title: Epidemiology of Burkitt's lymphoma in Northwest Province, Cameroon, 2003-2010.
abstract: BACKGROUND
  Burkitt's lymphoma (BL) is an aggressive non-Hodgkin's lymphoma endemic to regions of Africa. Cases are thought to be typically found in low-lying, humid regions where malaria is rife.
  
  
  OBJECTIVE
  To investigate the clinical characteristics of BL, its incidence and relationship with malarial incidence in Northwest (NW) Province, Cameroon.
  
  
  METHODS
  Data on BL were collected from the three tertiary referral centres for BL treatment in NW Province, Cameroon. Data on malaria were collected from the Delegation of Public Health in Bamenda, NW Province. Data were collected between March and May 2010.
  
  
  RESULTS
  471 cases of BL were identified. The St Jude's stage of patients at presentation was as follows: stage I, 14.4% (43/299); stage II, 8.4% (25/299); stage III, 69.9% (209/299); stage IV, 7.4% (22/299). The incidences of BL per 100,000 children <15 years of age from 2005 to 2009 were as follows: 2005, 3.01 (29); 2006, 2.02 (20); 2007, 2.45 (25); 2008, 2.38 (25); 2009, 3.06 (33). The average incidence in NW Province was 2.58. In the Ndop plain, Ngo-Ketunjia, the incidences of BL were as follows: 2005, 10.3 (10); 2006, 3.00 (3); 2007, 1.95 (2); 2008, 2.84 (3); 2009, 4.60 (5). The average incidence was 4.54/100,000 children <15 years of age. Statistical analysis demonstrated a sinusoidal distribution of malaria cases throughout the year (P<0.00), with a peak incidence on 10 April. Conversely, no sinusoidal distribution of BL cases was demonstrated throughout the year (P = 0.09).
  
  
  CONCLUSIONS
  No relationship was demonstrated between an acute malarial infection and BL. Significant clustering was found, with the low-lying Ndop plain of Ngo-Ketunjia having an incidence of BL nearly twice that elsewhere in the region. The study demonstrates that the incidence of BL in NW Province, Cameroon remains one of the highest documented in the world.
authors.affiliation: Department of Paediatrics, Fairfield General Hospital, Rochdale Old Road, Bury, BL9 7TD, UK. nickylewis@doctors.org.uk
authors.forename: N
authors.initials: N
authors.lastname: Lewis
authors.forename: J
authors.initials: J
authors.lastname: Young
authors.forename: P B
authors.initials: PB
authors.lastname: Hesseling
authors.forename: P
authors.initials: P
authors.lastname: McCormick
authors.forename: N
authors.initials: N
authors.lastname: Wright
mesh_terms: D000293:Adolescent; D002051:Burkitt Lymphoma / Q000453:epidemiology* / Q000473:pathology; D002163:Cameroon / Q000453:epidemiology; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D015994:Incidence; D007223:Infant; D008288:Malaria / Q000150:complications / Q000453:epidemiology; D008297:Male