Over 25 nodding disease victims at Mulago hospital

By Raymond Baguma and Wokorach-Oboi

Over 25 children suffering from the medically puzzling nodding disease from Kitgum district were transferred to Mulago national referral hospital on Friday night and are presently admitted at the hospital's Acute Care Unit.

The patients were received by the hospital staff led by executive director Dr. Byarugaba Baterana, Dr. Opika Opoka the consultant pediatrician and in-charge of the Acute Care Unit, senior nursing offers, and Dr. Jacinto Amandua the commissioner of curative services and Dr. Male.

Dr. Baterana said that they would be assessed and specific ailments be handled as medical investigations continue to be carried out.

He said the medical personnel would take off blood samples, carry out urine tests, as well as CT scan examinations.

“It is not the first time we are handling this. We handled this and we are going to reinvestigate. Mulago is the Supreme Court of medicine in the country, and we cannot fail to treat them,” Dr. Baterana assured.

Approval

The Kitgum Woman MP Beatrice Anywar said President Yoweri Museveni had approved and financially facilitated the transfer of the children to Mulago.

The transfer was also cleared by state minister for health Dr. Richard Nduhura and Director General of Health Services Dr. Jane Acheng.

“I know Mulago is a national referral hospital and whatever diseases fail in the region, are brought here. The children are in bad shape and that is why we have brought them here,” Anywar said.

Ronald Opio who traveled aboard the bus said: “We are dealing with a disease whose method of spread we don't know. Infections are rising. These are only samples. There are more cases on the ground. We brought only this number because of logistical challenges.”

The children, who traveled with their parents and guardians aboard a hired bus, were got from 25 Kigtum villages in the three sub-counties Akwang, Amida as well as Kitgum town council.

Bus briefly held

On their way to Kampala, the bus belonging to Homeland Northern Tours, registration number UAP 994L was intercepted by police in Gulu for over an hour.

The policed questioned why the sick children were being referred to Mulago hospital without a referral clearance from the Kitgum hospital medical superintendent Dr. Alex Layoo.

But MP Anywar blamed this on the Kitgum LC5 chief Luka Nyeko whom she said was opposed to the children being transported to Kampala.

“I exchanged bitter words with him last night [Thursday] over the matter. He said he was against taking the children to Kampala because it would embarrass the NRM government since it had already put up treatment centres to treat the children,” Anywar recalled.

From Gulu however, the bus was allowed to proceed.

Upon approaching Luweero, the bus was given a police escort up to the final destination at Mulago, which enabled it to weave through Kampala city's evening traffic jam.

The plan

On Friday, the government and World Health Organization (WHO) announced a plan to respond to the disease to be coordinated by the office of the Prime Minister.

The response plan includes case management, bi-annual mass treatment of river blindness, increased surveillance, multivitamin and multi-nutrient supplementation and research into the cause of the disease.

The outbreak of nodding disease was first reported in northern Uganda in 2009 with cases in Kitgum, Lamwo and Pader.

So far, over 3,000 children mainly boys between five and 15 years of age have been affected, with 170 reported deaths.

The affected region lies within an area where River Blindness is prevalent, according to the WHO reports.

According to the international health agency, nodding disease is believed to be a new type of seizure disorder characterized by head nodding episodes that consist of two repetitive dropping forward of the head.

The nodding is sometimes precipitated by food or cold weather and is often accompanied by other types of seizures or staring spells.

During the episodes, the child stops feeding and appears nonresponsive, with or without loss of consciousness.

There is deterioration of brain function in some of the victims, and malnutrition with growth retardation in the majority of cases. Children become malnourished and have dropped out of school.

Investigations reveal that the disease is not contagious.

 Similar cases have been identified in Tanzania in 1962, Liberia in 1983, and Southern Sudan in 2003. To-date, no definite cause or cure for the disease cases has been found.

Initial investigations link the disease to river blindness.

However, most affected children have been found to be lacking in vitamin B6 and other micronutrients (Vitamin A, Seleniun and Zinc).

In a statement released on Friday, it was revealed that the Ministry of Health has set up treatment centres in the three districts and is training health workers in the management and treatment of cases.