Reduced plasma concentrations of vitamin B6 and increased plasma concentrations of the neurotoxin 3-hydroxykynurenine are associated with nodding syndrome: a case control study in Gulu and Amuru districts, Northern Uganda

  • James Henry Obol
  • Denis Anywar Arony
  • Ronald Wanyama
  • Kenneth Luryama Moi
  • Bongomin Bodo
  • Patrick Olwedo Odong
  • Michael Odida

Abstract

Introduction: Nodding syndrome was first reported in Uganda in 2003 among internally displaced populations. Risk factors for the syndrome remain unknown. We therefore explored vitamin B6 deficiency and resulting high 3-hydroxykynurenine (3-HK) levels as risk factor for nodding syndrome in Northern Uganda. Methods: Case-control study conducted in Gulu and Amuru districts. Cases were children/young adults with nodding syndrome. Healthy children/young adults were recruited as controls from same community as cases. Data on socio-demographic and other risk factors was collected using questionnaires. Whole blood was collected in EDTA tubes for assay of 3-HK and vitamin B6 using sandwich ELISA. Conditional logistic regression model was used to assess associations. Results: 66 cases and 73 controls were studied. Factors associated with nodding syndrome were being positive for 3-HK (AOR=4.50, p=0.013), vitamin B6 concentration below mean (AOR=7.22, P=0.001), child being taken care of by mother only (AOR=5.43, p=0.011), child being taken care of by guardian (AOR=5.90, p=0.019) and child consuming relief food at weaning (AOR=4.05, p=0.021). Conclusion: Having low vitamin B6 concentration which leads to a build up of 3-hydroxykynurenine concentration in cases as a main risk factor. Therefore, cases should be treated with vitamin B6 and community members should be sensitise to ensure adequate dietary intake of vitamin B6 so that the risk of nodding syndrome among children is averted. We encourage future prospective intervention study to be conducted to assess the effect of low vitamin B6 on the development of nodding syndrome via raised 3-HK concentration.

Pan African Medical Journal 2016; 24

Author Biographies

James Henry Obol
Department of Public Health, Faculty of Medicine, Gulu University, P.O Box 166, Gulu
Denis Anywar Arony
Department of Medical Biochemistry, Faculty of Medicine, Gulu University, P.O Box 166, Gulu
Ronald Wanyama
Department of Medical Biochemistry, Faculty of Medicine, Gulu University, P.O Box 166, Gulu
Kenneth Luryama Moi
Department of Microbiology and Immunology, Faculty of Medicine, Gulu University, P.O Box 166, Gulu
Bongomin Bodo
Department of Paediatrics and Child Health, Faculty of Medicine, Gulu University, P.O Box 166, Gulu
Patrick Olwedo Odong
District Health Office, Amuru District Local Government, P.O Box 1074 Gulu
Michael Odida
Department of Pathology, Makerere University College of Health Sciences, P.O Box 7072 Kampala
Published
2016-09-13
Section
Articles

Journal Identifiers


eISSN: 1937-8688