Burkitt's Lymphoma (BL) is a malignant form of tumor associated with EBV and endemic to central parts of Africa and New Guinea.  It is associated with holoendemic malaria and occurs sporadically within these regions.  The transformation of B-lymphocytes by EBV occurs within the first few years of life (3).

The epidemiological involvement of EBV in Burkitt's Lymphoma is based on the recognition of the EBV viral genome in tumor cells, based on DNA fingerprinting, using techniques such as Southern blotting and PCR. (3).  An elevated antibody titer against EBV (VCA) is also observed in BL patients.

Morbidity
The most well known distribution of BL is in Africa, where Burkitt discovered the disease's association with EBV and traveled throughout the continent, visiting hospitals, and documenting the prevalence of BL.  This lead to the naming of the "lymphoma belt," a region of high incidence in Africa, extending from West Africa to East Africa between 10° north and south of the equator and continuing down the eastern coast south.  Temperature and humidity were associated with the belt, which was later considered to be the reason for an association of malaria with BL (3).

Descriptive Epidemiology
In the endemic areas of Africa, BL is the leading childhood cancer, occurring in as many as 4-5 cases per 100,000 (3).  In areas where EBV infection occurs at a very early age and malaria is holoendemic, the incidence of association with BL is highest.

Distribution
In African countries in the lymphoma belt, such as Uganda, there is a very high association between BL and EBV (97%).  In Northern Africa, the association drops to 85% in Algeria.  However, in France and the United States, the rare cases of Burkitt's lymphoma are only associated with EBV in 10-15% of all reported cases (3).
 

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