Retrospective study of childhood burkitts lymphoma in north eastern Nigeria.

BACKGROUND: Burkitt's lymphoma (BL) is one of the leading childhood cancers in tropical Africa. Despite this, after extensive literature search most literature reviews on BL found were old. Therefore, it is useful to learn the trend in the epidemiology of BL in north eastern Nigeria especially now that changing ecology of the disease are being published. OBJECTIVE: To determine the prevalence of BL, and the pattern of distribution of the tumour in relation to gender, sites and socio-demographic background of children. METHODS: A retrospective study of cases of BL over a 20 year period in the Paediatric Department of University of Maiduguri Teaching Hospital (UMTH) was conducted. A structured questionnaire was used to document socio-demographic characteristics and clinical features for all cases. Data were analyzed using SPSS software version 16 Illinois, Chicago USA and a computer program for epidemiologist (PEPI version 3.01). Student t test was used to test for significance of means. Kendall's rank correlation coefficient (tau b) hand Jonckheere-Terpstra test of relationship of socio-demographic variables and presenting symptoms of BL were determined. Likely ratio Chi-square (c2) by William's criterion was used to investigate association between yearly prevalence and trends in time and also between anatomical sites and staging of BL. RESULTS: During the period, 49 cases, 32 (65.3%) males and 17 (34.7%) females, were identified out of the 29,636 total paediatric admissions during the period under review. The prevalence of BL was 0.17%. , The 6-10-year age bracket were mostly affected by BL 31 (63.3%) and males had the disease more than females (p = 0.021). The majority of children affected by BL were the Fulani ethnic group 15 (30.6%), those from Borno state 18 (36.7%) and rural dwellers 20 (40.8%). Most patients presented with stage C disease 27 (42.9%), and the most common primary site was the maxilla 11 (40.7). There was no significant change in yearly prevalence of Burkitts lymphoma (P = 0.983). The association between anatomical sites and staging of BL was significant (p = 0.003). CONCLUSIONS: Males were more prone to BL than females and most cases of BL presented late to the hospital. There is no significant change in the yearly occurrence of BL. Socio-demographic and clinical features did not contribute significantly to the epidemiology of BL.

The effects of maternal haemoglobin as an indicator of maternal nutritional status on, maternal measles antibodies of mother-infant pairs at birth.

BACKGROUND: Maternal measles antibodies (MMA) are actively transferred through the placenta from mother to foetus. A relationship could exist between MMA of mother-infant pairs and maternal nutritional indicator (haemoglobin). OBJECTIVES: This study reviewed the effects of maternal haemoglobin (Hb) on MMA of mother-infant pairs at birth. METHODS: One hundred and fifty three mother-infant pairs were enrolled in this study using the systematic random sampling method. Means of maternal Hb and MMA of mother-infant pairs were compared using the Student t test. Correlation coefficients of maternal Hb and MMA of mother-infant pairs were also determined. Multivariate analysis of variable (MANOVA) and covariates (MANCOVA) was used to investigate the effects of maternal Hb (fixed factor), gestational age, maternal age, birth weight (covariates) on combined MMA of mother-infant pairs (dependent factors). Benferroni adjusted Univariate linear regression was used to investigate the dependent variables separately. RESULTS: There were 78 (51%) males and 75 (49%) females. The (mean ± SD) MMA of mother-infant pairs at birth were 134.66 ± 93.31 (95% CI, 119.76 - 149.56) U/ml, and 187.49 ± 85.01 (95% CI, 173.91 - 201.07) U/ml, and their correlation was significant (p = 0.025). Ninety one (59.5 %) mothers had low Hb, 62 (40.5 %) had acceptable Hb levels. The overall mean maternal Hb was 11.01 ± 1.00 (95% CI, 10.85 - 11.17) g/dl . A positive significant correlation was observed between maternal Hb and MMA of the newborn-infant (p = 0.031). The MANOVA showed a statistically significant difference between maternal Hb on the combined dependent variables (p =0.033); however, results for the dependent variables using the Benferroni adjusted Univariate analysis was significant for only MMA of the infants, (p = 0.009). CONCLUSION: There was a significant association between aacceptable levels of maternal Hb and high MMA of the newborn-infants. Therefore, these newborn infants start out with higher MMA that could give them better protection against measles during infancy.

Passive measles immunity in a Nigerian tertiary health care facility: the influence of human immunodeficiency virus infection on measles antibody levels in mother-infant pairs at birth.

BACKGROUND: Infants are protected from measles infection by maternal measles antibodies (MMA). The level of these MMA at birth in newborn children depends on the levels in their mother and the extent of placental transfer. We investigated maternal HIV infection as a predictor of levels of MMA in mother-infant pairs in Maiduguri. METHODS: A total of 180 mother-infant pairs were tested for MMA between 15th January and 29th March 2010. Levels of MMA were measured using enzyme linked immunosorbent assay (ELISA) test. RESULTS: Fifteen (8.3%) mothers were found with HIV infection and all were on antiretroviral treatment for HIV, and all of them had protective MMA. Of these mothers with HIV infection, only one (0.6%) of their newborn infants had un-protective level of maternal measles antibody. Maternal measles antibodies in mother-infant pairs had significant correlation (p = 0.005) for both HIV-infected and HIV-uninfected groups. The mean MMA of the newborn children was lower in infants of HIV-infected mothers than in HIV-uninfected mothers (p = 0.37). Linear regression analysis showed no significant association between maternal HIV infection and MMA in mother-infant pairs (p = 0.72) for mothers and (p = 0.37) for newborn infants. CONCLUSION: Maternal HIV infection was not associated with significantly reduced MMA in mother-infant pairs, as high protective levels were evident in both mother-infant pairs at birth.