伯基特淋巴瘤(BL)是撒哈拉以南非洲最常见的儿童癌症之一,在病因上与疟疾有关。然而,疟疾干预对BL的影响的证据有限.
■调查2000年代在撒哈拉以南非洲大规模推出经杀虫剂处理的蚊帐(ITN)与BL发病率之间的潜在人口水平关联。
■在本系统综述和荟萃分析中,在Embase进行了一次搜查,全球卫生,和Medline数据库以及1990年1月1日至2023年2月27日之间的癌症注册出版物。
■所有关于疟疾流行的撒哈拉以南非洲国家0至15岁儿童和青少年BL发病率的流行病学研究都是由两名对彼此决定不知情的审查者确定的。
■系统评价是根据系统评价和荟萃分析报告指南的首选报告项目进行的。数据由2名评审员独立提取,根据3个预定义的标准对质量进行评分:数据收集,案件确定,以及风险人员时间的计算。
■儿童时期BL的发病率和人群中平均ITN的使用。使用随机效应负二项回归模型分析数据。
■在符合选择标准的2333项研究中,根据来自17个国家/地区大规模使用ITN的地区的5226例BL病例,包括23个,包括66个BL发病率数据点。ITN引入后的BL比率比以前低44%(95%CI,12%-64%)。在引入ITN之前和之后,BL的调整后汇总发病率为每100000人年1.36(95%CI,0.88-2.10)和0.76(95%CI,0.50-1.16)。分别。在调整了潜在的混杂因素后,在BL数据收集前10年内,人群中平均ITN使用率增加1个百分点,与BL发病率降低2%(95%CI,1%-4%)相关.
■在本系统综述和荟萃分析中,在2000年代大规模推出驱虫蚊帐与减少撒哈拉以南非洲儿童的BL负担有关。尽管公布的数据可能无法代表撒哈拉以南非洲地区的所有发病率,这项研究强调了疟疾控制计划的潜在额外益处.
UNASSIGNED: Burkitt lymphoma (BL) is one of the most common childhood cancers in sub-Saharan Africa and is etiologically linked to malaria. However, evidence for an effect of malaria interventions on BL is limited.
UNASSIGNED: To investigate the potential population-level association between large-scale rollout of insecticide-treated bed nets (ITNs) in sub-Saharan Africa in the 2000s and BL incidence.
UNASSIGNED: In this systematic
review and meta-analysis, a search was conducted in the Embase, Global Health, and Medline databases and in cancer registry publications between January 1, 1990, and February 27, 2023.
UNASSIGNED: All epidemiologic studies on BL incidence rates in children and adolescents aged 0 to 15 years in sub-Saharan African countries where malaria is endemic were identified by 2 reviewers blinded to each other\'s decision.
UNASSIGNED: The systematic
review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-analyses reporting guideline. Data were extracted independently by 2 reviewers, and quality was scored based on 3 predefined criteria: data collection, case ascertainment, and calculation of person-time at risk.
UNASSIGNED: Incidence rates of BL during childhood and mean ITN use in the population. Data were analyzed using a random-effects negative binomial regression model.
UNASSIGNED: Of 2333 studies meeting selection criteria, 23 comprising 66 data points on BL incidence were included based on 5226 BL cases from locations with large-scale ITN use in 17 countries. Rates of BL were 44% (95% CI, 12%-64%) lower in the period after ITN introduction compared with before. The adjusted pooled incidence rates of BL were 1.36 (95% CI, 0.88-2.10) and 0.76 (95% CI, 0.50-1.16) per 100 000 person-years before and after introduction of ITNs, respectively. After adjusting for potential confounders, a 1-percentage point increase in mean ITN use in the population in the 10 years before BL data collection was associated with a 2% (95% CI, 1%-4%) reduction in BL incidence.
UNASSIGNED: In this systematic
review and meta-analysis, large-scale rollout of ITNs in the 2000s was associated with a reduction in BL burden among children in sub-Saharan Africa. Although published data may not be representative of all incidence rates across sub-Saharan Africa, this study highlights a potential additional benefit of malaria control programs.