Results from a prospective sero-epidemiological study initiated in Uganda in 1971 indicate that children with high antibody titres to Epstein-Barr virus structural antigens are at high risk of developing Burkitt's lymphoma. These findings strongly support a causal relationship between the Epstein-Barr virus and Burkitt's lymphoma but suggest that the oncogenic potential of the virus is realised only in exceptional circumstances.

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Epidemiological data relating to all 202 patients diagnosed with Burkitt's Lymphoma (BL) in the West Nile District of Uganda in the period 1961 to 1975 have been reviewed and analysed. Statistically significant evidence of space-time clustering of cases, first reported for the period 1961-65, was also present during 1972-73, but not during other periods. The patients involved in such clusters were found to be older than other patients (P less than 0.001). The average annual incidence of BL in the District was 2.45 x 10(-5) and overall there was no change in the incidence during the study period. However, there were statistically significant changes in incidence in different counties, which could not be explained as case-ascertainment artifacts. One sib pair of patients with BL was found and the series also included 7 instances of BL in two cousins. It is suggested that study of variation in the intensity and type of malarial infestation in different areas at different times may help explain the epidemiological findings and suggest what, if any, aspects of this infection are critical for inducing BL.

A cross-sectional survey of outpatients attending the three distinct hospitals in the towns of Mombasa, Kilifi, and Malindi was conducted to determine the patterns of hepatitis B transmission in eastern Kenya. Of 1,533 study subjects (mean age 21.9 +/- 13.2 years; range, 4 months to 80 years), 11.4% were positive for HBsAg and 56.2% were seropositive for at least one hepatitis B marker (HBsAg, anti-HBs, or anti-HBc). Anti-delta antibody was found in 1.2% of HBsAg-positive samples. HBeAg was found in 36.0% of HBsAg-positive samples obtained from women of childbearing age. The prevalence of seropositivity for hepatitis B markers was positively correlated with age, increasing from 20% in subjects less than 4 years old to more than 80% in study subjects greater than 40 years old. On multivariate analysis, male sex was found to be associated with HBsAg positivity, and age and previous deliveries of children were associated with seropositivity for any hepatitis marker (HBsAg, anti-HBs, or anti-HBc). An effective hepatitis B immunization strategy in this region of Kenya would require vaccination early in life because a major portion of hepatitis B transmission occurs in childhood.