PROMOTING ACCESS TO AFRICAN RESEARCH

African Health Sciences

Log in or Register to get access to full text downloads.

Remember me or Register



Clinical and epidemiologic characteristics of nodding syndrome in Mundri County, southern Sudan

JK Tumwine, K Vandemaele, S Chungong, M Richer, M Anker, Y Ayana, ML Opoka, DN Klaucke, A Quarello, PS Spencer

Abstract


Background: Nodding syndrome (repetitive nodding and progressive generalized seizures) is assuming epidemic proportions in South Sudan, Tanzania and Uganda.
Objective: To describe clinical and epidemiological features of nodding syndrome in southern Sudan based on preliminary investigations conducted in 2001 and 2002.
Method: Household surveys, clinical, electrophysiological (EEG) assessments, informant interviews and case-control studies were conducted in the town of Lui and the village of Amadi in southern Sudan.
Results: Nodding syndrome is characterized by involuntary repetitive nodding of the head, progressing to generalized seizures; mental and physical deterioration. The EEGs were consistent with progressive epileptic encephalopathy. Prevalence of Nodding syndrome in Lui and Amadi was 2.3% and 6.7% respectively. All case control studies showed a positive association between cases and Onchocerca volvulus. A history of measles was negatively associated with being a case: 2/13 of cases and 11/19 of controls had had measles: odds ratio 0.13 (95% CI 0.02, 0.76). Environmental assessment did not reveal any naturally occurring or manmade neurotoxic factors to explain Nodding Syndrome, although fungal contamination of food could not be ruled out.
Conclusion: Nodding Syndrome was strongly associated with Onchocerca volvulus. There was no evidence to suggest an environmental pollutant, chemical agent, or other toxic factor.

Key words: nodding, syndrome, South Sudan, clinical, epidemiology


Article Metrics

Metrics Loading ...

Metrics powered by PLOS ALM


http://dx.doi.org/10.4314/ahs.v12i3.1
AJOL African Journals Online