title: Family environment is associated with endemic Burkitt lymphoma: a population-based case-control study.
abstract: Endemic Burkitt's lymphoma (eBL) has been linked to Epstein-Barr virus and holoendemic Plasmodium falciparum malaria. These co-infections, however, are insufficient to explain the non-random occurrence of Endemic Burkitt's lymphoma within Equatorial Africa. To explore whether this distribution could be explained by household characteristics and family environment, we conducted a case-control study using 41 hospitalized incident endemic Burkitt's lymphoma cases and 91 healthy controls identified through a population-based multistage cluster-sampling scheme in Nyanza Province, Kenya. In a multivariate analysis, odds ratios associated with having one, two, and three or more younger siblings compared with none were 0.28 (90% CI: 0.09, 0.83), 0.59 (90% CI: 0.16, 2.23) and 0.15 (90% CI: 0.03, 0.67) respectively, suggesting that children with endemic Burkitt's lymphoma were more likely than controls to be last-born. Children with endemic Burkitt's lymphoma were also more likely to live in non-monogamous families (OR=3.12, 90% CI:1.19, 8.17) and to have at least one deceased parent (OR=3.38, 90% CI: 1.18, 9.64). Household characteristics, especially sibship relationships, may contribute to endemic Burkitt's lymphoma and therefore warrant further study.
authors.affiliation: Department of Microbiology and Immunology, SUNY Upstate Medical University, Syracuse, New York 13210, USA. jkr7@cdc.gov
authors.forename: Jeanette J
authors.initials: JJ
authors.lastname: Rainey
authors.forename: Rosemary
authors.initials: R
authors.lastname: Rochford
authors.forename: Peter O
authors.initials: PO
authors.lastname: Sumba
authors.forename: Dickens
authors.initials: D
authors.lastname: Kowuor
authors.forename: Mark L
authors.initials: ML
authors.lastname: Wilson
authors.forename: Ann M
authors.initials: AM
authors.lastname: Moormann
mesh_terms: D000293:Adolescent; D002051:Burkitt Lymphoma / Q000453:epidemiology*; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D019353:Endemic Diseases; D005191:Family Characteristics; D005260:Female; D006798:Housing; D006801:Humans; D007630:Kenya / Q000453:epidemiology; D008297:Male; D016017:Odds Ratio; D012307:Risk Factors