Nodding Syndrome (NS) in Northern Uganda: A Probable Metabolic Disorder
David Lagoro Kitara *
Department of Surgery, Gulu University, Faculty of Medicine, P.0. Box166, Gulu, Uganda.
Amos Deogratius Mwaka
Department of Internal Medicine, Makerere University, College of Health Sciences, Medical School, P.0. Box 7072, Kampala, Uganda.
Denis Arony Anywar
Department of Biochemistry and Biostatistics, Gulu University, P.0. Box 166, Gulu, Uganda.
Gilbert Uwonda
Department of Biochemistry and Biostatistics, Gulu University, P.0. Box 166, Gulu, Uganda.
Bernard Abwang
Uganda Ministry of Health, Headquarters, P.0. Box 7272, Kampala, Uganda.
Edward Kigonya
Uganda Ministry of Health, Headquarters, P.0. Box 7272, Kampala, Uganda.
*Author to whom correspondence should be addressed.
Abstract
Aims: To conduct an epidemiological study to establish the association between malnutrition, metabolic disorder and Onchocerciasis to Nodding Syndrome (NS) in Northern Uganda.
Study Design: Case-control study design.
Place and Duration of Study: Odek and Atiak sub counties in Gulu and Amuru districts between 10th to 20th June 2012.
Methodology: We recruited consecutively 101 children with probable NS in the 2 sub counties in Gulu and Amuru districts. Controls were from the same population but without symptoms of NS and were matched by age, sex and residents. History and physical examinations were conducted; anthropometry, blood samples and skin snips were obtained from cases and controls. Researchers were pediatricians, psychiatrists, nurses, laboratory scientists and epidemiologists. The research proposal was approved by the Ministry of Health and the IRB of Gulu University.
Results: There was a statistically significant association between NS with malnutrition (t=0.142; p=0.044), Onchocerciasis (Χ2 = 152.74, p<0.001; OR 7.025 95% CI 3.891, 12.682) and High Anion Gap (Χ2=146.752, p<0.001; OR 6.313 95%CI 4.027, 9.895).
Conclusion: Nodding syndrome is associated with metabolic disorder in young children who are malnourished and infected with Onchocerciasis.
Keywords: Nodding syndrome, Onchocerciasis, malnutrition, metabolic disorder, Gulu, Northern Uganda