Abstract

Anywar Arony Denis, Angwech Collines, Makumbi Edward Frederick, Suzanne Gazda,
*Prof. Kitara David Lagoro

ABSTRACT

Background: Nodding Syndrome (NS) is a childhood neurological disorder characterised by atonic seizures, cognitive decline, school dropout, muscle weakness, thermal dysfunction, wasting and stunted growth. The objective of this study was to describe the epidemiological, clinical, dietary and environmental factors associated with NS children who were undergoing treatment at the Hope for HumaNs (HfH) rehabilitation centre in Northern Uganda. Methods: We conducted a study on 47 NS children in 2014 as part of a pilot project. This was one of prospective studies conducted at HfH centre to find the cause of NS. Ethical approval for the study was obtained from Lacor Hospital IRB (LHIREC No. 065/10/14) and STATA version 12 (Stata Corp LP, Texas, USA) was used for data analysis. Results: We found Low BMI for age (z-scores) mean 16.92 95% CI(16.09, 17.74); Current age 14.08 95% CI(0.78, 4.66); Duration of IDP camp stay 4.82 95% CI(4.48, 5.21); Age of nodding onset 8.02 95% CI(7.03, 9.01); Nodding associated with loss of consciousness 1.98 95% CI(1.61, 2.35); multiple nodding episodes (?2)=22.15, p=0.005; Birth oders (?2)=9.68, p=0.38; Caretakers were their mothers (?2)=6.39; p=0.041; Mothers gave better social support (?2)=10.59; p=0.005; NS child had other siblings with NS (?2)=9.68, p=0.004; and NS child was in the IDP camps (?2)=22.15, p=0.005. Conclusion: Nodding Syndrome is a childhood neurological disorder identified by World Health Organization (WHO) in three sites in East Africa but the cause is not known. The epidemiological, clinical, dietary and environmental analysis of NS children’s history and physical assessments show that we may perhaps be dealing with environmental and dietary factors that have not yet been identified but perhaps experienced in the IDP camps. There are no new NS cases reported by the Ugandan Ministry of Health (MOH) or WHO since 2012 when all the IDP camps had been disbanded and communities resettled in their villages and feed on their own home grown foods.