Browsing by Author "Bhatia, Kishor"

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    African Burkitt Lymphoma: Age-Specific Risk and Correlations with Malaria Biomarkers
    (The American journal of tropical medicine and hygiene, 2011) Emmanuel, Benjamin; Kawira, Esther; Ogwang, Martin D.; Wabinga, Henry; Magatti, Josiah; Nkrumah, Francis; Neequaye, Janet; Bhatia, Kishor; Brubaker, Glen; Biggar, Robert J.; Mbulaiteye, Sam M.
    African Burkitt lymphoma is an aggressive B-cell, non-Hodgkin lymphoma linked to Plasmodium falciparum malaria. Malaria biomarkers related to onset of African Burkitt lymphoma are unknown. We correlated agespecific patterns of 2,602 cases of African Burkitt lymphoma (60% male, mean ± SD age = 7.1 ± 2.9 years) from Uganda, Ghana, and Tanzania with malaria biomarkers published from these countries. Age-specific patterns of this disease and mean multiplicity of P. falciparum malaria parasites, defined as the average number of distinct genotypes per positive blood sample based on the merozoite surface protein-2 assessed by polymerase chain reaction, were correlated and both peaked between 5 and 9 years. This pattern, which was strong and consistent across regions, contrasted parasite prevalence, which peaked at 2 years and decreased slightly, and geometric mean parasite density, which peaked between 2 and 3 years and decreased sharply. Our findings suggest that concurrent infection with multiple malaria genotypes may be related to onset of African Burkitt lymphoma.
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    Incidence and geographic distribution of endemic Burkitt lymphoma in northern Uganda revisited
    (International journal of cancer, 2008) Ogwang, Martin D.; Bhatia, Kishor; Biggar, Robert J.; Mbulaiteye, Sam M.
    Endemic Burkitt lymphoma (BL) is etiologically associated with Epstein-Barr virus and ecologically linked to Plasmodium falciparum malaria. However, these infections imperfectly correlate with BL epidemiology. To obtain recent epidemiological data, we studied district- and county-specific BL incidence and standardized incidence ratios using data collected from 1997 to 2006 at Lacor Hospital in northern Uganda, where studies were last done more than 30 years ago. Among 500 patients, median age was 6 years (interquartile range 5–8) and male-to-female ratio was 1.8:1. Among those known, most presented with abdominal (56%, M:F 1.4:1) vs. only facial tumors (35%, M:F 3.0:1). Abdominal tumors occurred in older (mean age: 7.0 vs. 6.0 years; p < 0.001) and more frequently in female children (68% vs. 50%; OR 2.2, 95% CI 1.5– 3.5). The age-standardized incidence was 2.4 per 100,000, being 0.6 in 1–4 year olds, 4.1 in 5–9 year olds and 2.8 in 10–14 year olds and varied 3- to 4-fold across districts. The incidence was lower in districts that were far from Lacor and higher in districts that were close to Lacor. Although districts close to Lacor were also more urbanized, the incidence was higher in the nearby perirural areas. We highlight high-BL incidence and geographic variation in neighboring districts in northern Uganda. Although distance from Lacor clearly influenced the patterns, the incidence was lower in municipal than in surrounding rural areas. Jaw tumors were characterized by young age and male gender, but presentation has shifted away from facial to mostly abdominal.
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    Mean platelet counts are relatively decreased with malaria but relatively increased with endemic Burkitt Lymphoma in Uganda, Tanzania, and Kenya
    (British journal of haematology, 2020) Peprah, Sally; Ogwang, Martin D.; Kerchan, Patrick; Reynolds, Steven J.; Tenge, Constance N.; Were, Pamela A.; Kuremu, Robert T.; Wekesa, Walter N.; Masalu, Nestory; Kawira, Esther; Kinyera, Tobias; Otim, Isaac; Legason, Ismail D.; Nabalende, Hadijah; Dhudha, Herry; Mumia, Mediatrix; Ayers, Leona W.; Biggar, Robert J.; Bhatia, Kishor; Goedert, James J.; Mbulaiteye, Sam M.
    Platelet counts are decreased in Plasmodium falciparum malaria, which is aetiologically linked with endemic Burkitt lymphoma (eBL). However, the pattern of platelet counts in eBL cases is unknown. We studied platelet counts in 582 eBL cases and 2 248 controls enrolled in a case-control study in Uganda, Tanzania and Kenya (2010–2016). Mean platelet counts in controls or eBL cases with or without malaria-infection in controls versus eBLcases were compared using Student’s t-test. Odds ratios (ORs) and two-sided 95% confidence intervals (95% CIs) were estimated using multiple logistic regression, controlling for age, sex, haemoglobin and white blood cell counts. Platelets were decreased with malaria infection in the controls [263 vs. 339 9 109 platelets/l, P < 0 0001; adjusted OR (aOR) = 3 42, 95% CI: 2 79–4 18] and eBL cases (314 vs. 367 9 109 platelets/ l, P-value = 0 002; aOR = 2 36, 95% CI: 1 49–3 73). Unexpectedly, platelets were elevated in eBL cases versus controls in overall analyses (mean: 353 vs. 307 9 109 platelets/l, P < 0 0001; aOR = 1 41; 95% CI: 1 12–1 77), and when restricted to malaria-positive (mean 314 vs. 263 9 109 platelets/ l, P < 0 0001; OR = 2 26; 95% CI: 1 56–3 27) or malaria-negative (mean 367 vs. 339 9 109 platelets/l, P < 0 001; OR = 1 46; 95% CI: 1 17–1 83) subjects. Platelets were decreased with malaria infection in controls and eBL cases but elevated with eBL.
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    Plasma magnesium is inversely associated with Epstein-Barr virus load in peripheral blood and Burkitt lymphoma in Uganda
    (Cancer epidemiology,, 2018) Juan, Ravell; Otim, Isaac; Nabalende, Hadijah; Legason, Ismail D.; Reynolds, Steven J.; Ogwang, Martin D.; Ndugwa, Christopher M.; Marshall, Vickie; Whitby, Denise; Goedert, James J.; Engels, Eric A.; Bhatia, Kishor; Lenardo, Michael J.; Mbulaiteye, Sam M.
    Epstein-Barr virus (EBV) causes endemic Burkitt lymphoma (eBL). EBV control was improved by magnesium (Mg2+) supplementation in XMEN, an X-linked genetic disease associated with Mg2+ deficiency, high circulating EBV levels (viral loads), and EBV-related lymphomas. We, therefore, investigated the relationship between Mg2+ levels and EBV levels and eBL in Uganda. Methods: Plasma Mg2+ was measured in 45 women with low or high circulating EBV levels, 40 pediatric eBL cases, and 79 healthy children. Mg2+ uptake by T-lymphocytes was evaluated in samples from healthy donors. Results: Plasma Mg2+ deficiency (plasma level<1.8 mg/dl) was more likely in women with high- vs. low-EBV levels (76.0% vs. 35%; odds ratio [OR] 11.3, 95% CI 2.14–60.2), controlling for age, and in eBL cases than controls (42.0% vs. 13.9%; OR 3.61, 95% CI 1.32–9.88), controlling for sex, age group, and malaria status. Mg2+ uptake by T-lymphocytes was related to extracellular Mg2+ concentration. Interpretation: Plasma Mg2+ deficiency is associated with high EBV levels and eBL.