THE NAKALANGA-SYNDROME IN KABAROLE DISTRICT, WESTERN UGANDA

An acquired condition resulting in arrested growth was reported in the 1950s and 1960s from along the Nile near Jinja in eastern Uganda. Thi s became known as Nakalanga dwarfism, and an association with onchocer ciasis was postulated. After control of onchocerciasis through larvaci ding in this area some 30 years ago, no new cases have been noted. We now report this condition from western Uganda where its appearance see ms to be a relatively recently event. Thirty-one persons with short st ature, 15 years of age and older, were identified through household su rveys in an area of Kabarole district with a high prevalence of onchoc erciasis. Cases identified were matched with controls selected for age and sex from the nearest household. Cases of Nakalanga syndrome weigh ed significantly less and were shorter than controls. The Z scores for weight-for-age, weight-for-height, height-for-age, and body mass inde x were significantly less among cases. Other clinical features observe d among cases included absence of secondary sexual characteristics, sk eletal deformities, dental caries, and mental retardation. All cases a nd 22 (79%) controls had microfilariae of Onchocerca volvulus in skin snips. All community members interviewed were aware of the Nakalanga s yndrome, and 93% believed it to be acquired sometime after birth. The possible association with onchocerciasis is discussed.