Table 1.
State of epilepsy in onchocerciasis endemic regions visited
| 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 | ||
NS nodding syndrome, IDP internally displaced persons
a JK personnal communication, unpublished