CoCoNod (Coma, Convulsions and Nodding Syndrome): aetiology, risk factors and outcome of paediatric neuroemergencies in resource poor settings
Group and collaboration
Collaboration: Michael Boele van Hensbroek, Lia van der Hoek, Menno de Jong. Departments of Paediatrics and Medical Microbiology, Academic Medical Center
PhD student: Arthur Edridge
Non-Traumatic Coma (NTC) and Convulsive Status Epileptics (CSE) are the most common neurologic emergencies in children and are associated with high mortality and long term morbidity. Although these syndromes have been studied extensively in developed countries, there is limited knowledge from resource poor countries (RPCs) where the cause often remains unidentified. A recent decline in malaria transmission has changed the aetiological spectrum with an increase in encephalopathies of, thus far, undetermined cause. In a cohort of 150 children presenting from 3 sub-Saharan African countries, this project aims to study the (infectious and non-infectious) aetiology of NTC/CSE and associated risk factors and outcome, by a combination of specific diagnostics and metagenomic next generation sequencing-based approaches for pathogen identification, complemented by host gene expression profiling analyses to provide aetiological and pathophysiological directions, in particular for those in whom a clear infectious cause has not been determined.
Research activities thus will be focused on:
- Systematically reviewing current knowledge on incidence, aetiology, outcome and risk factors of NTC/CSE;
- Investigating the distribution of known infectious (viral, bacterial, fungal, parasitic) and non-infectious (metabolic, toxic, auo-immune) aetiologies of NTC/CSE in the paediatric cohort, as determined by established diagnostic methods;
- Determining previously unidentified or unknown pathogens by metagenomic next generation sequncing-based approaches;
- Using host gene expression profiling to provide aetiological direction, pathophysiological insights and discovery of potential biomarkers;
- Identifying risk factors for specific aetiologies and poor outcome.