Nodding syndrome parasite discovered

Monday April 15 2019

Sick. Balaam Opio, one of the victims of

Sick. Balaam Opio, one of the victims of Nodding Syndrome, at Aromowangolobo Treatment Centre in April 17, 2018. PHOTO BY TOBIAS JOLLY OWINY 

By TOBBIAS JOLLY OWINY

A lead researcher into the mysterious Nodding Syndrome at the Ministry of Health has defined Onchocerca Volvulus (OV) as a parasite responsible for the cause of nodding in children where several lives in Acholi Sub-region have been lost.
The nodding syndrome is a mysterious illness that affects the brain and central nervous system of children, primarily between the ages of five and 15.

The children nod off their heads coupled with seizures and in most cases they lose the contact of the surrounding environment.
The disease causes increased diminishment in mental capacity and over the course of time, many children develop severe growth retardation.
A child who is 12 or 13 will appear to be six or eight years old.
While presenting his research report before stakeholders in Gulu Town on Friday, Dr Richard Idro said his team was able to identify OV, a parasite vectored by black fly as the responsible parasite behind the nodding syndrome.

The research that kicked off in 2015 in the northern region where nodding syndrome is reported relied on data provided by global positioning systems to come to a conclusion.
“We found that the nodding syndrome is associated with Onchocerciasis, which is transmitted by Onchocerca Volvulus found in black flies.
“This was after we tagged and mapped all the victims’ GPS coordinates which indicated victims’ concentration (population) on River Aswa which is an infection of the black fly,” Dr Idro said.
The research, which was conducted in laboratories across the six districts of Lamwo, Kitgum, Pader, Lira, Omoro and Gulu, discovered fragments of proteins of OV peptides in the cerebrospinal fluids drawn from the victims.

In his report, Dr Idro stated that more than 95 per cent of the specimen (participants) with nodding syndrome examined preliminarily showed higher levels of OV antibodies than in epileptic cases.
He stated that their conclusion on black fly factor, a vector of Onchocerca Volvulus Microfilaria, discovered as being the cause of the infection was derived from results of larviciding and aerial spraying done in communities around River Aswa.

“Following mapping, larviciding and spraying by government to eradicate black fly in 2013, Uganda has not had any new case of nodding disease, this means that the black fly itself has been a big factor in the infection although the mechanism is yet to be established,” he said.
The proportion of nodding syndrome patients testing positive for OV has since dropped from 15 in 2013 to four in 2017, when government embarked on massive vector control of black flies, the report stated.

Tested samples from hair, blood, urine, soil, water and animals from this infected area did not reveal any toxins, thus nullifying the assumption that the disease could have been a result of chemical weapons due to the long war in the sub-region between Lord Resistance Army and UPDF or poisoned food distributed by humanitarian bodies during the insurgency.
The report indicates that the brain damages in victims is permanent and requires medication for life.
“Even if we got the drugs that cure the syndrome, the brains of the already affected children will never be healed, because the infection damaged the brain,’’ he said.

It was also revealed that the brains of victims with severe conditions became smaller (generalised) cerebral atrophy [thinning] and degenerated like in the elderly with tau-Protein deposits [taupathy].
Last year, a team of researchers led by Dr Richard Echodu of Gulu University, in their six years’ research failed to link the infection to mycotoxins in contaminated foods when they discovered no supporting evidence for the association between the two.

The researchers were assessing whether the consumption of fungal mycotoxins contributes to nodding syndrome development after a WHO International meeting in Kampala in 2012 recommended that fungal contamination of foods should be investigated as a possible cause of the disease.
More than 3,000 children in Acholi are grappling with the disease and more than 500 have so far died.

Previous report

In September 2018, a group of six scientists led by Ontario-based Prof Michael Pollanen and Uganda’s consultant pathologist, Dr Sylvester Onzivua, released a report linking the disease to taupathy, referring to a degenerative disease linked to deposition of insoluble proteins in the brain.

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