Author/Authors :
Spencer, PS Oregon Health Science University - School of Medicine, Center for Research on Occupational and Environmental Toxicology, Global Health Center - Department of Neurology, USA , Vandemaele, K World Health Organization - Department of Pandemic and Epidemic Diseases, Switzerland , Richer, M U.S. Agency for International Development (USAID) - Carter Center, Health Net International, Sudan , Palmer, VS Oregon Health Science University - Global Health Center, USA , Chungong, S World Health Organization - Department of Global Capacities Alert and Response, Switzerland , Anker, M University of Massachusetts - School of Public Health and Health Sciences, USA , Ayana, Y World Health Organization, Sudan , Opoka, ML World Health Organization - Eastern Mediterranean Regional Office (EMRO) - Division of Communicable Disease Control (DCD), Disease Surveillance, Forecasting and Response, Egypt , Klaucke, BN , Quarello, A Clinica Medica University of Padova, Italy , Tumwine, JK Makerere University - Department of Paediatrics and Child Health, Uganda
Abstract :
Background: Nodding Syndrome is a seizure disorder of children in Mundri County, Western Equatoria, South Sudan. The disorder is reported to be spreading in South Sudan and northern Uganda. Objective: To describe environmental, nutritional, infectious, and other factors that existed before and during the de novo 1991 appearance and subsequent increase in cases through 2001. Methods: Household surveys, informant interviews, and case-control studies conducted in Lui town and Amadi village in 2001-2002 were supplemented in 2012 by informant interviews in Lui and Juba, South Sudan. Results: Nodding Syndrome was associated with Onchocerca volvulus and Mansonella perstans infections, with food use of a variety of sorghum (serena) introduced as part of an emergency relief program, and was inversely associated with a history of measles infection. There was no evidence to suggest exposure to a manmade neurotoxic pollutant or chemical agent, other than chemically dressed seed intended for planting but used for food. Food use of cyanogenic plants was documented, and exposure to fungal contaminants could not be excluded. Conclusion: Nodding Syndrome in South Sudan has an unknown etiology. Further research is recommended on the association of Nodding Syndrome with onchocerciasis/mansonelliasis and neurotoxins in plant materials used for food.
Keywords :
Epilepsy , filariasis , sorghum , neurotoxins , neurotoxins , Moru , Dinka
