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Table 1 State of epilepsy in onchocerciasis endemic regions visited

From: Nodding syndrome and epilepsy in onchocerciasis endemic regions: comparing preliminary observations from South Sudan and the Democratic Republic of the Congo with data from Uganda

 

Northern Uganda: Gulu, Kitgum, Pader and Lamwo districts

South Sudan: Western Equatoria State

Democratic Republic of the Congo: Bas-Uélé, Orientale Province

Year of first NS cases

NS cases reported since 2000 [1]

NS cases reported since 1990 [2, 3]

Unknown

Tribes

Acholi

Moro and dinka

Bowa, Zande, Lokele, Kango and others

Migration

IDP camps during civil war

IDP camps and “hiding in the forest” during civil war

No important migration, but some “hiding in the forest” during conflicts

Prevalence of all forms of epilepsy

2.9 % (Moyo, Adjumani, Kitgum and Gulu districts, 2010)a

9 % (Mvolo, 2013)

2.3 % (Titule, 2014) [22]

Prevalence of NS

0.68 % probable NS cases among children aged 5–18 years in three districts, 2012–2013 [27]

Exact prevalence never assessed but high based on high epilepsy prevalence

No confirmed NS according to WHO case definition, but NS-like suspected cases reported in the region

Stunted growth with lack of secondary sexual characteristics

Present, exact prevalence not reported

Present, not frequent

Nutritional status

Often poor [6]

Often poor [3]

Generally good

Availability of anti- epileptic drugs

Sodium valproate, carbamazepine and phenytoin

Generally not available

Phenobarbital available but often not affordable

Epidemiological situation of NS/epilepsy

NS/epilepsy epidemic until 2013 [18]

Ongoing NS/epilepsy epidemic

Endemic epilepsy

Incidence of NS/epilepsy

Very limited new cases of NS [14]

Still new NS/epilepsy cases

Stable incidence of new epilepsy cases

Ivermectin distribution

Twice a year

Not distributed during war

Once a year, low coverage

Not distributed during war

Once a year

Interrupted in 2004 [23], not distributed during war

Prevalence of onchocerciasis

Decreasing

Not known

Decreasing

Loa Loa endemic region

No

No

Yes

Insecticide/larvicide use

Before 1972 and since 2012 [26]

Only before 1972

Never

General ecology

Savannah forest

Tropical forest

Location of villages

Close to rapid flowing blackfly-breeding rivers

  1. NS nodding syndrome, IDP internally displaced persons
  2. a JK personnal communication, unpublished