Previous surveys have demonstrated that areas with high onchocerciasis transmission are prone to an increased prevalence of epilepsy (1). To describe this epidemiological phenomenon, the term onchocerciasis-associated epilepsy (OAE) was proposed that includes different seizure presentations including nodding syndrome (NS) (2,3). NS was first investigated in 2001–2 in Lui and Amadi in Western Equatoria region, South Sudan, by a team led by the World Health Organization (WHO) (4). Three small case control studies (82 pairs in total) performed during these investigations showed that infections with Onchocerca volvulus diagnosed by skin snips were more often present in NS cases compared to controls (OR 9.3-29.0) (4).
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