Background: Non-Hodgkinââ?¬â?¢s Lymphomas (NHL) are common in African children, with endemic Burkittââ?¬â?¢s lymphoma\r\n(BL) being the most common subtype. While the role of Epstein-Barr Virus (EBV) in endemic BL is known, no data\r\nare available about clinical presentations of NHL subtypes and their relationship to Human Immunodeficiency Virus\r\n(HIV) infection and Epstein Barr Virus (EBV) load in peripheral blood of children in north-western, Tanzania.\r\nMethods: A matched case control study of NHL subtypes was performed in children under 15 years of age and\r\ntheir respective controls admitted to Bugando Medical Centre, Sengerema and Shirati district designated hospitals\r\nin north-western, Tanzania, between September 2010 and April 2011. Peripheral blood samples were collected on\r\nWhatman 903 filter papers and EBV DNA levels were estimated by multiplex real-time PCR. Clinical and laboratory\r\ndata were collected using a structured data collection tool and analysed using chi-square, Fisher and Wilcoxon rank\r\nsum tests where appropriate. The association between NHL and detection of EBV in peripheral blood was assessed\r\nusing conditional logistic regression model and presented as odds ratios (OR) and 95% confidence intervals (CI).\r\nResults: A total of 35 NHL cases and 70 controls matched for age and sex were enrolled. Of NHLs, 32 had BL with\r\nequal distribution between jaw and abdominal tumour, 2 had large B cell lymphoma (DLBCL) and 1 had NHL-not\r\notherwise specified (NHL-NOS). Central nervous system (CNS) presentation occurred only in 1 BL patient; 19 NHLs\r\nhad stage I and II of disease. Only 1 NHL was found to be HIV-seropositive. Twenty-one of 35 (60%) NHL and 21 of\r\n70 (30%) controls had detectable EBV in peripheral blood (OR = 4.77, 95% CI 1.71 ââ?¬â?? 13.33, p = 0.003). In addition,\r\nlevels of EBV in blood were significantly higher in NHL cases than in controls (p = 0.024).\r\nConclusions: BL is the most common childhood NHL subtype in north-western Tanzania. NHLs are not associated\r\nwith HIV infection, but are strongly associated with EBV load in peripheral blood. The findings suggest that high\r\nlevels of EBV in blood might have diagnostic and prognostic relevance in African children.
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