Determinants of survival of patients with head nodding syndrome in northern Uganda

Abstract

The objectives of this study were to; ascertain the survival time of patients with nodding disease syndromes and establish the child-related and family of caregiver-specific factors associated with the survival time of patients aged 5 to 18 years with head nodding syndrome. Medical records were obtained from the medical health registry in health facilities within Kitgum and Omoro districts in Northern Uganda and the Kaplan–Meier estimator was used to display cumulative survival probability for categorical predictor variables, the log-rank test was used at the bivariate level while at the multivariate level, the Cox proportional hazard regression model was used to measure factors related to time-to-death event. Factors associated with head nodding syndrome were age group, district, drug, treatment, comorbidities, and the gender of the caregiver. Sex, age group of the caregiver, and education level were not significantly associated with their survival rates with patients aged 15 years and above. The Cox regression model showed that those 15 years and older are more likely to survive (HR=1.77, p=0.052), females were more likely to survive (HR=2.02, p=0.009), residents of Omoro were more likely to survive (HR=4.83, p=0.000), those on two or more drugs were less likely to survive HR=0.56, p=0.057). Having Epilepsies was significantly associated with survival rates. Patients without epilepsy were more likely to survive following diagnosis (HR=2.63, p=0.009). The study therefore concluded that efforts to eradicate the disease should include treatments that use more than one drug as well as special attention paid to patients who have comorbidities. The recommendations of this study are that support from health care practitioners and should ensure that the treatment for patients with head nodding syndrome includes a combination of drugs two or more drugs as part of the treatment plan. Additionally, there is a need for more research, training, and capacity building for staff to be done on patients suffering from Head Nodding Syndrome to discover the cause, proper treatment, and prevention means.