A Correction to this paper has been published: https://doi.org/10.1038/s41375-021-01140-5

Burkitt lymphoma (BL) is endemic in parts of Tanzania, but there is scant country or region level data about burden and trends of BL in Tanzania over the past three decades. Here, we update baseline epidemiology of BL in northern Tanzania using recent data.

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 age-specific 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.

Helicobacter pylori (H. pylori) infection is ubiquitous in sub-Saharan Africa, but paradoxically gastric cancer is rare.

Human herpesvirus 8 (HHV-8) infection is common in Africa. We examined the distribution of HHV-8 within families in rural Tanzania to determine routes of spread. HHV-8 infection was assessed by measuring antibody reactivity with a K8.1 (lytic-phase antigen) immunoassay. The prevalence increased from 3.7% (1/27) among infants to 58.1% (36/62) among children aged 3-4 years and 89.0% (65/73) among adults aged > or =45 years. Women with HHV-8-seropositive husbands had a 7-fold risk for infection (odds ratio [OR], 6.9; 95% confidence interval [CI], 1.9-25.3). HHV-8 seropositivity in children was associated with having at least 1 seropositive first-degree relative (OR, 14.7; 95% CI, 5.9-43.1), a seropositive mother (OR, 7.4; 95% CI, 3.2-16.8), a seropositive father (OR, 4.8; 95% CI, 2.3-10.1), or a seropositive next-older sibling (OR, 4.2; 95% CI, 1.9-9.4). Our data are consistent with the occurrence of HHV-8 transmission within families, from mothers and other relatives to children via nonsexual routes and between spouses via sexual routes.

Sera from 516 participants enrolled in a population-based cross-sectional study in northwest Tanzania were tested for antibodies to hepatitis C virus (HCV). The mean age of study subjects was 29 years (range = 16-49 years); 43% were men, 6% reported a history of blood transfusion, and 4% were infected with human immunodeficiency virus-1 (HIV-1). Although 53 of 516 sera (10.3%, 95% confidence interval [CI] = 7.8-13.2%) were repeatedly reactive by a third-generation enzyme immunoassay (EIA-3), only 6 of the 53 were positive when tested with a third-generation recombinant immunoblot assay (confirmed HCV seroprevalence = 1.2%, 95% CI = 0.4-2.5%). The positive predictive value of the HCV EIA-3 in this population was 18.8% (95% CI = 7.0-36.4%). False positivity was not correlated with EIA-3 optical density values, age, sex, infection with HIV-1, or a history of blood transfusion, but it was marginally associated with increased serum IgG levels. We conclude that the prevalence of HCV is low in this region and that the HCV EIA-3 has a higher false-positivity rate in this population than has been reported among U.S. blood donors.

The central demyelinating disease progressive multifocal leukoencephalopathy (PML) is caused by the human polyomavirus JC virus (JCV). JCV evolved as geographically based genotypes of which Type 3 is an African variant first characterized in HIV-1 positive patients from Tanzania. This study reports the complete sequence of five JCV Type 3 strains. The entire JCV genome was PCR amplified from urine specimens of three African and two African-American individuals. The African consensus sequence was compared to the Type 1 and Type 2 prototype strains, JCV (Mad-1) and JCV(GS/B), respectively. Type 3 differed in 2.2% of its coding region genome from JCV (Mad-1) and in 1.3% from JCV(GS/B). Within the coding region the sequence variation among the three types was higher in the capsid protein VP1 and in the regulatory protein large T antigen than in the agnoprotein or in VP2/3. Notable Type 3-specific changes were located at sites adjacent to the zinc finger motif and near the major donor and acceptor splice junctions of large T antigen. Four of the five urinary Type 3 strains had an unrearranged, archetypal regulatory region. African strain #309 showed a 10-bp deletion at a location similar to that previously described for #307 from Tanzania. The African-American Type 3 strain #312 was closely related to the African consensus sequence. The complete genome of a urinary JCV strain from another African-American male, previously reported as a possible Type 5, showed a sequence difference of only 0.52% from the Tanzanian consensus and has been reclassified as a subtype of Type 3.

AIDS Research and Human RetrovirusesVol. 12, No. 14 Sequence Note: Genetic Variability of Human Immunodeficiency Virus Type 1 in Rural Northwest TanzaniaKENNETH E. ROBBINS, CLAUDIU I. BANDEA, ARTHUR LEVIN, JAMES J. GOEDERT, WILLIAM A. BLATTNER, GLEN BRUBAKER, TERESA M. BROWN, GERALD SCHOCHETMAN, MARCIA L. KALISH, JOHN SHAO, and THOMAS R. O'BRIENKENNETH E. ROBBINSSearch for more papers by this author, CLAUDIU I. BANDEASearch for more papers by this author, ARTHUR LEVINSearch for more papers by this author, JAMES J. GOEDERTSearch for more papers by this author, WILLIAM A. BLATTNERSearch for more papers by this author, GLEN BRUBAKERSearch for more papers by this author, TERESA M. BROWNSearch for more papers by this author, GERALD SCHOCHETMANSearch for more papers by this author, MARCIA L. KALISHSearch for more papers by this author, JOHN SHAOSearch for more papers by this author, and THOMAS R. O'BRIENSearch for more papers by this authorPublished Online:15 Mar 2009https://doi.org/10.1089/aid.1996.12.1389AboutSectionsPDF/EPUB Permissions & CitationsPermissionsDownload CitationsTrack CitationsAdd to favorites Back To Publication ShareShare onFacebookTwitterLinked InRedditEmail FiguresReferencesRelatedDetailsCited byHIV-1 Subtypes and Recombinants in Northern Tanzania: Distribution of Viral Quasispecies31 October 2012 | PLoS ONE, Vol. 7, No. 10Phenotypic and Genotypic Comparisons of CCR5- and CXCR4-Tropic Human Immunodeficiency Virus Type 1 Biological Clones Isolated from Subtype C-Infected IndividualsJournal of Virology, Vol. 78, No. 6Recombination of HIV Type 1C (C′/C″) in Ethiopia: Possible Link of EthHIV-1C′ to Subtype C Sequences from the High-Prevalence Epidemics in India and Southern Africa Georgios Pollakis, Almaz Abebe, Aletta Kliphuis, Tobias F. Rinke de Wit, Bitew Fisseha, Belete Tegbaru, Girma Tesfaye, Hailu Negassa, Yohannes Mengistu, Arnaud L. Fontanet, Marion Cornelissen, and Jaap Goudsmit5 July 2004 | AIDS Research and Human Retroviruses, Vol. 19, No. 11High Genetic Diversity of HIV-1 Strains in Chad, West Central AfricaJAIDS Journal of Acquired Immune Deficiency Syndromes, Vol. 33, No. 2Among 46 Near Full Length HIV Type 1 Genome Sequences from Rakai District, Uganda, Subtype D and AD Recombinants Predominate Matthew E. Harris, David Serwadda, Nelson Sewankambo, Bohye Kim, Godfrey Kigozi, Noah Kiwanuka, James B. Phillips, Fred Wabwire, Mary Meehen, Tom Lutalo, James R. Lane, Randall Merling, Ron Gray, Maria Wawer, Deborah L. Birx, Merlin L. Robb, and Francine E. McCutchan5 July 2004 | AIDS Research and Human Retroviruses, Vol. 18, No. 17Common Genetic Arrangements among Human Immunodeficiency Virus Type 1 Subtype A and D Recombinant Genomes Vertically Transmitted in Tanzania Irene N. Koulinska, Gernard Msamanga, Davis Mwakagile, Max Essex, and Boris Renjifo5 July 2004 | AIDS Research and Human Retroviruses, Vol. 18, No. 13Forty-one near full-length HIV-1 sequences from Kenya reveal an epidemic of subtype A and A-containing recombinantsAIDS, Vol. 16, No. 13High proportion of unrelated HIV-1 intersubtype recombinants in the Mbeya region of southwest TanzaniaAIDS, Vol. 15, No. 12A New Human Immunodeficiency Virus Type 1 Circulating Recombinant Form from Tanzania Irene N. Koulinska, Thumbi Ndung'u, Davis Mwakagile, Gernard Msamanga, Charles Kagoma, Wafaie Fawzi, Max Essex, and Boris Renjifo5 July 2004 | AIDS Research and Human Retroviruses, Vol. 17, No. 5Identification of a Genetic Subcluster of HIV Type 1 Subtype C (C′) Widespread in Ethiopia Almaz Abebe, Georgios Pollakis, Arnaud L. Fontanet, Bitew Fisseha, Belete Tegbaru, Aletta Kliphuis, Girma Tesfaye, Hailu Negassa, Marion Cornelissen, Jaap Goudsmit, and Tobias F. Rinke de Wit5 July 2004 | AIDS Research and Human Retroviruses, Vol. 16, No. 17Evidence of Subtype B-Like Sequences in the V3 Loop Region of Human Immunodeficiency Virus Type 1 in Kilimanjaro, Tanzania Ireen E. E. Kiwelu, Hanne L. Nakkestad, John Shao, and Maja A. Sommerfelt5 July 2004 | AIDS Research and Human Retroviruses, Vol. 16, No. 12HIV-1 Subtype C in Commercial Sex Workers in Addis Ababa, EthiopiaJournal of Acquired Immune Deficiency Syndromes, Vol. 23, No. 2HIV-1 Subtype C in Commercial Sex Workers in Addis Ababa, EthiopiaJAIDS Journal of Acquired Immune Deficiency Syndromes, Vol. 23, No. 2Genetic Analysis of Human Immunodeficiency Virus Type 1 Strains in Kenya: A Comparison Using Phylogenetic Analysis and a Combinatorial Melting Assay Kenneth E. Robbins, Leondios G. Kostrikis, Teresa M. Brown, Omu Anzala, Sunny Shin, Francis A. Plummer, and Marcia L. Kalish5 July 2004 | AIDS Research and Human Retroviruses, Vol. 15, No. 4Sequence Note: Epidemic Expansion of HIV Type 1 Subtype C and Recombinant Genotypes in Tanzania BORIS RENJIFO, BETH CHAPLIN, DAVIS MWAKAGILE, PULIN SHAH, FREDRIK VANNBERG, GERNARD MSAMANGA, DAVID HUNTER, WAFAIE FAWZI, and MAX ESSEX15 March 2009 | AIDS Research and Human Retroviruses, Vol. 14, No. 7HIV-1 Subtypes and Recombinants Volume 12Issue 14Sep 1996 To cite this article:KENNETH E. ROBBINS, CLAUDIU I. BANDEA, ARTHUR LEVIN, JAMES J. GOEDERT, WILLIAM A. BLATTNER, GLEN BRUBAKER, TERESA M. BROWN, GERALD SCHOCHETMAN, MARCIA L. KALISH, JOHN SHAO, and THOMAS R. O'BRIEN.Sequence Note: Genetic Variability of Human Immunodeficiency Virus Type 1 in Rural Northwest Tanzania.AIDS Research and Human Retroviruses.Sep 1996.1389-1391.http://doi.org/10.1089/aid.1996.12.1389Published in Volume: 12 Issue 14: March 15, 2009PDF download

Constitutive expression of c-myc resulting from a chromosomal translocation, which juxtaposes c-myc to an immunoglobulin gene, is a pivotal lesion in Burkitt's lymphomas. This deregulated expression of c-myc is associated with mutations in the regulatory regions, i.e. the first exon and the first intron of c-myc in tumors where the chromosomal breakpoint is not itself within the regulatory region. Until recently it was widely believed that the c-myc protein in these tumors is wild type. We have demonstrated that in a fraction of Burkitt's lymphomas from Africa and from the continental USA, and in mouse plasmacytomas, the c-myc gene carries mutations in the coding region. We now show that, occasionally, such mutations are also present in multiple myelomas--tumors which do not carry translocations or amplifications of c-myc. We also show that the frequency of the c-myc coding region mutations in BL is independent of the frequency of mutations in the regulatory region. These results suggest that the mechanisms that induce missense mutations involving the coding region of c-myc may be different from those that lead to mutations in the regulatory regions.

HIV-1 positive patients from Tanzanian villages near Shirati were examined for urinary excretion of the human polyomaviruses JC and BK using the polymerase chain reaction (PCR). BK virus (BKV) was detected in 11 of 23 individuals tested. The BKV DNA sequences were all closely related to prototype Gardner strain and BKV (DUN). In contrast, a new type of JCV, termed Type 3 [or JCV (Shi)], was identified in seven of these same 23 individuals by comparison with Type 1 and Type 2 sequences of the VP1/intergenic/T antigen region of U.S., European and Asian strains. This suggests that JCV and BKV, although closely related, have different evolutionary histories within the African population. The six BKV regulatory regions amplified all showed the archetypal configuration. However, two of the seven JCV regulatory regions showed rearrangements: a small deletion and an inverted repeat. JCV causes a fatal demyelinating disease, progressive multifocal leukoencephalopathy (PML), in about 5% of AIDS patients in Europe and the U.S.A., but only one case has been reported in Africa. Our results suggest that this rarity of PML is not due to the absence of JCV in the African population.

A population-based HIV-1 seroprevalence survey of 4,086 individuals, aged 15-49 years, in the North Mara district of Tanzania from rural, periurban, and urban areas, including high-risk (prostitutes, and co-workers) individuals, was performed in 1989 and 1990. The overall seroprevalence was 7.3% (95% confidence interval, 6.5-8.1), with a gradient of seropositivity from high-risk 13.0% (9.1, 16.8), urban 8.8% (7.6, 10.0), periurban 6.5% (4.7, 8.4), to rural 2.6% (1.6, 3.7) subjects. Adjusted for population group, HIV-1 seroprevalence was significantly elevated for men over age 24 and for women 20-34 years old, while age-specific prevalence rates were similar for men and women in the rural area. Recent treponemal infection, measured by the rapid plasma reagin test, was not associated with HIV-1 seropositivity in men or women. These data suggest a growing HIV-1 epidemic paralleling rising rates in other rural areas of Africa distant from areas that have been previously recognized as having high prevalence.

Objective: Little is known about variations in patterns of sexual behaviour in different countries, cultures, and subpopulations that determine the spread of HIV-1. Quantitative studies are required to improve understanding. Methods: To assess reported patterns of sexual behaviour, we administered a standardized questionnaire to 416 men and 498 women aged 15-49 years from a rural population in northwest Tanzania. Results: Reported levels of sexual activity were highest in men and among younger age groups. The number of sexual partners and number of sex acts per unit of time were strongly correlated: men reported 10 times as many lifetime partners than women. Frequency of sexual partner exchange plateaued earlier in women (by age 25 years) than in men (by age 35 years). For the great majority, age of first intercourse was 15 years or younger; older subjects were older at first intercourse and had fewer lifetime partners than younger subjects. Conclusions: This age-related pattern suggests that more recent birth cohorts have behaviour patterns that increase the risk of sexually transmitted infectious agents such as HIV. Preventive education programmes should be targeted at young adults, who adopt higher risk profiles of frequent partner exchange linked with first intercourse at an early age.

Two Tanzanian patients with konzo were severely disabled by a non-progressive spastic paraparesis, since the sudden onset during an epidemic six years earlier. At the time of onset they had a high dietary intake of cyanide from exclusive consumption of insufficiently processed bitter cassava roots. MRI of brain and spinal cord were normal but motor evoked potentials on magnetic brain stimulation were absent, even in the only slightly affected upper limbs. Other neurophysiological investigations were largely normal but the more affected patient had central visual field defects. Konzo is a distinct disease entity with selective type upper motor neuron damage.

OBJECTIVE To test the hypothesis that consumption of cassava with liberation of cyanide causes diabetes in malnourished individuals. RESEARCH DESIGN AND METHODS Glucose tolerance was assessed in two rural communities in Tanzania; in one (Nyambori), the main source of calories was cassava; and in the other (Uswaa), cassava was rarely eaten. Undernutrition was prevalent in both communities. The people of Nyambori were known to have high dietary cyanide exposure for many years from consumption of insufficiently processed cassava. Of the 1435 people in Nyambori ≥ 15 yr old, 1067 (74%) were surveyed, and 1429 of 1472 (97%) eligible subjects in Uswaa were surveyed. All had 75-g oral glucose tolerance tests and measurement of BMI. Plasma and urine thiocyanate and blood cyanide also were measured in some subjects. RESULTS Mean ± SD plasma and urine thiocyanate levels in Nyambori were 296 ± 190 and 497 ± 457 μM (n = 204), respectively, compared with 30 ± 37 and 9 ± 13 μM, respectively, in Uswaa (n = 92) (P < 0.001 for all differences). The mean blood cyanide level in Nyambori was elevated (1.4 [range 0.1–30.2] μM; n = 91). The prevalence of diabetes in the cassava village (Nyambori) was 0.5% compared with 0.9% in Uswaa (NS). The prevalence of IGT was similar in the two villages in the 15- to 34- and the 34- to 54-yr-old age-groups; but in those ≥ 55 yr old, IGT was higher in Nyambori (17.4 vs 7.2%, P = 0.029). Mean fasting and 2-h blood glucose levels were slightly higher in Nyambori village after adjusting for age, sex, and BMI (4.5 vs. 4.2 and 5.0 vs. 4.4 mM, respectively). CONCLUSIONS High dietary cyanide exposure was not found to have had a significant effect on the prevalence of diabetes in an undernourished population in Tanzania. Cassava consumption is thus highly unlikely to be a major etiological factor in so-called MRDM, at least in East Africa.