Is the Nodding Syndrome among Ugandan Children connected to Vitamin B Deficiency?

Children aged between 5 and 15 who live in northern Uganda, Tanzania and southern Sudan continue to experience Nodding Syndrome, a neurological disorder that is associated with a physical and psychological function degeneration that leads to death. The suffering begins with concentration disturbances as well as with an enigmatic frightening at the sight of food. In later stages cramps, speech, hearing and movement disorders occur which make school visits impossible. In the final stage, apathic states and confusion occur. Experts particularly suspect poisonings or infections e.g. by roundworms, as possible causes of this disease (1).

Other risk factors remained unknown, but an Ugandan research team from Gulu University found a link between vitamin B₆ status and the occurrence of Nodding Syndrome. A total of 139 children and adolescents from Gulu and the Amuru district were examined. It turned out that the children suffering from the syndrome had a lower concentration of vitamin B₆ in the blood compared to the healthy children of the control group. These lowered concentration leads to an increased production of 3-hydroxykynurenine (3-HK), a degradation product in the tryptophan metabolism. 3-HK has a toxic effect on brain cells and could therefore be a risk factor for the Nodding Syndrome, the scientists concluded. Therefore, they recommend a sufficient intake of vitamin B₆ in children and adolescents. Community members should be sensitize to ensure adequate dietary intake of vitamin B₆ so that the risk of Nodding Syndrome among children is averted (2).

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(1) R Idro et al. Nodding syndrome in Ugandan children—clinical features, brain imaging and complications: a case series. Nodding syndrome in Ugandan children—clinical features, brain imaging and complications: a case series BMJ Open 2013;3:e002540. doi: 10.1136/bmjopen-2012-002540

(2) JH Obol et al. Reduced plasma concentrations of vitamin B6 and increased plasma concentrations of the neurotoxin 3-hydroxykynurenine are associated with nodding syndrome: a case control study in Gulu and Amuru districts, Northern Uganda. Pan Afr Med J. 2016; 24: 123. Published online 2016 Jun 8., available via: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5012759/