Volume 19, Number 9—September 2013
Synopsis
Nodding Syndrome
Table 4
Selected risk factors for nodding syndrome from 4 case–control studies*
Risk factor | Study (reference) |
|||
---|---|---|---|---|
Sudan, 2002; 13 case-patients, 19 controls (2) | Uganda, 2009; 49 case-patients, 49 controls (6) | Uganda, 2010; 73 case-patients, 73 controls† | South Sudan, 2011; 38 case-patients, 38 controls (7,8) | |
Infectious | ||||
History of measles | Less common (15% cases vs. 58% controls; p = 0.03) | No difference (24% case-patients vs. 6% controls; p = 0.02‡) | NA | NA |
History of malaria | NA | ND | NA | NA |
History of meningitis | No difference (0% vs. 6%; p = 1.0) | NA | NA | NA |
Prior treatment for onchocerciasis (ivermectin) | No difference 62% cases vs. 37% controls) | No difference (33% case-patients vs. 25% controls) | NA | NA |
Consumption of animal brain (risk for prion disease) |
Baboon brain consumption (46% vs. 22%; p = 0.25) |
No association with brain consumption |
NA |
NA |
Toxic/environmental | ||||
Exposure to munitions | NA | More common in case-patients (71% vs. 51%; p = 0.06) | Exposure to gun raids more common in case-patients (54% vs. 27%) | ND |
Exposure to pesticides (on seeds) | No difference | ND | NA | NA |
Consumption of crushed roots | NA | More common in case-patients (39% vs. 16%; p = 0.02) | No differences in 17 root types before onset of nodding syndrome; root consumption more common after onset of nodding syndrome (22% vs. 0%) | ND |
Consumption of cassava (thiocyanate toxicity) |
Widely consumed, no acute toxicity reported |
ND (100% consumption) |
Specifically asked about bitter cassava: no difference |
NA |
Nutritional | ||||
Early malnutrition | NA | NA | NA | Hunger more common for case-patients 2 y of age (24% vs. 8%; p = 0.03) |
Current wasting | Weight-for-age Z scores lower in case-patients (−1.6 vs. −1.0, p = 0.09) | Low BMI for age (42% vs. 13%; p<0.01) | Low BMI for age (42% vs. 26%; p = 0.03) | Low BMI for age (16% vs. 3%; p = 0.06) |
Current stunting | Height-for-age Z scores lower in case-patients (−1.5 vs. −0.8, p = 0.29) | Low height for age (60% vs. 29%; p<0.01) | Low height for age (35% vs. 20%; p = 0.05) | Low height for age (24% vs. 3%; p = 0.03) |
Consumption of red sorghum | 54% case-patients vs. 16% controls; p = 0.05 | ND | ND | ND |
Consumption of spoiled relief foods | NA | ND | NA | NA |
Consumption of river fish | NA | ND | NA | ND |
Consumption of rodent brain | NA | ND | NA | NA |
Consumption of river water | NA | ND | NA | NA |
*Selected risk factors, all positive associations and selected negative findings (see original reference for full listings). NA, not assessed; ND, no difference; BMI body mass index.
†Unpub. data.
‡Not significant after age adjustment.
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