Study 8 — Plasmodium falciparum Control and Endemic Burkitt Lymphoma in Sub-Saharan Africa: Meta-Analysis and ITS

Study 8 of the Hidden Infections research series. Evidence tier: STRONG. Plasmodium falciparum malaria is currently IARC Group 2A (probably carcinogenic) for endemic Burkitt lymphoma (eBL), the most common childhood cancer in malaria-endemic sub-Saharan Africa. This study presents: a 17-country systematic review and meta-analysis documenting malaria transmission intensity as a predictor of eBL incidence; a three-epoch coastal Kenya temporal series showing eBL rate decline coinciding with ITN scale-up; and dose-response evidence from the EMBLEM study showing cumulative malaria exposure quantitatively predicts eBL risk at the individual level. The population attributable fraction for P. falciparum as a cause of eBL is estimated at approximately 80% (Imperial College). Together, the evidence supports upgrading P. falciparum to IARC Group 1. Group B: Causal natural experiments. CC0 public domain. AI-assisted draft pre-print.