Volume 78, Issue 3
  • ISSN: 0002-9637
  • E-ISSN: 1476-1645


Kaposi sarcoma (KS) is endemic in Uganda and shares several risk factors with intestinal parasite infestation, including rural residence, contact with surface water, and walking barefoot, however, the significance of these ecologic relationships is unknown. We investigated these relationships among 1,985 Ugandan patients with cancer. Odds ratios (OR) were calculated using logistic regression. KS patients had higher carriage of larvae (OR 2.1, 95% CI 1.2–3.7) and lower carriage of hookworm ova (0.6, 0.4–1.0) and cysts (0.7, 0.5–1.0), after adjusting for region of residence, age, gender, and diagnosis. While our findings may be due to confounding, they are compatible with shared risk factors or etiological association between parasites and KS, and warrant well-designed follow up studies.


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  1. Wabinga HR, Parkin DM, Wabwire-Mangen F, Nambooze S, 2000. Trends in cancer incidence in Kyadondo County, Uganda, 1960–1997. Br J Cancer 82 : 1585–1592.
  2. Chang Y, Cesarman E, Pessin MS, Lee F, Culpepper J, Knowles DM, Moore PS, 1994. Identification of herpesvirus-like DNA sequences in AIDS-associated Kaposi’s sarcoma. Science 266 : 1865–1869.
  3. Vitale F, Briffa DV, Whitby D, Maida I, Grochowska A, Levin A, Romano N, Goedert JJ, 2001. Kaposi’s sarcoma herpes virus and Kaposi’s sarcoma in the elderly populations of 3 Mediterranean islands. Int J Cancer 91 : 588–591.
  4. Templeton AC, Hutt MS, 1973. Distribution of tumours in Uganda. Recent Results Cancer Res 41 : 1–22.
  5. Mbulaiteye SM, Biggar RJ, Pfeiffer RM, Bakaki PM, Gamache C, Owor AM, Katongole-Mbidde E, Ndugwa CM, Goedert JJ, Whitby D, Engels EA, 2005. Water, socioeconomic factors, and human herpesvirus 8 infection in Ugandan children and their mothers. J Acquir Immune Defic Syndr 38 : 474–479.
  6. Newton R, Ziegler J, Bourboulia D, Casabonne D, Beral V, Mbidde E, Carpenter L, Reeves G, Parkin DM, Wabinga H, Mbulaiteye S, Jaffe H, Weiss R, Boshoff C, 2003. The seroepidemiology of Kaposi’s sarcoma-associated herpesvirus (KSHV/HHV-8) in adults with cancer in Uganda. Int J Cancer 103 : 226–232.
  7. de-The G, Bestetti G, van Beveren M, Gessain A, 1999. Prevalence of human herpesvirus 8 infection before the acquired immunodeficiency disease syndrome-related epidemic of Kaposi’s sarcoma in East Africa. J Natl Cancer Inst 91 : 1888–1889.
  8. Ziegler J, Newton R, Bourboulia D, Casabonne D, Beral V, Mbidde E, Carpenter L, Reeves G, Parkin DM, Wabinga H, Mbulaiteye S, Jaffe H, Weiss R, Boshoff C, 2003. Risk factors for Kaposi’s sarcoma: a case-control study of HIV-sero-negative people in Uganda. Int J Cancer 103 : 233–240.
  9. Handzel T, Karanja DM, Addiss DG, Hightower AW, Rosen DH, Colley DG, Andove J, Slutsker L, Secor WE, 2003. Geographic distribution of schistosomiasis and soil-transmitted helminths in Western Kenya: implications for anthelminthic mass treatment. Am J Trop Med Hyg 69 : 318–323.
  10. Williams EH, Williams PH, 1966. A note on an apparent similarity in distribution of onchocerciasis, femoral hernia and Kaposi’s sarcoma in the West Nile district of Uganda. East Afr Med J 43 : 208–209.
  11. Robinson AJ, Katongole-Mbidde E, 2006. Gastrointestinal parasites in Ugandan cancer patients: a retrospective departmental review. Trop Doct 36 : 188–189.
  12. Brown M, Miiro G, Nkurunziza P, Watera C, Quigley MA, Dunne DW, Whitworth JA, Elliott AM, 2006. Schistosoma mansoni, nematode infections, and progression to active tuberculosis among HIV-1-infected Ugandans. Am J Trop Med Hyg 74 : 819–825.
  13. Fontanet AL, Sahlu T, Rinke de Wit T, Messele T, Masho W, Woldemichael T, Yeneneh H, Coutinho RA, 2000. Epidemiology of infections with intestinal parasites and human immunodeficiency virus (HIV) among sugar-estate residents in Ethiopia. Ann Trop Med Parasitol 94 : 269–278.
  14. Kelly P, Baboo KS, Wolff M, Ngwenya B, Luo N, Farthing MJ, 1996. The prevalence and aetiology of persistent diarrhoea in adults in urban Zambia. Acta Trop 61 : 183–190.
  15. Tarimo DS, Killewo JZ, Minjas JN, Msamanga GI, 1996. Prevalence of intestinal parasites in adult patients with enteropathic AIDS in north-eastern Tanzania. East Afr Med J 73 : 397–399.
  16. Kamal SM, El Sayed Khalifa K, 2006. Immune modulation by helminthic infections: worms and viral infections. Parasite Immunol 28 : 483–496.
  17. Murphy RA, Barton G, Pinkas H, Schaefer R, 1991. Severe colitis due to Strongyloides stercoralis in a patient with cutaneous Kaposi’s sarcoma. Gastrointest Endosc 37 : 79–82.
  18. Lucas SB, 1990. Missing infections in AIDS. Trans R Soc Trop Med Hyg 84 (Suppl 1): 34–38.
  19. Newton R, Ziegler J, Bourboulia D, Casabonne D, Beral V, Mbidde E, Carpenter L, Parkin DM, Wabinga H, Mbulaiteye S, Jaffe H, Weiss R, Boshoff C, 2003. Infection with Kaposis ’ sarcoma-associated herpesvirus (KSHV) and human immunodeficiency virus (HIV) in relation to the risk and clinical presentation of Kaposi’s sarcoma in Uganda. Br J Cancer 89 : 502–504.
  20. Brown M, Mawa PA, Kaleebu P, Elliott AM, 2006. Helminths and HIV infection: epidemiological observations on immunological hypotheses. Parasite Immunol 28 : 613–623.
  21. Newton R, Ziegler J, Beral V, Mbidde E, Carpenter L, Wabinga H, Mbulaiteye S, Appleby P, Reeves G, Jaffe H, 2001. A case-control study of human immunodeficiency virus infection and cancer in adults and children residing in Kampala, Uganda. Int J Cancer 92 : 622–627.
  22. Brink AK, Mahe C, Watera C, Lugada E, Gilks C, Whitworth J, French N, 2002. Diarrhea, CD4 counts and enteric infections in a community-based cohort of HIV-infected adults in Uganda. J Infect 45 : 99–106.
  23. Viney ME, Brown M, Omoding NE, Bailey JW, Gardner MP, Roberts E, Morgan D, Elliott AM, Whitworth JA, 2004. Why does HIV infection not lead to disseminated strongyloidiasis? J Infect Dis 190 : 2175–2180.
  24. Viney M, 2002. How do host immune responses affect nematode infections? Trends Parasitol 18 : 63–66.
  25. Ziegler JL, Newton R, Katongole-Mbidde E, Mbulataiye S, De Cock K, Wabinga H, Mugerwa J, Katabira E, Jaffe H, Parkin DM, Reeves G, Weiss R, Beral V, 1997. Risk factors for Kaposi’s sarcoma in HIV-positive subjects in Uganda. AIDS 11 : 1619–1626.

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  • Received : 08 Nov 2007
  • Accepted : 15 Dec 2007

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