Changes in Patterns of Hodgkin’s Disease in Algeria, 1966–1985: Influence of Health Care Delivery System

Prof. Pierre, Colonna Haematology Clinic, Centre Pierre et Marie Curie, Hôpital Mustapha, Alger (Algeria) Descriptive epidemiology of Hodgkin’s disease (HD) has led to the identification of several patterns, attributed to the interplay of environmental and host aetiologic factors. Pattern I (high rate in children, predominance of mixed cellularity histologic subtype) prevails in developing countries, whereas pattern III (initial pronounced peak in young adults, predominance of nodular sclerosis histologic subtype) is prevalent in affluent, wealthy, urbanized countries. The intermediate pattern II is observed in rural areas of developed countries [1]. We studied the epidemiologic characteristics of all Algerian patients with HD who were recorded at our clinic from January 1966 to December 1985. During this period, the age and sex stratification of the Algerian population remained identical, but the percentage of children in our outpatient department diminished from 0.26 to 0.16 [2]. The data are summarized in the table I. The most striking features are: (i) a decrease in the number of children, as a consequence of the development in the Algiers area of a network of paediatric oncology units, for adult patients age stratification remained similar; (ii) a significant shift of clinical stages 1 This work was supported by INESSM (Algiers), INSERM (Paris) and AREMAS (Paris). Table I. Changes in patterns of Hodgkin’s disease in Algiers, 1966–1985