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case_images: Age of nodding onset among the NS children studied at HfH Centre
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case_images: The age of onset of NS among the children peaked at 8 years (32.3%) but there were two semi-peaks at 7 years (12.9%) and 9 years (12.9%) respectively (Figure 3).
case_images: (BMI for Age (z-scores) for the 32 NS children studied at HfH Centre
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case_images: In addition, it was noted that on admission of NS children at the HfH center in 2012 using WHO criteria for surveillance and epidemiological diagnosis, their nutritional status were poor, NS children presenting with moderate to severe wasting was 29.1% and those presenting with moderate to severe stunting was 54.8% (Figure 4, Figure 5). At the end of this study period, 64.1% of NS children were within normal Body Mass Index (BMI) for age (z-score) ranges (-1 to 1) with 15.4% being above average and 20.5% having mild thinness (Figure 4). The severely low BMI for age (z-scores) that remained unimproved over the period was for a single 13 year old male who presented with dramatic stunting with an appearance of 6 years old child (Figure 4). Malnutrition resulting into stunting and wasting has also been shown to improve with treatment and food rehabilitation with only a small population of NS children remaining severely stunted (Figure 4, Figure 5).
case_images: Height for Age (z-scores) for the 32 NS children studied at HfH Care Centre
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case_images: In addition, it was noted that on admission of NS children at the HfH center in 2012 using WHO criteria for surveillance and epidemiological diagnosis, their nutritional status were poor, NS children presenting with moderate to severe wasting was 29.1% and those presenting with moderate to severe stunting was 54.8% (Figure 4, Figure 5). In addition, severe and moderate stunting improved substantially from baseline admission figures and by the end of this study, 58% were above or at average height for age, while 20.5% were just below average (Figure 5). One case of moderate to severe stunting remained unimproved despite adequate nutrition and multivitamin supplementation (Figure 5). Furthermore, stunting for the majority of cases was corrected with regular local nutrition and multivitamin supplementation (Figure 5). Malnutrition resulting into stunting and wasting has also been shown to improve with treatment and food rehabilitation with only a small population of NS children remaining severely stunted (Figure 4, Figure 5).
case_images: HfH monthly seizure reports for the 32 NS children studied
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case_images: During monitoring, three months of increased seizure activities were observed; November 2012 (43.8%); February 2013 (43.8%); and July 2013 (34.4%) (Figure 6). This is shown in Figure 6 and it indicates that there was a general reduction in frequency of nodding among NS children reviewed. The majority of NS children demonstrated significant reduction in the frequencies of nodding. When comparing the timing of illness in the children's medical books to the children's seizure diaries, NS children with more episodes of febrile illnesses showed higher monthly seizure averages (Figure 6, Figure 7). However, these authors suggest that further studies are needed to assess if these seizures were solely due to febrile illnesses, or rapid changes in core temperatures or changes in arousal states of NS children (Figure 6 & Figure 7). In addition, NS children who presented with more frequent episodes of febrile illnesses appeared to be at higher risk of frequent seizure activity as compared to those with less (Figure 6, Figure 7).
case_images: Monthly pattern of seizures with respect to febrile illnesses among NS children
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case_images: All three peaks were associated with increases in febrile illnesses and cold weather experienced by the children (Figure 7). The third peak in July 2013 occurred when the HfH center had 6 cases of febrile illnesses in close proximity (Figure 7). Monthly pattern of seizures with respect to febrile illnesses among NS children: The overall pattern of febrile illnesses (Violet dotted lines) in Figure 7 show patterns corresponding fairly with the high mean seizures which peaked in November 2012 and two semi peaks in March 2013 and August 2013. When comparing the timing of illness in the children's medical books to the children's seizure diaries, NS children with more episodes of febrile illnesses showed higher monthly seizure averages (Figure 6, Figure 7). However, these authors suggest that further studies are needed to assess if these seizures were solely due to febrile illnesses, or rapid changes in core temperatures or changes in arousal states of NS children (Figure 6 & Figure 7). In addition, NS children who presented with more frequent episodes of febrile illnesses appeared to be at higher risk of frequent seizure activity as compared to those with less (Figure 6, Figure 7). Therefore, body temperature and seasonal impact on seizure frequency could bear potentials for further investigations (Figure 7).