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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.
Authors’ addresses: Christoph Kaiser, Practice for Child and Adolescent Health, Baden-Baden, Germany, E-mail: email@example.com. George Asaba and Tom Rubaale, District Health Department, Kabarole District Local Government, Fort Portal, Uganda, E-mails: firstname.lastname@example.org and email@example.com. Walter Kipp, Department of Public Health Sciences, University of Alberta, Edmonton, Canada, E-mail: firstname.lastname@example.org. Ephraim Tukesiga, Vector Control Unit, Ministry of Health, Fort Portal, Uganda, E-mail: email@example.com.