title: Microgeographic variations in Burkitt's lymphoma incidence correlate with differences in malnutrition, malaria and Epstein-Barr virus.
abstract: BACKGROUND
  Endemic Burkitt's lymphoma (eBL) has been associated with Epstein-Barr virus (EBV) and holoendemic Plasmodium falciparum malaria. But recent evidence suggests that other risk factors are involved.
  
  
  METHODS
  We hypothesised that selenoprotein glutathione peroxidase (GPx), a surrogate of nutritional status, is an important biomarker for eBL risk. We measured plasma GPx, anthropometric markers of malnutrition, EBV viral loads and malaria parasitaemia in children aged 1-9 years (n=258) from two locations in Nyanza Province, Kenya, with higher-than-expected and lower-than-expected incidence of eBL. The study participants were malaria asymptomatic children from the community.
  
  
  RESULTS
  Children from eBL high-incidence areas had significantly lower GPx levels, high EBV viral load and more evidence of chronic malnutrition than children from eBL low-incidence areas (all P<0.001). Additionally, GPx levels were significantly lower in children with the highest EBV viral load and for those with P. falciparum infections (P=0.035 and P=0.004, respectively).
  
  
  CONCLUSIONS
  These results suggest that selenium deficiency may be a risk factor for eBL.
authors.affiliation: Department of Global Health, Kenya Medical Research Institute, PO Box 1578, Kisumu, Kenya. odadakasumba@yahoo.com
authors.forename: P O
authors.initials: PO
authors.lastname: Sumba
authors.forename: E W
authors.initials: EW
authors.lastname: Kabiru
authors.forename: E
authors.initials: E
authors.lastname: Namuyenga
authors.forename: N
authors.initials: N
authors.lastname: Fiore
authors.forename: R O
authors.initials: RO
authors.lastname: Otieno
authors.forename: A M
authors.initials: AM
authors.lastname: Moormann
authors.forename: A S
authors.initials: AS
authors.lastname: Orago
authors.forename: P F
authors.initials: PF
authors.lastname: Rosenbaum
authors.forename: R
authors.initials: R
authors.lastname: Rochford
mesh_terms: D002051:Burkitt Lymphoma / Q000453:epidemiology* / Q000209:etiology; D002648:Child; D002675:Child, Preschool; D005260:Female; D005979:Glutathione Peroxidase / Q000097:blood; D004854:Herpesvirus 4, Human / Q000302:isolation & purification*; D006801:Humans; D015994:Incidence; D007223:Infant; D007630:Kenya / Q000453:epidemiology; D016015:Logistic Models; D008288:Malaria / Q000150:complications*; D008297:Male; D044342:Malnutrition / Q000150:complications*; D019562:Viral Load
chemical_list: D005979:Glutathione Peroxidase