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[ subject:"Public health." ]
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Epidemiological and environmental co...
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Rainey, Jeanette Jane.
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Epidemiological and environmental co-factors linked to endemic Burkitt's lymphoma in Kenya.
紀錄類型:
書目-電子資源 : Monograph/item
正題名/作者:
Epidemiological and environmental co-factors linked to endemic Burkitt's lymphoma in Kenya./
作者:
Rainey, Jeanette Jane.
面頁冊數:
207 p.
附註:
Source: Dissertation Abstracts International, Volume: 66-08, Section: B, page: 4183.
Contained By:
Dissertation Abstracts International66-08B.
標題:
Public health. -
電子資源:
http://pqdd.sinica.edu.tw/twdaoapp/servlet/advanced?query=3186739
ISBN:
9780542302398
Epidemiological and environmental co-factors linked to endemic Burkitt's lymphoma in Kenya.
Rainey, Jeanette Jane.
Epidemiological and environmental co-factors linked to endemic Burkitt's lymphoma in Kenya.
- 207 p.
Source: Dissertation Abstracts International, Volume: 66-08, Section: B, page: 4183.
Thesis (Ph.D.)--University of Michigan, 2005.
Endemic Burkitt's lymphoma (eBL) is a fast-growing extra-nodal B-cell malignancy, and is the most common pediatric cancer in sub-Saharan Africa. This tumor is associated with early Epstein-Barr Virus (EBV) infection and geographically coincides with holoendemic malaria transmission. The epidemiologic association between malaria transmission intensity and eBL, however, has not been unequivocally established, and these two factors alone are unlikely to explain the observed non-random occurrence of eBL in many areas. Using retrospective eBL case data from Kenya for 1989 to 2004, we examined the association between eBL and malaria endemicity on a national level and tested for eBL case-clustering within a high-risk region. We conducted a case-control study in this high-risk region to assess the role of family environmental factors on eBL risk.
ISBN: 9780542302398Subjects--Topical Terms:
534748
Public health.
Epidemiological and environmental co-factors linked to endemic Burkitt's lymphoma in Kenya.
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Source: Dissertation Abstracts International, Volume: 66-08, Section: B, page: 4183.
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Chair: Mark L. Wilson.
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Thesis (Ph.D.)--University of Michigan, 2005.
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Endemic Burkitt's lymphoma (eBL) is a fast-growing extra-nodal B-cell malignancy, and is the most common pediatric cancer in sub-Saharan Africa. This tumor is associated with early Epstein-Barr Virus (EBV) infection and geographically coincides with holoendemic malaria transmission. The epidemiologic association between malaria transmission intensity and eBL, however, has not been unequivocally established, and these two factors alone are unlikely to explain the observed non-random occurrence of eBL in many areas. Using retrospective eBL case data from Kenya for 1989 to 2004, we examined the association between eBL and malaria endemicity on a national level and tested for eBL case-clustering within a high-risk region. We conducted a case-control study in this high-risk region to assess the role of family environmental factors on eBL risk.
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On a national level, eBL was significantly associated with malaria endemicity. The rate of eBL in regions with chronic and intense malaria transmission was 3.47 times greater than regions with no or sporadic malaria transmission, independent of tribe (p-value = 0.013). Within a high-risk eBL region, we detected a significant low-risk eBL cluster and two significant high-risk clusters using third and fourth administrative level boundaries, respectively. In our population-based case-control study of 33 cases and 91 controls recruited from this region, several family characteristics were identified as significant eBL risk factors. Cases were less likely to have younger siblings compared to controls, regardless of birth order and tribe, and female children with at least one deceased parent were at increased risk, independent of tribe (OR = 27.99, 90% CI = 2.21 - 354.91). Despite its potential as a tumor promoter and presence in some high-risk eBL areas, no association with the plant species Euphorbia tirucalli was observed.
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Our findings further strengthen the role of malaria exposure in eBL etiology. However, case clustering detected within a high-risk region suggests other environmental or socio-cultural factors may be involved. Certain identified factors, including family characteristics, may increase risk through competition for limited resources and poor nutrition, which in turn may decrease immunosurveillance and contribute to eBL progression. We recommend a large population-based case-control study further investigating these factors.
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