1921
Volume 99, Issue 5
  • ISSN: 0002-9637
  • E-ISSN: 1476-1645

Abstract

Abstract.

Nodding syndrome (NS) is an encephalopathy characterized by the core symptom of epileptic head nodding seizures, affecting children at the age between 3 and 18 years in distinct areas of tropical Africa. A consistent correlation with onchocerciasis was found, but so far, the causation of NS has not been fully clarified. With a systematic analysis of features of a cohort of epilepsy patients examined in the Itwara onchocerciasis focus of western Uganda in 1994, we provide evidence that NS actually occurred in this area at this time, and we demonstrate a correlation between prevalence of NS and that of onchocerciasis in different villages. Following the elimination of onchocerciasis by community-directed treatment with ivermectin and ground larviciding, our data provide a baseline to examine the question whether NS will disappear once its putative cause has been removed.

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References

  1. Ovuga E, Kipp W, Mungherera M, Kasoro S, , 1992. Epilepsy and retarded growth in a hyperendemic focus of onchocerciasis in rural western Uganda. East Afr Med J 69: 554556. [Google Scholar]
  2. Kipp W, Kasoro S, Burnham G, , 1994. Onchocerciasis and epilepsy in Uganda. Lancet 343: 183184. [Google Scholar]
  3. Kaiser C, Kipp W, Asaba G, Mugisa C, Kabagambe G, Rating D, Leichsenring L, , 1996. The prevalence of epilepsy follows the distribution of onchocerciasis in a west Ugandan focus. Bull World Health Organ 74: 361367. [Google Scholar]
  4. Kaiser C, Benninger C, Asaba G, Mugisa C, Kabagambe G, Kipp W, Rating D, , 2000. Clinical and electro-clinical classification of epileptic seizures in west Uganda. Bull Soc Pathol Exot 93: 255259. [Google Scholar]
  5. Kaiser C, Rubaale T, Tukesiga E, Kipp W, Asaba G, , 2015. Case report: nodding syndrome, western Uganda, 1994. Am J Trop Med Hyg 93: 198202. [Google Scholar]
  6. Aall-Jilek LM, , 1965. Epilepsy in the Wapagoro tribe in Tanganyika. Acta Psychiatr Scand 41: 5786. [Google Scholar]
  7. Lacey M, , 2003. Nodding disease: mystery of southern Sudan. Lancet Neurol 2: 714. [Google Scholar]
  8. Spencer PS, 2013. Nodding syndrome in Mundri county, South Sudan: environmental, nutritional and infectious factors. Afr Health Sci 13: 183204. [Google Scholar]
  9. Idro R, 2014. Nodding syndrome in Ugandan children–clinical features, brain imaging and complications: a case series. BMJ Open 3: e002540. [Google Scholar]
  10. Foltz JL, 2013. An epidemiologic investigation of potential risk factors for nodding syndrome in Kitgum District, Uganda. PLoS One 8: e66419. [Google Scholar]
  11. Van Bemmel K, Derluyn I, Stroeken K, , 2014. Nodding syndrome or disease? On the conceptualization of an illness-in-the-making. Ethn Health 19: 100118. [Google Scholar]
  12. Winkler AS, 2015. The head nodding syndrome—clinical classification and possible causes. Epilepsia 49: 20082015. [Google Scholar]
  13. Dowell SF, 2013. Nodding syndrome. Emerg Infect Dis 19: 13741384. [Google Scholar]
  14. World Health Organisation, 2012. International Scientific Meeting on Nodding Syndrome, Kampala, Uganda. Available at: http://www.who.int/neglected_diseases/diseases/Nodding_syndrom_Kampala_Report_2012.pdf. Accessed April 10, 2018.
  15. Fischer P, Kipp W, Bamuhiga J, Binta-Kahwa J, Kiefer A, Büttner DW, , 1993. Parasitological and clinical characterization of Simulium neavei-transmitted onchocerciasis in western Uganda. Trop Med Parasitol 44: 311321. [Google Scholar]
  16. Garms R, Lakwo TL, Ndyomugyenyi R, Kipp W, Rubaale T, Tukesiga E, Katamanywa J, Post RJ, Amazigo UV, , 2009. The elimination of the vector Simulium neavei from the Itwara onchocerciasis focus in Uganda by ground larviciding. Acta Trop 111: 203210. [Google Scholar]
  17. Kaiser C, , 1998. Introducing Anti-Epileptic Treatment into Primary Health Care: A Case Study in an Area of High Epilepsy Prevalence in Kabarole District, West Uganda. MSc Thesis, Institute of Tropical Hygiene and Public Health, University of Heidelberg, Heidelberg, Germany.
  18. Kaiser C, Asaba G, Leichsenring M, Kabagambe G, , 1998. High incidence of epilepsy related to onchocerciasis in west Uganda. Epilepsy Res 30: 247251. [Google Scholar]
  19. Kaiser C, Asaba G, Mugisa C, Kipp W, Kasoro S, Rubaale T, Kabagambe G, , 1998. Antiepileptic drug treatment in rural Africa: involving the community. Trop Doct 28: 7377. [Google Scholar]
  20. Kuczmarski RJ, Ogden CL, Grummer-Strawn LM, Flegal KM, Mei Z, Wei R, Curtin LR, Roche AF, Johnson CL, , 2002. 2000 CDC growth charts for the United States: methods and development. Vital Health Stat 11: 1190. [Google Scholar]
  21. Marshall WA, Tanner JM, , 1969. Variations in pattern of pubertal changes in girls. Arch Dis Child 235: 291303. [Google Scholar]
  22. Marshall WA, Tanner JM, , 1970. Variations in the pattern of pubertal changes in boys. Arch Dis Child 239: 1323. [Google Scholar]
  23. Abreu AP, Kaiser UB, , 2016. Pubertal development and regulation. Lancet Diabetes Endocrinol 4: 254264. [Google Scholar]
  24. Iyengar PJ, Centers for Disease Control and Prevention (CDC) , 2014. Prevalence of nodding syndrome–Uganda 2012–2013. MMWR Morb Mortal Wkly Rep 63: 603606. [Google Scholar]
  25. Schmutzhard E, Winkler AS, , 2016. Nodding syndrome–a critical note and a plea to join forces. Trop Med Int Health 20: 201204. [Google Scholar]
  26. Burnham G, , 2003. The right word. Lancet 361: 456. [Google Scholar]
  27. Van Bemmel K, Van der Weegen K, , 2017. Universal classifications, national approaches and specific situations: a comparative study on the conceptualization of nodding syndrome in Uganda and Tanzania. Anthropol Med 30: 120. [Google Scholar]
  28. Jilek WG, Jilek-Aall LM, , 1970. The problem of epilepsy in rural Africa: ‘Kifafa’ in a Tanzanian tribe. Transcult Psychiatry 7: 4348. [Google Scholar]
  29. Tumwine JK, Vandemaele K, Chungong S, Richer M, Anker M, Ayana Y, Opoka ML, Klaucke DN, Quarello A, Spencer PS, , 2012. Clinical and epidemiologic characteristics of nodding syndrome in Mundri county, southern Sudan. Afr Health Sci 12: 242248. [Google Scholar]
  30. Anonymous, 2009. Nodding Disease or “River Epilepsy.” Integrated Regional Information Network (IRIN), Kitgum. Press release 10 August 2009. Available at: http://www.irinnews.org/report/85646/uganda-nodding-disease-or-river-epilepsy. Accessed April 10, 2018.
  31. Kitara DL, Oh J, Mwaka AD, , 2013. Nodding syndrome in Uganda—a disease cluster: an epidemiological dilemma. Pac J Med Sci 11: 2133. [Google Scholar]
  32. Colebunders R, 2016. Nodding syndrome and epilepsy in onchocerciasis endemic regions: comparing preliminary observations from South Sudan and the Democratic Republic of the Congo with data from Uganda. BMC Res Notes 9: 182. [Google Scholar]
  33. Spencer PS, other Members of the Oregon-Uganda Nodding Syndrome Research Team , 2016. Environmental, dietary and case-control study of nodding syndrome in Uganda: a post-measles brain disorder triggered by malnutrition? J Neurol Sci 369: 191203. [Google Scholar]
  34. Mpagi J, Katamanywa J, Garms R, , 2001. Dispersal range of Simulium neavei in an onchocerciasis focus of western Uganda. Med Vet Entomol 14: 9599. [Google Scholar]
  35. Pion SDS, 2009. Epilepsy in onchocerciasis endemic areas: systematic review and meta-analysis of population-based surveys. PLoS Negl Trop Dis 3: e461. [Google Scholar]
  36. Levick B, 2017. High prevalence of epilepsy in onchocerciasis endemic regions in the Democratic Republic of the Congo. PLoS Negl Trop Dis 11: e0005732. [Google Scholar]
  37. Ngugi AK, SEEDS Group , 2013. Prevalence of active convulsive epilepsy in sub-Saharan Africa and associated risk factors: cross-sectional and case-control studies. Lancet Neurol 12: 253263. [Google Scholar]
  38. Boussinesq M, Pion SD, Demanga-Ngangue Kamgno J, , 2002. Relationship between onchocerciasis and epilepsy: a matched case-control study in the Mbam Valley, Republic of Cameroon. Trans R Soc Trop Med Hyg 96: 537541. [Google Scholar]
  39. Colebunders R, 2016. Prevalence of river epilepsy in the Orientale Province in the Democratic Republic of the Congo. PLoS Negl Trop Dis 10: e0004478. [Google Scholar]
  40. Kaiser C, Pion SDS, Boussinesq M, , 2013. Case-control studies on the relationship between onchocerciasis and epilepsy: systematic review and meta-analysis. PLoS Negl Trop Dis 7: e2147. [Google Scholar]
  41. König R, 2010. The role of Onchocerca volvulus in the development of epilepsy in a rural area of Tanzania. Parasitology 137: 15591568. [Google Scholar]
  42. Sejvar JJ, 2013. Clinical, neurological, and electrophysiological features of nodding syndrome in Kitgum, Uganda: an observational case series. Lancet Neurol 12: 166174. [Google Scholar]
  43. Johnson TP, 2017. Nodding syndrome may be an autoimmune reaction to the parasitic worm Onchocerca volvulus. Sci Transl Med 9: eaaf6953. [Google Scholar]
  44. Spencer PS, Schmutzhard E, Winkler AS, , 2017. Nodding syndrome in the spotlight–placing recent findings in perspective. Trends Parasitol 33: 490492. [Google Scholar]
  45. Kakooza-Mwesige A, , 2017. Unravelling the mysterious onchocerciasis-nodding syndrome link: new developments and future challenges. Ann Transl Med 5: 486. [Google Scholar]
  46. Kaiser C, Pion SDS, , 2017. River blindness goes beyond the eye: autoimmune antibodies, cross-reactive with Onchocerca volvulus antigen, detected in brain of patients with nodding syndrome. Ann Transl Med 5: 459. [Google Scholar]
  47. Kaiser C, Asaba G, Kasoro S, Rubaale T, Kabagambe G, Mbabazi M, , 2007. Mortality from epilepsy in an onchocerciasis-endemic area in west Uganda. Trans R Soc Trop Med Hyg 101: 4855. [Google Scholar]
  48. Kipp W, Burnham G, Bamuhiiga J, Leichsenring M, , 1996. The Nakalanga syndrome in Kabarole district, western Uganda. Am J Trop Med Hyg 54: 8083. [Google Scholar]
  49. Föger K, Gora-Stahlberg G, Sejvar J, Ovuga E, Jilek-Aall L, Schmutzhard E, Kaiser C, Winkler AS, , 2017. Nakalanga syndrome: clinical characteristics, potential causes, and its relationship with recently described nodding syndrome. PLoS Negl Trop Dis 11: e0005201. [Google Scholar]
  50. Colebunders R, Suykerbuyk P, Jacob ST, van Oijen M, , 2017. Nodding syndrome, other forms of epilepsy, and the Nakalanga syndrome most likely directly or indirectly caused by Onchocerca volvulus. J Neurol Sci 372: 439440. [Google Scholar]
  51. Chesnais CB, Njamnshi AK, Zoung-Kanyi Bissek A-C, Tatah GY, Nana-Djeunga HC, Kamgno J, Colebunders R, Boussinesq M, , 2018. First evidence by a cohort study in Cameroon that onchocerciasis does induce epilepsy [Abstract at the first International Workshop on Onchocerciasis-Associated Epilepsy, Antwerp, Belgium, 2017]. Infect Dis Poverty 7: 23. Available at: https://www.uantwerpen.be/en/conferences/oae-2017/. Accessed May 23, 2018. [Google Scholar]
  52. Coffeng LE, 2013. African programme for onchocerciasis control 1995–2015: model-estimated health impact and cost. PLoS Negl Trop Dis 7: e2032. [Google Scholar]
  53. Katabarwa MN, 2018. After 70 years of fighting an age-old scourge, onchocerciasis in Uganda, the end is in sight. Int Health 10 (Suppl 1): 7988. [Google Scholar]
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  • Received : 16 Jun 2018
  • Accepted : 05 Aug 2018
  • Published online : 17 Sep 2018

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