J.
dc.contributor.authorOmenah, Dorine
dc.contributor.authorSumba, Peter Odada
dc.contributor.authorMoormann, Ann M.
dc.contributor.authorRochford, Rosemary A.
dc.contributor.authorWilson, Mark L.
dc.date2022-08-11T08:10:40.000
dc.date.accessioned2022-08-23T17:15:49Z
dc.date.available2022-08-23T17:15:49Z
dc.date.issued2006-10-05
dc.date.submitted2010-06-08
dc.identifier.citationInt J Cancer. 2007 Jan 1;120(1):121-7. <a href="http://dx.doi.org/10.1002/ijc.22179">Link to article on publisher's site</a>
dc.identifier.issn0020-7136 (Linking)
dc.identifier.doi10.1002/ijc.22179
dc.identifier.pmid17019706
dc.identifier.urihttp://hdl.handle.net/20.500.14038/47253
dc.description.abstractEndemic 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.
dc.language.isoen_US
dc.relation<a href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&list_uids=17019706&dopt=Abstract">Link to Article in PubMed</a>
dc.relation.urlhttp://dx.doi.org/10.1002/ijc.22179
dc.subjectAdolescent
dc.subjectAnimals
dc.subjectBurkitt Lymphoma
dc.subjectChild
dc.subjectChild, Preschool
dc.subjectCluster Analysis
dc.subject*Endemic Diseases
dc.subjectFemale
dc.subjectHumans
dc.subjectIncidence
dc.subjectKenya
dc.subjectMale
dc.subjectRisk Factors
dc.subjectBiostatistics
dc.subjectEpidemiology
dc.subjectHealth Services Research
dc.subjectImmunology and Infectious Disease
dc.subjectPediatrics
dc.titleSpatial clustering of endemic Burkitt's lymphoma in high-risk regions of Kenya
dc.typeJournal Article
dc.source.journaltitleInternational journal of cancer. Journal international du cancer
dc.source.volume120
dc.source.issue1
dc.identifier.legacycoverpagehttps://escholarship.umassmed.edu/qhs_pp/396
dc.identifier.contextkey1347927
html.description.abstract<p>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.</p>
dc.identifier.submissionpathqhs_pp/396
dc.contributor.departmentDepartment of Pediatrics
dc.contributor.departmentDepartment of Quantitative Health Sciences
dc.source.pages121-7


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