Risk Factors for Nodding Syndrome and Other Forms of Epilepsy in Northern Uganda: A Case-Control Study.

Journal: Pathogens (Basel, Switzerland)

Volume: 10

Issue: 11

Year of Publication: 

Affiliated Institutions:  Department of Mental Health, Kabale University School of Medicine, Kabale P.O. Box , Uganda. Global Health Institute, University of Antwerp, Antwerp, Belgium. Department of Statistical methods, School of Statistics and Planning, College of Business and Management Sciences, Makerere University, Kampala P.O. Box , Uganda. College of Health Sciences, Makerere University, Kampala P.O. Box , Uganda. Centre for Tropical Medicine and Global Health, University of Oxford, Oxford OX LG, UK.

Abstract summary 

Epidemiological studies suggest a link between onchocerciasis and various forms of epilepsy, including nodding syndrome (NS). The aetiopathology of onchocerciasis associated epilepsy remains unknown. This case-control study investigated potential risk factors that may lead to NS and other forms of non-nodding epilepsy (OFE) in northern Uganda. We consecutively recruited 154 persons with NS (aged between 8 and 20 years), and age-frequency matched them with 154 with OFE and 154 healthy community controls. Participants' socio-demography, medical, family, and migration histories were recorded. We tested participants for serum antibodies. The 154 controls were used for both OFE and NS separately to determine associations. We recruited 462 people with a median age of 15 years (IQR 14, 17); 260 (56.4%) were males. Independent risk factors associated with the development of NS were the presence of antibodies [aOR 8.79, 95% CI (4.15-18.65), -value < 0.001] and preterm birth [aOR 2.54, 95% CI (1.02-6.33), -value = 0.046]. Risk factors for developing OFE were the presence of O. volvulus antibodies [aOR 8.83, 95% CI (4.48-17.86), -value < 0.001] and being born in the period before migration to IDP camps [aOR 4.28, 95% CI (1.20-15.15), -value = 0.024]. In conclusion, was a risk factor to develop NS and OFE; premature birth was a potential co-factor. Living in IDP camps was not a risk factor for developing NS or OFE.

Authors & Co-authors:  Gumisiriza Kugler Brusselaers Mubiru Anguzu Ningwa Ogwang Akun Mwaka Abbo Sekibira Hotterbeekx Colebunders Marsh Idro

Study Outcome 

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Statistics
Citations :  Sejvar J.J., Kakooza A.M., Foltz J.L., Makumbi I., Atai-Omoruto A.D., Malimbo M., Ndyomugyenyi R., Alexander L.N., Abang B., Downing R.G., et al. Clinical, Neurological, and Electrophysiological Features of Nodding Syndrome in Kitgum, Uganda: An Observational Case Series. Lancet Neurol. 2013;12:166–174. doi: 10.1016/S1474-4422(12)70321-6.
Authors :  15
Identifiers
Doi : 1451
SSN : 2076-0817
Study Population
Male,Female
Mesh Terms
Other Terms
Uganda;epilepsy;nodding syndrome;onchocerciasis;risk factors
Study Design
Study Approach
Country of Study
Uganda
Publication Country
Switzerland