Prevalence of EBV-Associated Burkitt Lymphoma Among Paediatric Oncology Patients in Enugu State

Epstein-Barr virus (EBV) plays a central aetiological role in endemic Burkitt lymphoma, the most common childhood cancer in sub-Saharan Africa, where its incidence is strongly linked to holoendemicmalaria and EBV co-infection. This study investigates the proportion of paediatric Burkitt lymphoma cases at the University of Nigeria Teaching Hospital (UNTH), Enugu, South East Nigeria, that are EBV-positive, and characterises patient demographics and treatment outcomes. A retrospective laboratory-based study will review histopathological records and archived tissue specimens from paediatric Burkitt lymphoma diagnoses at UNTH between 2019 and 2024. Formalin-fixed paraffin-embedded tumour sections will be subjected to in situ hybridisation for EBV-encoded small RNA (EBER) detection. Clinical data on age at presentation, jaw versus abdominal tumour site, staging, and chemotherapy response will be extracted. Prior studies from South East Nigeria and comparable African settings report EBV association in 90 to 100 percent of endemic Burkitt lymphoma cases. Confirming EBV aetiology in Enugu's paediatric oncology population contributes to the evidence base for EBV vaccination as a preventive strategy and informs pathology departments in standardising EBV testing for lymphoma diagnosis. This study supports paediatric oncology infrastructure development in South East Nigeria. Keywords: Epstein-Barr virus, Burkitt lymphoma, paediatric oncology, UNTH Enugu, EBER