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Qualitative evaluation of the outcomes of care and treatment for children and adolescents with nodding syndrome and other epilepsies in Uganda

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Infectious Diseases of Poverty 2019年第2期8卷 93-93页

作者： Catherine Abbo Amos Deogratius Mwaka bernard Toliva opar Richard Idro Department of Psychiatry School of Medicine College of Health SciencesMakerere UniversityKampalaUgandd 不详

Background:In 2012,the Ugandan Government declared an epidemic of Nodding Syndrome(NS)in the Northern districts of Gulu,Kitgum,Lamwo and *** guidelines were developed and NS treatment centres were established to provide symptomatic control and ***,a wide gap remained between the predefined care standards and the quality of routine care provided to those *** study is to qualitatively assess adherence to accepted clinical care standards for NS;identify gaps in the care of affected children and offer Clinical Support Supervision(CSS)to Primary Health Care(PHC)staff at the treatment centres;and identify psychosocial challenges faced by affected children and their ***:This case study was carried out in the districts of Gulu,Kitgum,Lamwo and Pader in Uganda from September to December in *** the 5-stage approach of Clinical Audit,data were collected through direct observations and interviews with PHC providers working in public and private-not-for-profit health facilities,as well as with caregivers and political *** qualitative data was analysed using Seidel model of data ***:Clinical Audit and CSS revealed poor adherence to treatment *** affected children had suboptimal NS management resulting in poor seizure control and complications including severe *** causes of these outcomes were frequent antiepileptic drugs stock outs,migration of health workers from their work stations and psychosocial *** was hardly any specialized multidisciplinary team(MDT)to provide for the complex rehabilitation needs of the patients and a task shifting model with inadequate support supervision was employed,leading to loss of skills *** psychosocial and psychosexual issues associated with NS included early pregnancies,public display of sexual behaviours and child ***:Despite involvement of relevant MDT members in the development of multidisciplinary NS

关键词： Nodding syndrome Epilepsy Multi-disciplinary Clinical audit Clinical support supervision Uganda

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Prevalence and incidence of nodding syndrome and other forms of epilepsy in onchocerciasis-endemic areas in northern Uganda after the implementation of onchocerciasis control measures

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Infectious Diseases of Poverty 2020年第2期9卷 93-93页

作者： Nolbert Gumisiriza Frank Mubiru Joseph Nelson Siewe Fodjo Martin Mbonye Kayitale An Hotterbeekx Richard Idro Issa Makumbi Tom Lakwo bernard opar Joice Kaducu Joseph Francis Wamala Robert Colebunders 不详 Global Health Institute University of AntwerpAntwerpBelgium Full list of author information is available at the end of the article

Background:Around 2007,a nodding syndrome(NS)epidemic appeared in onchocerciasis-endemic districts of northern Uganda,where ivermeain mass distribution had never been *** study evaluated the effect of community-directed treatment with ivermectin(CDTI)and ground larviciding of rivers initiated after 2009 and 2012 respectively,on the epidemiology of NS and other forms of epilepsy(OFE)in some districts of northern ***:In 2012,a population-based community survey of NS/epilepsy was carried out by the Ugandan Ministry of Health in Kitgum and Pader *** August 2017,we conducted a new survey in selected villages of these districts and compared our findings with the 2012 *** addition,two villages in Moyo distria(where CDTI was ongoing since 1993)served as comparative onchocerciasis-endemic sites in which larviciding had never been *** comparison between 2012 and 2017 prevalence and cumulative incidence were done using the Fisher's and Pearson's Chi-square tests at 95%level of ***:A total of 2138 individuals in 390 households were *** the seleaed villages of Kitgum and Pader,there was no significant decrease in prevalence of NS and OFE between 2012 and ***,the cumulative incidence of all forms of epilepsy decreased from 1165 to 130 per 100000 persons per year(P=0.002);that of NS decreased from 490 to 43 per 100000 persons per year(P=0.037);and for OFE from 675 to 87 per 100000 persons per year(P=0.024).The median age of affeaed persons(NS and OFE)shifted from 13.5(IQR:11.0-15.0)years in 2012 to 18.0(IQR:15.0-20.3)years in 2017;P<*** age-standardized prevalence of OFE in Moyo in 2017 was 4.6%,similar to 4.5%in Kitgum and ***:Our findings support the growing evidence of a relationship between infection by Onchocerca volvulus and some types of childhood epilepsy,and suggest that a combination of bi-annual mass distribution of ivermectin and ground larviciding of rivers is an

关键词： Nodding syndrome Epilepsy Onchocerciasis Prevalence Incidence Ivermeain Larviciding Uganda

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