Abstract
The emergence of nodding syndrome (NS) in Northern Uganda has generated controversial views with respect to patterns, natural history, and aetiology of the disease which is yet unknown. This study explored spatial patterns of NS using spatial-temporal methods to establish its clustering patterns across both space and time. Village and year of NS onset for individual patients between the years 1990 and 2014 were entered as input for spatial and temporal analysis in the 6 districts in northern Uganda where it is prevalent. Our temporal results showed that NS onset started before the population was moved in Internally Displaced People’s (IDPs) camps. It also shows that NS continued to be reported during the IDPs and after people had left the IDPs. Our spatial and spatiotemporal analysis showed that two periods had persistent NS clusters. These were 2000-2004 and 2010-2014, coinciding with the period when the population was in the IDP camps and when the population was already out of the camps, respectively. Our conclusion is that the view of associating NS outbreak with living conditions in IDP camps is thus coincidental. We, therefore, contend that the actual aetiological factor of NS is still at large.
Highlights
Nodding syndrome (NS) is a degenerative disorder that affects children originally born normal and growing well between the age of 3 - 18 years [1]
We investigated the outbreak of nodding syndrome (NS) in the light of some of these views, especially its possible association with the life of the population of northern Uganda that spent a long time in Internally Displaced People (IDPs)
Our investigation shows that the temporal onset of nodding syndrome started before the population was moved to IDPs and persisted after the population had returned to their homes
Summary
Nodding syndrome (NS) is a degenerative disorder that affects children originally born normal and growing well between the age of 3 - 18 years [1]. The burden places upon affected communities are multifaceted; ranging from physical and mental health decline of an individual child to increasing health disparities of the entire community. Spatial-temporal analysis and surveillance of nodding syndrome are constrained by lack of properly established aetiological (cause) factors as well as limited knowledge about environmental factors that may influence its emergence [10]. There is hardly any surveillance model for investigating spatial diffusion and supporting geographical knowledge on how to intervene on the spreading of nodding syndrome outbreak. We reviewed the literature in relation to the outbreak and discussed the methodology as well as findings from our survey
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