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UGANDA/SOUTH SUDAN: Nodding Syndrome - Hundreds of children infected

Re: UGANDA: Nodding disease or "river epilepsy"? Hundreds of children infected

Re: UGANDA: Nodding disease or "river epilepsy"? Hundreds of children infected

Apparently the USA CDC has determined that African Swine Fever virus is not a causal factor in this outbreak of nodding disease.

They have begun further pathogen discovery work using next generation sequencing and they will release the results of this work if approved by the Ugandan government. This process is expected to take several months.
 
Last edited:
Re: UGANDA: Nodding disease or "river epilepsy"? Hundreds of children infected

Re: UGANDA: Nodding disease or "river epilepsy"? Hundreds of children infected

http://www.promedmail.org/

ished Date: 2012-04-22 21:42:17
Subject: PRO/EDR> Undiagnosed cerebral disease - Uganda (06): nodding disease
Archive Number: 20120422.1109909

UNDIAGNOSED CEREBRAL DISEASE - UGANDA (06): NODDING DISEASE
***********************************************************
A ProMED-mail post
http://www.promedmail.org
ProMED-mail is a program of the
International Society for Infectious Diseases
http://www.isid.org

[1]Date: Sun, Apr 22, 2012
Source: Friedrich MJ. Targeting Nodding Disease. Journal of the American Medical Association, JAMA 2012;307(15):1573.doi: 10.1001/jama.2012.477 < http://jama.ama-assn.org/content/307/15/1573.1.extract>


Task force to address nodding disease in Uganda
-----------------------------------------------
The Ugandan Ministry of Health is setting up a task force to raise awareness about a mysterious illness called nodding disease or nodding syndrome ? characterized by repetitive head nodding and seizures?that is affecting thousands of children in East Africa (http://tinyurl.com/73zj53r).
The plan is to establish screening and treatment centers and mobile clinics in the affected districts, enhance surveillance, and continue efforts to determine the etiology of the disease.

In the last several years, an increase in nodding syndrome has been reported in children between the ages of 5 and 15 years in northern Uganda, as well as South Sudan and southern Tanzania, but the cause and natural history of the disease remain unclear.

Earlier in the year, findings from a case-control study of 2 clusters of nodding syndrome assessed in 38 matched case-control pairs in South Sudan indicated a positive association between the disease and infection with a nematode that causes ? [onchocerciasis].

(Full text only available to registered users or after purchase).

[Communicated by
Terry S. Singeltary Sr.
flounder9@verizon.net]

--
[2]
Date: Fri, 13 Apr, 2012
Source: Science 2012;336(6078) :144-146. DOI: 10.1126/science.336.6078.144
http://www.sciencemag.org/content/336/6078/144


Mystery Disease Haunts Region
-----------------------------
In Mahenge, a town in a mountainous and isol
ated area of southern Tanzania, a great number of people suffer from epilepsy. Some of the most severe cases are found in people who were normal until they were around 4 or 5 years old, when they began to have seizures characterized by repeated downward
movements of their heads. For many years, Western colleagues doubted or dismissed reports of the nodding seizures, first described in a 1964 paper.

Now an apparent outbreak of a similar nodding syndrome in Uganda and southern South Sudan over the past few years has attracted many more researchers to look for possible causes. They are chasing several suspects, including a parasitic worm, but so far there's no proven culprit. Without a clear explanation of the condition's cause or effective treatments, defeating the disease will be no easy task.

(Full text only available to registered users or after purchase).

[Communicated by
Terry S. Singeltary Sr.
flounder9@verizon.net]

--
[3]
Date: Thu, 12 Apr, 2012
Source: United Against Infectious Diseases [edited]
http://uaidintl.org/2012/04/12/um-uaid-nodding-disease-a-ugandan-mystery/


Nodding Disease: A Ugandan Mystery
----------------------------------
In the northern plains of Uganda, thousands of children convulse, writhe, and wander uncontrollably. They aimlessly crawl across the grounds of their villages, serving only to scare their worrisome mothers and leave the rest of the community wondering what has happened to the boisterous, playful children they once knew. You see, these once ?normal? children have developed what is now being referred to as nodding disease.

Though nodding disease was actually first documented in Tanzania during the 1960s, only recently has it gained media attention from its increased prevalence in Uganda. Usually affecting children between the ages of 3 and 11, nodding disease causes seizures, personality changes, permanently stunted growth, increased aggression (though this is debated), mental retardation, and peculiarly persistent nodding, from which the disease derives its name. One mother says of her daughter, ?Her personality has changed greatly from before. She was normal ...[but] now she just moves around and serves no purpose.? Another says of her son, ?I feel dark in my heart. This boy has become nothing.?

Sadly, physicians and health professionals are still unsure of what exactly causes the disease. Though they have noted a high correlation between the presence of Black Flies ? which carry the parasitic worm _Onchocerca volvulus_ responsible for river blindness ? and nodding disease, there is much evidence suggesting that this correlation may be mere coincidence. Other hypotheses for means of infection include tainted monkey meat and chemical exposure resulting from Joseph Kony?s Lord?s Resistance Army. Whatever the cause, much more field and laboratory research must be conducted before effective treatments or cures can be implemented.

To learn more about this mysterious disease, check out this video made by the Centers for Disease Control and Prevention, the resources listed below, and the related material in UAID?s own awareness campaign, Educate Yourself.

[Byline: Nathan Wood]

References:
Wadman, M. (2011, July 13). African outbreak stumps experts. Nature, 475, 148-149. doi:10.1038/475148a

McKenzie, D. (2012, March 19). Mysterious nodding disease debilitates children. CNN. Retrieved from
http://www.cnn.com/2012/03/19/world/africa/uganda-nodding-disease/index.html?hpt=hp_c1

Ferguson, D. (2012, March 21). Mysterious ?zombie? disease afflicts thousands of Ugandan children. The Raw Story. Retrieved from http://www.rawstory.com/rs/2012/03/...sease-afflicts-thousands-of-ugandan-children/

Mick, J. (2012, March 20). Baffling illness strikes Africa, turns children into mindless ?zombies.? Message posted to http://www.dailytech.com/article.aspx?newsid=24276

--
Communicated by
Terry S. Singeltary Sr.
flounder9@verizon.net

[ProMED thanks Terry S. Singeltary Sr. for communicating these 3 news pieces about the Nodding Disease outbreak in Uganda. We agree that the evidence for onchocerciasis and the cause of the disease is circumstantial and not convincing.
The hypothesis put forward in message no. 3 above, that it may indeed be a prion disease has to our knowledge not been investigated as post mortems of the central nervous system have not been performed to our knowledge.

We have previously hypothesized that food items may be involved, for instance the use of mineral oil instead of vegetable oil caused the ?Spanish oil syndrome,? and mycotoxins in mouldy food may also cause symptoms from the central nerve system. Neither of these two possibilities have to our knowledge been investigated.

Health Map location: http://healthmap.org/r/2fMh - Mod. EP]

[If the cause is a food item, one would have thought all ages would show symptoms, unless susceptibility wanes dramatically with age.

Case photo:
http://mysteriousuniverse.org/wp-content/uploads/2012/03/NoddingDisease.jpg.
- Mod.JW]
 
Re: UGANDA: Nodding disease or "river epilepsy"? Hundreds of children infected

Re: UGANDA: Nodding disease or "river epilepsy"? Hundreds of children infected

http://www.monitor.co.ug/News/National/-/688334/1397850/-/avft6qz/-/index.html

Nodding disease kills two in Kitgum, 380 new cases reported
Ministry of Health.


Reports from Kitgum and Pader, the districts most affected by the nodding head syndrome, indicate that two more children passed on over the weekend while the number of those affected has increased after 388 new cases were registered at Atanga Health Centre between March and April, 2012.

This brings the death toll to 205 while the number of the affected children is 3,526, according to data from the Ministry of Health although the World Health Organisation country representative, Dr Joaquim Saweka, says the number of affected children is about 5,000 in 1,633 households in the four affected districts, which also include Lamwo and Gulu.

According to the Commissioner in-charge of Community Health, Dr Anthony Mbonye, the ministry is not aware of the deaths but they are yet to get updates from the respective districts.

?We have surveillance officers who are supposed to report such cases to the district, and then the district informs us so that we carry out postmortem but we haven?t received information about the deaths,? Dr Mbonye told Daily Monitor.

While Dr Mbonye says the recent deaths cannot be confirmed as a result of nodding syndrome, he called on the affected communities to report any suspected nodding disease deaths to the nearest health facilities early so that the district health officer arranges a postmortem.

[snip]
 
Re: UGANDA: Nodding disease or "river epilepsy"? Hundreds of children infected

Re: UGANDA: Nodding disease or "river epilepsy"? Hundreds of children infected

Uganda Health News: Nodding Disease Feared To Have Started Affecting Adults
First published: 20120507 1:11:37 PM EST

Ultimate Media

Kitgum District woman Member of Parliament, Atim Anywar Beatrice has expressed fear that the nodding disease has started attacking adults and yet government is still reluctant to address the problem.

Anywar who was addressing Journalists at parliament said that she has received information from Kitgum of three adults one 40 years and the other 35 years have been infected and are Hospitalized.
...
http://www.ugpulse.com/uganda-news/...d-to-have-started-affecting-adults/25210.aspx
 
Re: UGANDA: Nodding disease or "river epilepsy"? Hundreds of children infected

Re: UGANDA: Nodding disease or "river epilepsy"? Hundreds of children infected

Uganda Government News: Parliament Fails To Vote On Nodding Disease Emergence Motion
First published: 20120516 1:14:27 AM EST


Ultimate Media

Parliament has decided to discuss the issue and motion of declaring northern Uganda a humanitarian emergency zone over nodding disease syndrome with the leader of government business, Amama mbabazi
...
Anywar revealed that over 7000 people are reported to have been affected by the syndrome, yet the studies conducted have not yielded any result to show the cause of the disease and the medication.

Earlier The Prime Minister had pleaded with members to stay the voting on the matter urging that government is in the process of putting up necessary measures to address the matter.
http://www.ugpulse.com/uganda-news/...n-nodding-disease-emergence-motion/25333.aspx
 
Re: UGANDA: Nodding disease or "river epilepsy"? Hundreds of children infected

Re: UGANDA: Nodding disease or "river epilepsy"? Hundreds of children infected

received at FT email


Livelihoods at risk as nodding disease takes toll on adults
By Harriet Anena

Posted Thursday, May 24 2012 at 00:00
In Summary
Nodding disease has been widely believed to affect children between five and 15 years, but as cases are cited among adults, worry is rife that families, who are unable to cater for their livelihoods, will starve.


more...

http://www.monitor.co.ug/News/National/-/688334/1412120/-/ahe1r8z/-/index.html
 
Re: UGANDA: Nodding disease or "river epilepsy"? Hundreds of children infected

Re: UGANDA: Nodding disease or "river epilepsy"? Hundreds of children infected

http://www.promedmail.org/

Published Date: 2012-05-25 02:44:30
Subject: PRO/EDR> Undiagnosed cerebral disease - Uganda (07): nodding disease:
Archive Number: 20120525.1143757

UNDIAGNOSED CEREBRAL DISEASE - UGANDA (07): NODDING DISEASE
***********************************************************
A ProMED-mail post
http://www.promedmail.org
ProMED-mail is a program of the
International Society for Infectious Diseases
http://www.isid.org

Date: Thu 24 May 2012
Source: The Monitor [edited]
http://www.monitor.co.ug/News/National/-/688334/1412120/-/ahe1r8z/-/index.html


Nodding disease has been widely believed to affect children between 5 and 15 years old, but as cases are cited among adults, worry is rife that families who are unable to cater for their livelihoods will starve.

As the nodding disease syndrome previously notable among children takes its toll on adults, fears of a looming food shortage is rife among residents, who want the government to act fast and salvage livelihoods in Acholi-sub-region.

Nodding disease, which has, according to a WHO report, affected 7000 children, has subdued economic and domestic activities by parents, as most stay at home to take care of their sick children.

The situation is, however, more worrying now that cases of the disease are being cited among adults, with Kitgum Woman MP Beatrice Anwyar placing the figure at about 49.

A 40-year-old female resident of Tumangu village, Akwang Sub-county, Kitgum district has been suffering from nodding disease since 2009 and says that if the government does not provide for affected families, the situation will become more dire.

The HIV-positive mother, who lost her son in 2009 to nodding disease syndrome, says it has become impossible for her to look after her 5-year-old orphaned niece, also suffering from the ailment. "I cannot dig because I have no energy; it is just impossible. The government should provide food items to affected families," says the woman, who believes that nodding disease is contagious and says the government should isolate sick people from the community to avoid further spread and allow for special provisions for victims.

Ms Dorothy Akwero, a clinical officer in Palabek Gem, Pader district, recently put the number of adults affected by the nodding syndrome at 19 and expressed concern about how sick children will be attended to. She said it will be difficult for affected children to adhere to medication if their parents are affected.

A 63-year-old mother is another adult victim of nodding disease syndrome. The resident of Tumangu Ward, Akwang Sub-county says she started experiencing the symptoms 6 months ago. Although she says the medication she started taking a week ago has not had much impact on her health, her greatest worry is about how she will provide food to the 8 children under her care.

Dr Alex Layoo, the medical superintendent of Kitgum Hospital, says although cases of nodding disease in adults are being reported, no confirmation of the cases or the total number of people affected have been compiled.

"We don't know the complete behaviour of the disease, so we can't deny the problem in adults, he said on Saturday [19 May 2012] while speaking to a group of American researchers and a psychiatrist headed by MP Anywar.

Dr Layoo, however, agrees that the disease is affecting families immensely and emphasised the need for broad research to ascertain the cause and mode of spread of the disease.

"Do you expect a child [suffering from nodding disease] to grow up and continue with the family line," he wondered. "It is a big problem that is threatening the existence of families," he said of the nodding disease, which he called a medical insecurity.

[Byline: Harriet Anena]

--
Communicated by:
ProMED-mail Rapporteur Mary Marshall

[The WHO press release on nodding disease from 21 May 2012 can be found at: http://www.afro.who.int/en/media-ce...nt-centres-are-opened-in-northern-uganda.html.

The etiology of the syndrome is still elusive. The occurrence of adult cases does not help point to the cause of the syndrome. It is suggested in the article that the condition is contagious, but that adult cases appear sometimes in the same households as pediatric cases can just as well point to a common exposure.

Toxicological investigations and autopsy studies are still pending. - Mod.EP

A HealthMap/ProMED-mail map can be accessed at: http://healthmap.org/r/1wa6.]
 
Re: UGANDA: Nodding disease or "river epilepsy"? Hundreds of children infected

Re: UGANDA: Nodding disease or "river epilepsy"? Hundreds of children infected

http://www.promedmail.org/

Published Date: 2012-05-26 12:41:18
Subject: PRO> Undiagnosed cerebral disease - Uganda (08): nodding disease, comment
Archive Number: 20120526.1145693

UNDIAGNOSED CEREBRAL DISEASE - UGANDA (08): NODDING DISEASE, COMMENT
********************************************************************
A ProMED-mail post
http://www.promedmail.org
ProMED-mail is a program of the
International Society for Infectious Diseases
http://www.isid.org

Date: Sat, 26 May 2012
From: Deryck Read


Nodding Disease, Uganda: further data needed
---------------------------------
In several animal species, a clinical presentation of "head nodding" indicates cerebellar involvement. Is there any reason why routine histopathology of the brain, particularly of the cerebellum and related cerebral structures, has not yet been published by PubMed?

Results of such studies should be available within a few days of autopsy. This disease was reported months ago. To date, thousands of people have been afflicted.

Histopathology might quickly and cost-effectively rule in/out an infectious etiology or aquired cerebellar abiotrophy... and also provide a "raison d'etre" for ancillary testing for a possible etiology.

--
Deryck Read BVSc, PhD,
Diplomate, The American College of Veterinary Pathologists
Professor Emeritus
University of California-Davis


[ProMED-mail thanks Professor Deryck Read for his comment. We entirely agree. We have been asking for autopsy studies and more MR imaging studies including the brain stem.

Published and unpublished MR's have not been consistent, and some described as normal. Results from a few spinal taps describe the spinal fluid as macroscopical normal, but cell counts and protein analysis have not been performed to our knowledge. Also to our knowledge no post mortems have been performed and we agree with Professor Read, that this is urgently needed.

With a prevalence of up to 519 per 100 000 in Pader District, it is urgent to increase efforts to define the etiology in order to be able to control the outbreak prevent new outbreaks. HealthMap location: http://healthmap.org/r/2rUf. - Mod. EP]
 
Re: UGANDA: Nodding disease or "river epilepsy"? Hundreds of children infected

Re: UGANDA: Nodding disease or "river epilepsy"? Hundreds of children infected

Desperate Ugandans Seek Traditional Healers as Mysterious Illness Strikes Young
By JOSH KRON
Published: June 8, 2012

OJURU, Uganda ? Haunted by a merciless and debilitating disease that doctors cannot cure, villagers in this remote enclave in northern Uganda have turned to traditional healers like Alfred Ojara...
 
Re: UGANDA: Nodding disease or "river epilepsy"? Hundreds of children infected

Re: UGANDA: Nodding disease or "river epilepsy"? Hundreds of children infected

There is a LOT of garbage (anti-vaccine conspiracies, debunked rumors, etc.) in this editorial from the Daily Monitor, but the following line is of note, suggesting that the parasitic worms previously considered have indeed been linked to epilepsy elsewhere:

http://www.monitor.co.ug/OpEd/Comme...seases/-/689364/1456528/-/vsh1q6/-/index.html

[snip]

Another related disease is Nakalanga Syndrome, which was first identified in 1950s along River Nile in Jinja, Busoga. It was characterised by epilepsy, stunted growth, mental retardation, absence of secondary sexual features, bone deformities and dental carries in children and teenagers. No genetic or familial association was reported. It eventually reduced and disappeared in Busoga, with the control of the filarial worm. But it re-emerged in 1990s in western Uganda, specifically in Kabarole. It was also later reported in Liberia.
 
Re: UGANDA: Nodding disease or "river epilepsy"? Hundreds of children infected

Re: UGANDA: Nodding disease or "river epilepsy"? Hundreds of children infected

http://www.monitor.co.ug/News/Natio...h+350/-/688334/1463842/-/2b7qhnz/-/index.html

Pader nodding deaths reach 350

At least 351 children have been killed by epilepsy and nodding disease in Pader District since 2009, an official report indicates.

The survey, tagged ?Nodding Syndrome Registration? conducted by a team of experts from the Ministry of Health and partners in July also points out that 4,998 cases have been registered from 612 villages in the district.

?These figures were arrived at using very sensitive community case definitions and hence present the worst case scenario for the magnitude of nodding syndrome and epilepsy,? the report, released on Monday, adds.

?Given that we visited all the villages in the district and used very sensitive case definitions; the actual magnitude of NS [Nodding Syndrome] and Epilepsy in Pader cannot be above the levels presented here,? the report adds.

Most of the nodding syndrome cases were registered from Awere, making the sub-county lead with 532 cases; Atanga recorded 435 cases, while Angagura Sub-county registered 399 cases. Laguti and Lapul recorded 271 and 94 cases respectively.

The report assures the public that all the registered nodding syndrome and epilepsy cases and deaths would be verified by trained healthcare workers to get more accurate estimates.
 
Re: UGANDA: Nodding disease or "river epilepsy"? Hundreds of children infected

Re: UGANDA: Nodding disease or "river epilepsy"? Hundreds of children infected

Nodding Syndrome meeting, researchers agree on case definition and establish research agenda


48eaa47a66f10e79d2e59b1c6ab86728_M.jpg

The Director General of Health Services, Dr Jane Ruth Aceng officially closing the Nodding Syndrome meeting. Seated are: Dr Anthony Mbonye, Commissioner of Health Services, Dr Joaquim Saweka, WHO Representative and Dr. Jenny Amery from DFID.

Kampala, 1 August 2012 -- The First International Scientific Meeting on Nodding Syndrome (NS) concluded its third day of proceedings by finalizing a standard case definition and identifying critical next steps in a research agenda that will guide future scientific studies.

Over the last two days, the meeting participants heard presentations from representatives who have conducted studies in Uganda, South Sudan and Tanzania. These presentations provided insight into the different research activities that have taken place in each country and progress made to date.

The key objective achieved by the meeting was a standardized case definition for suspect and probable cases of NS. Although the multinational audience has referred to this illness as ?Nodding Disease? and ?Head Nodding Disease? in the past, a consensus was reached to refer to the combination of signs and symptoms as Nodding Syndrome.

This term will provide consistency across all research activities in the future. The researchers and representatives from the three countries identified key strategic steps that the meeting participants should take to move forward on NS research. For example, researchers should conduct systematic surveys to determine prevalence, burden, and geographic distribution of NS. Other topics for next steps include clinical case management, collaborative research with conference participants, and the involvement of additional specialty fields in research including anthropology.

In their closing remarks, leaders from the Uganda Ministry of Health, World Health Organization (WHO), Centers for Disease Control and Prevention (CDC) and the UK Department of International Development (DFID) all expressed their thanks and gratitude to the researchers, conference participants and the media. As the chairman of the closing ceremony, Dr. Anthony Mbonye, Ministry of Health, expressed, ?When we came here on Monday, we aimed to have a case definition. We aimed to have a research agenda. We aimed to have research collaboration. I think we achieved these things?.

Dr. Jenny Amery, DFID, further expressed her perception of one of the meetings outcomes, ?we worked on taking forward the important issues of care and management of the poor children affected by this syndrome.? In his closing remarks, Dr. Scott Dowell, CDC, reminded the participants of the significance of these deliberations, but redirected the attention to the children with NS. Dr. Dowell said, ?I hope that we hold on to a sense of urgency that the kids with this syndrome deserve.?

The WHO Country Representative Dr Joaquim Saweka noted that ?the syndrome is still with us and we need to use the information shared in this meeting to alleviate the suffering of the affected childrens much as possible?. Uganda?s Director General of Health Services Dr Jane Ruth Aceng closed the meeting on behalf of the Health Minister with a series of remarks that complimented the participants on the success of the meeting and urged the participants and Ministries of Health to continue to move the scientific research forward. Dr. Aceng insisted that coordinated collaboration in NS research is necessary; she said ?If we work in an uncoordinated way, we will not make progress with Nodding Syndrome.?

The Dr. Aceng concluded the meeting by making an appeal to address some of the challenges ahead. ?If we retreat to our countries and business as usual, we will not make progress. We need to keep in touch and update each other of progress. Nodding syndrome is here with us and will remain with us, but it will get better. It was much better today than it was yesterday.?

http://www.afro.who.int/fr/ouganda/...definition-and-establish-research-agenda.html
 
Re: UGANDA: Nodding Syndrome - Hundreds of children infected

Re: UGANDA: Nodding Syndrome - Hundreds of children infected

Whatever the cause, it seems the children are responding to treatment.

http://www.newvision.co.ug/news/636570-96-nodding-disease-children-discharged.html

96% nodding disease children dischargedPublish Date: Oct 19, 2012

By Francis Kagolo

The nodding syndrome that has been ravaging parts of northern Uganda is being contained after 96% of the victims have been discharged in better condition, says a health ministry report.

Besides, no new case has been recorded since March when the Government first intervened with campaigns of mass sensitisation and treatment in the region.

According to Dr. Bernard Opar, the national co-coordinator for nodding syndrome, 302 of the 313 children who were admitted in critical condition had been discharged by Wednesday.

The children had been admitted at Kitgum hospital and Lamwo, Pader, Gulu and Lira treatment centres where they received anti-epileptic (Sodium Valproate) drugs and Vitamin B complex.

The nodding syndrome broke out in 2007 among children formerly in the internally displaced people?s (IDP) camps mainly in the districts of Kitgum, Lamwo and Pader.

By early this year, about 200 children had reportedly succumbed to the disease.

However, Opar said, ?The children have shown a dramatic positive response to the drugs. Convulsions reduced and some children who had been bedridden for two years started walking about a month or two of treatment.?

Opar also attributed the progress in children?s condition to food supplied by the prime minister?s office, which he said improved their nutrition and energized them to move.

The report shows video clips of some hitherto bedridden nodding children, who can now wash their clothes and do other household chores after receiving treatment.


[snip]
 
Re: UGANDA: Nodding Syndrome - Hundreds of children infected

Re: UGANDA: Nodding Syndrome - Hundreds of children infected

This is wonderful news, alert! :tiphat: I hope the reported synergy of treatments will help many more children recover.

  • Anti-epileptic (Sodium Valproate) drugs
  • Vitamin B complex
  • Improved nutrition from food
 
Re: UGANDA: Nodding Syndrome - Hundreds of children infected

Re: UGANDA: Nodding Syndrome - Hundreds of children infected

This article focuses on the importance of local knowledge:

http://www.dw.de/hope-for-victims-of-nodding-disease-in-uganda/a-16484301
Hope for victims of nodding disease in Uganda
Date 28.12.2012
Author Isabella Bauer
Editor Mark Caldwell
[snip]
More interesting for the scientists was the suggestion that food aid distributed by the World Food Program (WFP) was the culprit. Medical staff in the region point to chronic undernourishment of the refugees, toxic seeds that were eaten out of desperation, and poisoning by chemical and biological weapons. In addition, they believe that river water was contaminated by the extraction of minerals...

The University of Gulu has been focusing on that and the article says that children are showing swift recovery from generous portions of milk and food supplements. (Medications recommended by WHO and the Ugandan Health Ministry were not helping.)
 
Re: UGANDA: Nodding Syndrome - Hundreds of children infected

Re: UGANDA: Nodding Syndrome - Hundreds of children infected

Hattip Crofsblogs
February 17, 2013

Uganda: 45% of school's students have nodding syndrome
http://crofsblogs.typepad.com/h5n1/2013/02/uganda-45-of-school-students-have-nodding-syndrome.html
--------------------------------------------------------------------------------------------------
This article was published earlier by Uganda Radio:

Nodding Disease Kills 15 Pupils in Gulu
...
The nodding disease has claimed the lives of 15 pupils of Aromo-wang-lobo Primary School in Gulu district over the last six months. The latest victim passed away last week...
...
Okello says that 241 out of the 532 pupils in the school are victims of the nodding disease syndrome. He says that the school faces serious challenges which include frequent interruptions whenever the victims get attacks during lessons. He says that some teachers and pupils have abandoned the school for fear of contracting the disease. Currently, there are only six teachers at the school including the head teacher.
...
2013-02-04 09:30:24

http://ugandaradionetwork.com/a/story.php?s=49467
 
Re: UGANDA: Nodding Syndrome - Hundreds of children infected

Re: UGANDA: Nodding Syndrome - Hundreds of children infected

Nodding Syndrome: A Devastating Medical Mystery In Uganda

June 02, 2013 5:20 AM
Matthew Kielty for NPR
...
The strange and deadly illness known as nodding syndrome affects only children, and only in a small pocket of East Africa. It has affected more than 3,000 children since the late 1990s, when it first appeared in what was then southern Sudan. And for more than three years, the cause of nodding syndrome has eluded epidemiologists around the globe.

Investigators at the Centers for Disease Control in Prevention in Atlanta have made the syndrome among their top priorities on the short list of new, unexplained outbreaks.

But as they, and others, continue to investigate the syndrome ? figuring out its origin and how it spreads ? much of the work trying to treat affected children has been left to Uganda.
...
Health care in Uganda isn't good. Less than one-third of the major health centers in the country are fully operational. Still, the Ugandan Ministry of Health carved out $1.4 million in its budget last year to mount a response to nodding syndrome.
...
The ministry hired and trained physicians and nurses, like Nyeko. It bought big white vans, emblazoned with "Nodding Syndrome Response Team" in blue lettering. It also bought more than a million tablets of a generic anti-convulsant called sodium valproate, a drug that came on recommendation from the Centers for Disease Control and Prevention and the World Health Organization.

The idea is that if you can begin to control the nodding ? in other words, the seizure ? then maybe you can start to return a child to normal.
...
The CDC in Atlanta has spent hundreds of thousands of dollars and countless hours assisting the Ugandan government in investigating nodding syndrome. Among the possibilities explored is whether nodding syndrome could be caused by war-related chemical exposure, a response to a local parasite, or a vitamin deficiency or genetics. So far, investigators have hit dead ends.

So, short of a cause, they're trying to treat a symptom. Sodium valproate has proved effective in treating seizures similar to nodding syndrome, which is why the CDC and the World Health Organization recommended the drug to the Ugandan government as a potential treatment.
...

Full text:
http://www.npr.org/blogs/parallels/...drome-a-devastating-medical-mystery-in-uganda
 
Re: UGANDA: Nodding Syndrome - Hundreds of children infected

Re: UGANDA: Nodding Syndrome - Hundreds of children infected

Go to the links for complete reports - Ro

Nodding syndrome research good start
Posted Monday, August 12 2013 at 01:00

A new report on the nodding syndrome ? a condition that has so far killed more than 500 children and affected nearly 3,000 in Acholi sub-region ? is a positive development that should be given due attention and further investigation. Doctors from Gulu University, who conducted the study last June have ? after carrying out 10 major studies into the syndrome ? linked the condition to excessive acid in the bodies.

The lead researcher, Dr David Kitara Lagoro, says their study found that the environment where the nodding children lived, such as the Internally Displaced Peoples camps that were set up at the height of the Lords Resistance Army rebellion, had been contaminated.

While this particular research did not delve into what exactly caused the disease ? precisely because the goal of the researchers was to find healing approaches, it has discovered some vital clues such as why the nodding and seizure increases even during the course of medication and how the seizures can be reduced, especially with sustained special diets and drugs.
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http://www.monitor.co.ug/OpEd/Edito...start/-/689360/1944284/-/stvr0cz/-/index.html

Environment responsible for nodding attack, study reveals
By Sam Lawino

Posted Friday, August 9 2013 at 01:00
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Dr David Kitara Lagoro, head of Department of Surgery of Science Faculty at the university, says their findings established that the environment where the children stayed such as IDP camps had been contaminated.

?When the metabolic acidosis increases in the body, the nodding and seizure increases even when medications are given,? Dr Lagoro, also the lead researcher, says.

?But if the acidosis is controlled, the seizure disappears or reduces once special diets and drugs are repeatedly given to the children,? he adds.

Dr Lagoro says children have low carbonate which is below clinical critical level, making it possible for the production of excessive acid.
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http://www.monitor.co.ug/SpecialRep...eveals/-/688342/1941288/-/cqed8d/-/index.html
 
Re: UGANDA: Nodding Syndrome - Hundreds of children infected

Re: UGANDA: Nodding Syndrome - Hundreds of children infected

The Nodding Disease Mystery

August 14, 2013
Carolina Uribe

There?s a mystery disease ravaging communities in East Africa, and even the world?s best epidemiologists can?t figure out where it?s coming from.
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Since 2009, investigators from the Centers for Disease Control and Prevention (CDC) have ruled out over 36 possible causes including water contamination. Specific exposures examined in previous studies include munitions, monkey meat and relief food. What has been found is that there is a significant association to onchocerciasis (river blindness) and that the children lack vitamin B-6. Although there is a strong link to onchocerciasis, it leaves to question why there is an absence of nodding syndrome in other endemic areas.

An interesting finding is the higher prevalence of the syndrome in areas affected by conflict and displacement. Overcrowded refugee camps, some say, may have caused exposure to toxins or contaminated food or water. Now in post war recovery, families have returned home and are faced with the disease, which often afflicts multiple children in a single household. While there is no evidence suggesting chemical agents or other toxic factors, there is a commonality of displacement.
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- See more at: http://www.undispatch.com/the-noddi...18d94&utm_medium=twitter#sthash.xQiscnUE.dpuf
 
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