Psychosocial study of epilepsy in Africa

As documented by many authors, the social position of epileptics in many small scale societies of Africa is marginal at best, and is often characterized by rejection, discrimination, even ostracism. Such negative and noxious attitudes toward persons suffering from epilepsy are rooted in traditional beliefs about causes and nature of convulsive disorders and these have parallels in European history. This article focuses on the psychosociocultural aspects and indigenous concepts of epilepsy, on popular attitudes towards, and social status of, sufferers from epilepsy in a Tanzanian tribal population. The authors present a comparative analysis of focus group discussions conducted with epileptics and with matched controls in two isolated communities. In one community (Mahenge) a clinic for epilepsy has been operating for over 36 years, with a public education component during the last four years, whereas in the other community (Ruaha) epileptics have only been sporadically treated in a small mission dispensary and people have had little opportunity to learn about the nature and modern treatment of convulsive disorders. The responses obtained in focus group discussions reflect the significant change in notions about the illness, in the attitude toward and in the social status of epileptics in Mahenge, while the people of Ruaha still regard epilepsy as a typical "African" affliction fraught with supernatural danger and not effectively treatable by modern medicine.epilepsy psychosocial study Africa qualitative analyses

Nakalanga Syndrome: Clinical Characteristics, Potential Causes, and Its Relationship with Recently Described Nodding Syndrome

<div><p>Nakalanga syndrome is a condition that was described in Uganda and various other African countries decades ago. Its features include growth retardation, physical deformities, endocrine dysfunction, mental impairment, and epilepsy, amongst others. Its cause remains obscure. Nodding syndrome is a neurological disorder with some features in common with Nakalanga syndrome, which has been described mainly in Uganda, South Sudan, and Tanzania. It has been considered an encephalopathy affecting children who, besides head nodding attacks, can also present with stunted growth, delayed puberty, and mental impairment, amongst other symptoms. Despite active research over the last years on the pathogenesis of Nodding syndrome, to date, no convincing single cause of Nodding syndrome has been reported. In this review, by means of a thorough literature search, we compare features of both disorders. We conclude that Nakalanga and Nodding syndromes are closely related and may represent the same condition. Our findings may provide new directions in research on the cause underlying this neurological disorder.</p></div

Map of sub-Saharan Africa.

<p>Cases of Nakalanga and Nodding syndrome are reported from onchocerciasis endemic areas throughout West, Central, and East Africa.</p

Proposed criteria for definition of Nakalanga syndrome compared to criteria for definition of a probable case of Nodding syndrome consented in Kampala 2012 (adapted from ref. [26,33]).

<p>Proposed criteria for definition of Nakalanga syndrome compared to criteria for definition of a probable case of Nodding syndrome consented in Kampala 2012 (adapted from ref. [<a href="http://www.plosntds.org/article/info:doi/10.1371/journal.pntd.0005201#pntd.0005201.ref026" target="_blank">26</a>,<a href="http://www.plosntds.org/article/info:doi/10.1371/journal.pntd.0005201#pntd.0005201.ref033" target="_blank">33</a>]).</p