Risk Factors for Nodding Syndrome and Other Forms of Epilepsy in Northern Uganda: A Case-Control Study
Nolbert Gumisiriza,
Marina Kugler,
Nele Brusselaers,
Frank Mubiru,
Ronald Anguzu,
Albert Ningwa,
Rodney Ogwang,
Pamela Akun,
Amos Deogratius Mwaka,
Catherine Abbo,
Rogers Sekibira,
An Hotterbeekx,
Robert Colebunders,
Kevin Marsh,
Richard Idro
Affiliations
Nolbert Gumisiriza
Department of Mental Health, Kabale University School of Medicine, Kabale P.O. Box 317, Uganda
Marina Kugler
Global Health Institute, University of Antwerp, 2600 Antwerp, Belgium
Nele Brusselaers
Global Health Institute, University of Antwerp, 2600 Antwerp, Belgium
Frank Mubiru
Department of Statistical methods, School of Statistics and Planning, College of Business and Management Sciences, Makerere University, Kampala P.O. Box 7062, Uganda
Ronald Anguzu
College of Health Sciences, Makerere University, Kampala P.O. Box 7072, Uganda
Albert Ningwa
College of Health Sciences, Makerere University, Kampala P.O. Box 7072, Uganda
Rodney Ogwang
College of Health Sciences, Makerere University, Kampala P.O. Box 7072, Uganda
Pamela Akun
College of Health Sciences, Makerere University, Kampala P.O. Box 7072, Uganda
Amos Deogratius Mwaka
College of Health Sciences, Makerere University, Kampala P.O. Box 7072, Uganda
Catherine Abbo
College of Health Sciences, Makerere University, Kampala P.O. Box 7072, Uganda
Rogers Sekibira
College of Health Sciences, Makerere University, Kampala P.O. Box 7072, Uganda
An Hotterbeekx
Global Health Institute, University of Antwerp, 2600 Antwerp, Belgium
Robert Colebunders
Global Health Institute, University of Antwerp, 2600 Antwerp, Belgium
Kevin Marsh
Centre for Tropical Medicine and Global Health, University of Oxford, Oxford OX3 7LG, UK
Richard Idro
College of Health Sciences, Makerere University, Kampala P.O. Box 7072, Uganda
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 O. volvulus 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 O. volvulus antibodies [aOR 8.79, 95% CI (4.15–18.65), p-value p-value = 0.046]. Risk factors for developing OFE were the presence of O. volvulus antibodies [aOR 8.83, 95% CI (4.48–17.86), p-value p-value = 0.024]. In conclusion, O. volvulus seropositivity 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.
