Nodding syndrome in Kitgum District, Uganda: association with conflict and internal displacement.
Bottom Line: Data were obtained from publicly available information reported by the Ugandan Ministry of Health (MOH), the Armed Conflict Location & Event Data (ACLED) Project of the University of Sussex in the UK, peer-reviewed publications in professional journals and other sources.Cases rapidly increased annually beginning in 2001, with peaks in 2003-2005 and 2008, 5-6 years after peaks in the number of wartime conflicts and deaths.Peaks of Nodding syndrome reported by the MOH are associated with, but temporally displaced from, peaks of wartime conflicts, deaths and household internment, where infectious disease was rampant and food insecurity rife.
Affiliation: Global Health Center, Oregon Health & Science University, Portland, Oregon, USA.Show MeSH
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Mentions: We examine annual MOH reports of NS cases in relation to regional wartime conflict, casualties and household displacement in Kitgum District (figure 1). We find a delayed temporal association between peaks in conflict events and deaths. Peaks of reported NS also correlate with peaks of household displacement and prolonged residence in camps for internally displaced people (IDP), where residents were heavily dependent on food aid.13 The camps were insecure, unsanitary and squalid, and morbidity and mortality rates were high.14 Starting in the mid-1990s, these camps were established by the government of Uganda with the goal of protecting people from the LRA, including an estimated 285 000 from Kitgum District.15
Affiliation: Global Health Center, Oregon Health & Science University, Portland, Oregon, USA.