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Nodding Syndrome: a trans-disciplinary approach to identify the cause and decrease the incidence of river epilepsy

Objective

Nodding syndrome (NS) is a neurological, incurable syndrome, currently affecting mainly children between 5 and 15 years of age in South Sudan, Uganda and Tanzania. Since 1950, when NS was first described, its cause has remained a mystery. NS is characterized by head-nodding (an atonic form of epilepsy), often followed by clonic - tonic seizures, developmental retardation and faltering growth. In the affected regions, NS is a major public health problem associated with severe socio-economic consequences. After exploratory missions to South Sudan, Uganda and the Democratic Republic of the Congo (DRC), we gathered epidemiological evidence that supports the hypothesis that NS is a disease caused by a pathogen transmitted by blackflies, the vectors that transmit the parasitic worm that causes onchocerciasis. This pathogen could be an unknown neurotropic virus or another pathogen that is transmitted either independently or as a symbiont of the worm. We postulate that this pathogen is able to cause typical NS, but also other forms of epidemic epilepsy. We hypothesise that the same disease is also endemic in other onchocerciasis hyper-endemic regions e.g. in the Mbam valley, Cameroon and the Orientale Province, DRC (where it is referred to as “river epilepsy”). In this project we aim to investigate our hypotheses in South Sudan, Uganda, Tanzania, Cameroon and the DRC with a trans-disciplinary approach including clinical-epidemiological, post-mortem, eco-entomological, and metagenomic studies. We will study the effect of vector control methods and ivermectin distribution on the incidence of river epilepsy. So far a multi-country study on NS was never done and nearly all previous studies were cross-sectional, carried out during short country visits. With this long term research plan we hope to finally discover the cause of NS and detect effective control strategies to decrease the incidence of epilepsy in onchocerciasis endemic areas.

Call for proposal

ERC-2014-ADG
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Host institution

UNIVERSITEIT ANTWERPEN
Address
Prinsstraat 13
2000 Antwerpen
Belgium
Activity type
Higher or Secondary Education Establishments
EU contribution
€ 2 224 931,49

Beneficiaries (4)

UNIVERSITEIT ANTWERPEN
Belgium
EU contribution
€ 2 224 931,49
Address
Prinsstraat 13
2000 Antwerpen
Activity type
Higher or Secondary Education Establishments
UNIVERSITATSKLINIKUM BONN
Germany
EU contribution
€ 61 000
Address
Venusberg-campus 1
53127 Bonn
Activity type
Higher or Secondary Education Establishments
SAN DIEGO STATE UNIVERSITY FOUNDATION
United States
EU contribution
€ 72 500,01
Address
Campanile Drive 5520 Mc 1931
5520 San Diego
Activity type
Other
ERASMUS UNIVERSITAIR MEDISCH CENTRUM ROTTERDAM
Netherlands
EU contribution
€ 58 568,50
Address
Dr Molewaterplein 40
3015 GD Rotterdam
Activity type
Higher or Secondary Education Establishments