First description of Nodding Syndrome in the Central African Republic.

<h4>Background</h4>The term Nodding Syndrome (NS) refers to an atypical and severe form of childhood epilepsy characterized by a repetitive head nodding (HN). The disease has been for a long time limited to East Africa, and the cause is still unknown. The objective of this study was to c...

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Autores principales:	Salvatore Metanmo, Farid Boumédiène, Pierre-Marie Preux, Robert Colebunders, Joseph N Siewe Fodjo, Eric de Smet, Emmanuel Yangatimbi, Andrea S Winkler, Pascal Mbelesso, Daniel Ajzenberg
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2021
Materias:	Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270
Acceso en línea:	https://doaj.org/article/e15bed78d1d04531b0c48218e8ffbb4e
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spelling	oai:doaj.org-article:e15bed78d1d04531b0c48218e8ffbb4e2021-11-25T06:31:45ZFirst description of Nodding Syndrome in the Central African Republic.1935-27271935-273510.1371/journal.pntd.0009430https://doaj.org/article/e15bed78d1d04531b0c48218e8ffbb4e2021-06-01T00:00:00Zhttps://doi.org/10.1371/journal.pntd.0009430https://doaj.org/toc/1935-2727https://doaj.org/toc/1935-2735<h4>Background</h4>The term Nodding Syndrome (NS) refers to an atypical and severe form of childhood epilepsy characterized by a repetitive head nodding (HN). The disease has been for a long time limited to East Africa, and the cause is still unknown. The objective of this study was to confirm the existence of NS cases in Central African Republic (CAR).<h4>Methodology/principal findings</h4>This was a cross-sectional descriptive study in the general population. The identification of NS cases was conducted through a door-to-door survey in a village near Bangui along the Ubangui River. Based on Winkler's 2008 and the World Health Organization (WHO)'s 2012 classifications, the confirmation of cases was done by a neurologist who also performed the electroencephalograms. No laboratory tests were done during this investigation. Treatment was offered to all patients. A total of 6,175 individuals was surveyed in 799 households. After reviewing the cases, we identified 5 NS cases in girls aged between 8 and 16. The age of onset of the seizures was between 5 and 12 years of age. Two cases were classified as "HN plus" according to Winkler's 2008 classification. Four NS cases were classified as probable and one as confirmed according to the WHO's 2012 classification. Three of them presented with developmental delay and cognitive decline, and one had an abnormally low height-for-age z-score. Electroencephalographic abnormalities were found in four patients.<h4>Conclusions/significance</h4>Nodding Syndrome cases were described in CAR for the first time. Despite certain peculiarities, these cases are similar to those described elsewhere. Given that only a small part of the affected area was investigated, the study area along the Ubangui River needs to be expanded in order to investigate the association between Onchocerca volvulus and NS and also evaluate the real burden of NS in CAR.Salvatore MetanmoFarid BoumédiènePierre-Marie PreuxRobert ColebundersJoseph N Siewe FodjoEric de SmetEmmanuel YangatimbiAndrea S WinklerPascal MbelessoDaniel AjzenbergPublic Library of Science (PLoS)articleArctic medicine. Tropical medicineRC955-962Public aspects of medicineRA1-1270ENPLoS Neglected Tropical Diseases, Vol 15, Iss 6, p e0009430 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270
spellingShingle	Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 Salvatore Metanmo Farid Boumédiène Pierre-Marie Preux Robert Colebunders Joseph N Siewe Fodjo Eric de Smet Emmanuel Yangatimbi Andrea S Winkler Pascal Mbelesso Daniel Ajzenberg First description of Nodding Syndrome in the Central African Republic.
description	<h4>Background</h4>The term Nodding Syndrome (NS) refers to an atypical and severe form of childhood epilepsy characterized by a repetitive head nodding (HN). The disease has been for a long time limited to East Africa, and the cause is still unknown. The objective of this study was to confirm the existence of NS cases in Central African Republic (CAR).<h4>Methodology/principal findings</h4>This was a cross-sectional descriptive study in the general population. The identification of NS cases was conducted through a door-to-door survey in a village near Bangui along the Ubangui River. Based on Winkler's 2008 and the World Health Organization (WHO)'s 2012 classifications, the confirmation of cases was done by a neurologist who also performed the electroencephalograms. No laboratory tests were done during this investigation. Treatment was offered to all patients. A total of 6,175 individuals was surveyed in 799 households. After reviewing the cases, we identified 5 NS cases in girls aged between 8 and 16. The age of onset of the seizures was between 5 and 12 years of age. Two cases were classified as "HN plus" according to Winkler's 2008 classification. Four NS cases were classified as probable and one as confirmed according to the WHO's 2012 classification. Three of them presented with developmental delay and cognitive decline, and one had an abnormally low height-for-age z-score. Electroencephalographic abnormalities were found in four patients.<h4>Conclusions/significance</h4>Nodding Syndrome cases were described in CAR for the first time. Despite certain peculiarities, these cases are similar to those described elsewhere. Given that only a small part of the affected area was investigated, the study area along the Ubangui River needs to be expanded in order to investigate the association between Onchocerca volvulus and NS and also evaluate the real burden of NS in CAR.
format	article
author	Salvatore Metanmo Farid Boumédiène Pierre-Marie Preux Robert Colebunders Joseph N Siewe Fodjo Eric de Smet Emmanuel Yangatimbi Andrea S Winkler Pascal Mbelesso Daniel Ajzenberg
author_facet	Salvatore Metanmo Farid Boumédiène Pierre-Marie Preux Robert Colebunders Joseph N Siewe Fodjo Eric de Smet Emmanuel Yangatimbi Andrea S Winkler Pascal Mbelesso Daniel Ajzenberg
author_sort	Salvatore Metanmo
title	First description of Nodding Syndrome in the Central African Republic.
title_short	First description of Nodding Syndrome in the Central African Republic.
title_full	First description of Nodding Syndrome in the Central African Republic.
title_fullStr	First description of Nodding Syndrome in the Central African Republic.
title_full_unstemmed	First description of Nodding Syndrome in the Central African Republic.
title_sort	first description of nodding syndrome in the central african republic.
publisher	Public Library of Science (PLoS)
publishDate	2021
url	https://doaj.org/article/e15bed78d1d04531b0c48218e8ffbb4e
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First description of Nodding Syndrome in the Central African Republic.

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