Colebunders Robert, Hendy Adam, Mokili John L, Wamala Joseph Francis, Kaducu Joice, Kur Lucia, Tepage Floribert, Mandro Michel, Mucinya Gisele, Mambandu Germain, Komba Michel Yendema, Lumaliza Jean Louis, van Oijen Marieke, Laudisoit Anne
Global Health Institute, Gouverneur Kinsbergen Centrum, University of Antwerp, Doornstraat 331, 2610, Antwerp, Belgium.
Department of Clinical Sciences, Institute of Tropical Medicine, Antwerp, Belgium.
BMC Res Notes. 2016 Mar 22;9:182. doi: 10.1186/s13104-016-1993-7.
Nodding syndrome (NS) is an epilepsy disorder occurring in children in South Sudan, northern Uganda and Tanzania. The etiology of NS is unknown, but epidemiological studies demonstrate an association between NS and onchocerciasis.
Between November 2013 and July 2015 we visited onchocerciasis endemic regions in South Sudan, Uganda, and the Democratic Republic of the Congo (DRC) to assess the epilepsy situation. In South Sudan we interviewed patients and affected families, health officials, colleagues and healthcare workers, and performed a small household survey to estimate the epilepsy prevalence in the village of Mvolo, Western Equatoria State. Most information from Uganda was collected through discussions with colleagues and a review of published literature and reports. In the Bas-Uélé district of the DRC, we visited the villages of Liguga, Titule and Dingila, interviewed patients with epilepsy and family members and conducted a preliminary entomological assessment.
In South Sudan there is an ongoing NS and epilepsy epidemic in the Western Equatoria state that started around 1990. A survey of 22 households in Mvolo revealed that 28 out of 168 (16.7%) children suffered from NS or another form of epilepsy. Thirteen (59%) households had at least one child, and nine (41%) households at least two children with NS or another form of epilepsy. In northern Uganda, an NS and epilepsy epidemic started around 2000. The occurrence of new NS cases has been in decline since 2008 and no new NS cases were officially reported in 2013. The decline in NS cases coincided with the bi-annual distribution of ivermectin and the treatment of blackfly-breeding rivers with larvicides. In Bas-Uélé district in the DRC, epilepsy appears to be endemic with cases clustered in villages close to blackfly-infested, rapid-flowing rivers. The majority of epilepsy cases in Liguga, Dingila and Titule presented with generalized (tonic-clonic) seizures without nodding, but with mental retardation. In Titule, an epilepsy prevalence of 2.3% was documented. The only anthropophilic species of blackfly collected in the region belonged to the Simulium damnosum complex.
Blackflies may play a key role in the transmission of an etiological agent that either directly or indirectly cause, not only NS, but also other forms of epilepsy in onchocerciasis endemic regions.
点头综合征（NS）是一种在南苏丹、乌干达北部和坦桑尼亚儿童中出现的癫痫疾病。NS的病因尚不清楚，但流行病学研究表明NS与盘尾丝虫病之间存在关联。
2013年11月至2015年7月期间，我们走访了南苏丹、乌干达和刚果民主共和国（DRC）的盘尾丝虫病流行地区，以评估癫痫病情。在南苏丹，我们采访了患者及其受影响的家庭、卫生官员、同事和医护人员，并进行了一项小型家庭调查，以估计西赤道州姆沃洛村的癫痫患病率。来自乌干达的大多数信息是通过与同事的讨论以及对已发表文献和报告的回顾收集的。在刚果民主共和国的下韦莱区，我们走访了利古加、蒂图莱和丁吉拉等村庄，采访了癫痫患者及其家庭成员，并进行了初步的昆虫学评估。
在南苏丹，西赤道州正在发生始于1990年左右的NS和癫痫疫情。对姆沃洛村22户家庭的调查显示，168名儿童中有28名（16.7%）患有NS或其他形式的癫痫。13户（59%）家庭至少有一名儿童，9户（41%）家庭至少有两名儿童患有NS或其他形式的癫痫。在乌干达北部，NS和癫痫疫情始于2000年左右。自2008年以来，新的NS病例数量一直在下降，2013年没有官方报告新的NS病例。NS病例的下降与伊维菌素的半年一次分发以及用杀幼虫剂处理蚋滋生的河流相吻合。在刚果民主共和国的下韦莱区，癫痫似乎是地方病，病例集中在靠近蚋滋生的湍急河流的村庄。利古加、丁吉拉和蒂图莱的大多数癫痫病例表现为全身性（强直阵挛性）发作，无点头症状，但伴有智力迟钝。在蒂图莱，记录的癫痫患病率为2.3%。该地区采集到的唯一嗜人蚋种类属于恶蚋复合体。
蚋可能在一种病原体的传播中起关键作用，这种病原体直接或间接导致盘尾丝虫病流行地区不仅发生NS，还发生其他形式的癫痫。
