Clinical and epidemiologic characteristics of nodding syndrome in Mundri County, southern Sudan
Clinical and epidemiologic characteristics of nodding syndrome in Mundri County, southern Sudan
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DOI：
10.4314/ahs.v12i3.1
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发表时间：
2012-01-01
影响因子：
1
通讯作者：
Spencer, P. S.
中科院分区：
文献类型：
--
作者：
Tumwine, J. K.;Vandemaele, K.;Spencer, P. S.
背景资料：点头综合症目的：根据2001年和2002年对苏丹南部地区点头综合征（nodding syndrome，NRS）的初步调查，描述NRS的临床和流行病学特征。方法：家庭调查、临床、电生理（EEG）评估，在苏丹南部的Lui镇和Amadi村进行了知情者访谈和病例对照研究。结果：点头综合征的特征是不自主的重复点头，进展为全身性癫痫发作;精神和身体的退化。脑电图与进行性癫痫性脑病一致。Lui和Amadi的Noding综合征患病率分别为2.3%和6.7%。所有病例对照研究均显示病例与盘尾丝虫扭转呈正相关。麻疹病史与病例呈负相关：2/13的病例和11/19的对照曾患麻疹：比值比为0.13（95%CI 0.02，0.76）。环境评估没有发现任何自然发生的或人为的神经毒性因素来解释点头综合征，虽然真菌污染的食物不能排除。结论：点头综合征是密切相关的盘尾丝虫扭转。没有证据表明存在环境污染物、化学制剂或其他有毒因素
Background: Nodding syndrome (repetitive nodding and progressive generalized seizures) is assuming epidemic proportions in South Sudan, Tanzania and Uganda.Objective: To describe clinical and epidemiological features of nodding syndrome in southern Sudan based on preliminary investigations conducted in 2001 and 2002.Method: Household surveys, clinical, electrophysiological (EEG) assessments, informant interviews and case-control studies were conducted in the town of Lui and the village of Amadi in southern Sudan.Results: Nodding syndrome is characterized by involuntary repetitive nodding of the head, progressing to generalized seizures; mental and physical deterioration. The EEGs were consistent with progressive epileptic encephalopathy. Prevalence of Nodding syndrome in Lui and Amadi was 2.3% and 6.7% respectively. All case control studies showed a positive association between cases and Onchocerca volvulus. A history of measles was negatively associated with being a case: 2/13 of cases and 11/19 of controls had had measles: odds ratio 0.13 (95% CI 0.02, 0.76). Environmental assessment did not reveal any naturally occurring or manmade neurotoxic factors to explain Nodding Syndrome, although fungal contamination of food could not be ruled out.Conclusion: Nodding Syndrome was strongly associated with Onchocerca volvulus. There was no evidence to suggest an environmental pollutant, chemical agent, or other toxic factor