{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,26]],"date-time":"2026-09-26T05:30:44Z","timestamp":1790400644054,"version":"4.1.0"},"reference-count":44,"publisher":"MDPI AG","issue":"11","license":[{"start":{"date-parts":[[2021,11,9]],"date-time":"2021-11-09T00:00:00Z","timestamp":1636416000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000265","name":"Medical Research Council","doi-asserted-by":"publisher","award":["MR\/M025489\/1"],"award-info":[{"award-number":["MR\/M025489\/1"]}],"id":[{"id":"10.13039\/501100000265","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Pathogens"],"abstract":"<jats:p>Epidemiological studies suggest a link between onchocerciasis and various forms of epilepsy, including nodding syndrome (NS). The aetiopathology of onchocerciasis associated epilepsy remains unknown. This case-control study investigated potential risk factors that may lead to NS and other forms of non-nodding epilepsy (OFE) in northern Uganda. We consecutively recruited 154 persons with NS (aged between 8 and 20 years), and age-frequency matched them with 154 with OFE and 154 healthy community controls. Participants\u2019 socio-demography, medical, family, and migration histories were recorded. We tested participants for O. volvulus serum antibodies. The 154 controls were used for both OFE and NS separately to determine associations. We recruited 462 people with a median age of 15 years (IQR 14, 17); 260 (56.4%) were males. Independent risk factors associated with the development of NS were the presence of O. volvulus antibodies [aOR 8.79, 95% CI (4.15\u201318.65), p-value &lt; 0.001] and preterm birth [aOR 2.54, 95% CI (1.02\u20136.33), p-value = 0.046]. Risk factors for developing OFE were the presence of O. volvulus antibodies [aOR 8.83, 95% CI (4.48\u201317.86), p-value &lt; 0.001] and being born in the period before migration to IDP camps [aOR 4.28, 95% CI (1.20\u201315.15), p-value = 0.024]. In conclusion, O. volvulus seropositivity was a risk factor to develop NS and OFE; premature birth was a potential co-factor. Living in IDP camps was not a risk factor for developing NS or OFE.<\/jats:p>","DOI":"10.3390\/pathogens10111451","type":"journal-article","created":{"date-parts":[[2021,11,9]],"date-time":"2021-11-09T12:46:23Z","timestamp":1636461983000},"page":"1451","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":14,"title":["Risk Factors for Nodding Syndrome and Other Forms of Epilepsy in Northern Uganda: A Case-Control Study"],"prefix":"10.3390","volume":"10","author":[{"given":"Nolbert","family":"Gumisiriza","sequence":"first","affiliation":[{"name":"Department of Mental Health, Kabale University School of Medicine, Kabale P.O. Box 317, Uganda"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marina","family":"Kugler","sequence":"additional","affiliation":[{"name":"Global Health Institute, University of Antwerp, 2600 Antwerp, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nele","family":"Brusselaers","sequence":"additional","affiliation":[{"name":"Global Health Institute, University of Antwerp, 2600 Antwerp, Belgium"},{"name":"Centre for Translational Microbiome Research, Karolinska Institute, 17177 Stockholm, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Frank","family":"Mubiru","sequence":"additional","affiliation":[{"name":"Department of Statistical methods, School of Statistics and Planning, College of Business and Management Sciences, Makerere University, Kampala P.O. Box 7062, Uganda"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7924-7182","authenticated-orcid":false,"given":"Ronald","family":"Anguzu","sequence":"additional","affiliation":[{"name":"College of Health Sciences, Makerere University, Kampala P.O. Box 7072, Uganda"},{"name":"Division of Epidemiology, Institute for Health and Equity, Medical College of Wisconsin, Milwaukee, WI 53226, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Albert","family":"Ningwa","sequence":"additional","affiliation":[{"name":"College of Health Sciences, Makerere University, Kampala P.O. Box 7072, Uganda"},{"name":"Centre of Tropical Neuroscience, Kitgum Site, Kampala P.O. Box 27520, Uganda"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rodney","family":"Ogwang","sequence":"additional","affiliation":[{"name":"College of Health Sciences, Makerere University, Kampala P.O. Box 7072, Uganda"},{"name":"Centre of Tropical Neuroscience, Kitgum Site, Kampala P.O. Box 27520, Uganda"},{"name":"KEMRI-Wellcome Trust Research Programme, Centre for Geographic Medicine Coast, Kilifi P.O. Box 230-80108, Kenya"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pamela","family":"Akun","sequence":"additional","affiliation":[{"name":"College of Health Sciences, Makerere University, Kampala P.O. Box 7072, Uganda"},{"name":"Centre of Tropical Neuroscience, Kitgum Site, Kampala P.O. Box 27520, Uganda"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amos Deogratius","family":"Mwaka","sequence":"additional","affiliation":[{"name":"College of Health Sciences, Makerere University, Kampala P.O. Box 7072, Uganda"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Catherine","family":"Abbo","sequence":"additional","affiliation":[{"name":"College of Health Sciences, Makerere University, Kampala P.O. Box 7072, Uganda"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rogers","family":"Sekibira","sequence":"additional","affiliation":[{"name":"College of Health Sciences, Makerere University, Kampala P.O. Box 7072, Uganda"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3356-4032","authenticated-orcid":false,"given":"An","family":"Hotterbeekx","sequence":"additional","affiliation":[{"name":"Global Health Institute, University of Antwerp, 2600 Antwerp, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1919-1340","authenticated-orcid":false,"given":"Robert","family":"Colebunders","sequence":"additional","affiliation":[{"name":"Global Health Institute, University of Antwerp, 2600 Antwerp, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kevin","family":"Marsh","sequence":"additional","affiliation":[{"name":"Centre for Tropical Medicine and Global Health, University of Oxford, Oxford OX3 7LG, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4728-4605","authenticated-orcid":false,"given":"Richard","family":"Idro","sequence":"additional","affiliation":[{"name":"College of Health Sciences, Makerere University, Kampala P.O. Box 7072, Uganda"},{"name":"Centre of Tropical Neuroscience, Kitgum Site, Kampala P.O. Box 27520, Uganda"},{"name":"Centre for Tropical Medicine and Global Health, University of Oxford, Oxford OX3 7LG, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2021,11,9]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"166","DOI":"10.1016\/S1474-4422(12)70321-6","article-title":"Clinical, Neurological, and Electrophysiological Features of Nodding Syndrome in Kitgum, Uganda: An Observational Case Series","volume":"12","author":"Sejvar","year":"2013","journal-title":"Lancet Neurol."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"208","DOI":"10.1016\/j.pt.2017.11.009","article-title":"Onchocerciasis-Associated Epilepsy, an Additional Reason for Strengthening Onchocerciasis Elimination Programs","volume":"34","author":"Colebunders","year":"2018","journal-title":"Trends Parasitol."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"297","DOI":"10.1002\/epi4.12463","article-title":"Systemic and Cerebrospinal Fluid Immune and Complement Activation in Ugandan Children and Adolescents with Long-Standing Nodding Syndrome: A Case-Control Study","volume":"6","author":"Ogwang","year":"2021","journal-title":"Epilepsia Open"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1371\/journal.pntd.0003880","article-title":"Nodding Syndrome May Be Only the Ears of the Hippo","volume":"9","author":"Wamala","year":"2015","journal-title":"PLoS Negl. 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Notes, 11.","DOI":"10.1186\/s13104-018-3774-y"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"e006195","DOI":"10.1136\/bmjopen-2014-006195","article-title":"Nodding Syndrome in Kitgum District, Uganda: Association with Conflict and Internal Displacement","volume":"4","author":"Landis","year":"2014","journal-title":"BMJ Open"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"123","DOI":"10.11604\/pamj.2016.24.123.8409","article-title":"Reduced Plasma Concentrations of Vitamin B6 and Increased Plasma Concentrations of the Neurotoxin 3-Hydroxykynurenine Are Associated with Nodding Syndrome: A Case Control Study in Gulu and Amuru Districts, Northern Uganda","volume":"24","author":"Obol","year":"2016","journal-title":"Pan Afr. Med. 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