TY - JOUR
T1 - Neuroepidemiology of konzo a spastic para-tetraparesis of acute onset in a new area of the Democratic Republic of Congo
AU - Tshala-Katumbay, Désiré
AU - Banea-Mayambu, Jean Pierre
AU - Kazadi-Kayembe, Théodore
AU - Nunga-Matadi, Raphaël
AU - Bikangi-Nkiabungu, Fidèle
AU - Edebol Eeg-Olofsson, Karin
AU - Tylleskär, Thorkild
PY - 2001
Y1 - 2001
N2 - Background: Konzo is an acute non-progressive spastic paraparesis associated with a consumption of insufficiently processed bitter cassava, and a low intake of sulfur amino acids. Method: To determine whether an outbreak of spastic paraparesis in the Democratic Republic of Congo was compatible with konzo, we surveyed and screened the population in the affected area by using the WHO criteria. Interviews and focus group discussions were done on diet and the occurrence of konzo. Serum samples were analyzed for prealbumin, albumin and thiocyanate; urine samples for linamarin, thiocyanate and sulfate. Serum samples were tested for HIV1-2 (Behring ELISA) and HTLV I-II antibodies (ELISA/Wellcome). Results: Of 2,723 inhabitants, 55 were affected by konzo i.e. a prevalence of 20 per thousand. The main symptom was a sudden onset of a non-progressive spastic paraparesis or a tetraparesis in severe cases. Bitter cassava was the staple diet. We found high exposure to cyanogenic compounds i.e., mean (± SD) concentration of serum thiocyanate 502 (±153) mmol/L, of urinary linamarin 482 (±322) mmol/L, and urinary thiocyanate 1128 (±670) mmol/L. The mean (± SD) urinary sulfate concentration was 4.0 ± 3.3 mmol/L. Most subjects had low proteins concentration in serum: of 38 subjects 37 and 28 were below the albumin and prealbumin reference values respectively. All 38 blood samples were negative to the tested retroviruses. Conclusion: This outbreak was compatible with konzo. Improving cassava processing might prevent the disease.
AB - Background: Konzo is an acute non-progressive spastic paraparesis associated with a consumption of insufficiently processed bitter cassava, and a low intake of sulfur amino acids. Method: To determine whether an outbreak of spastic paraparesis in the Democratic Republic of Congo was compatible with konzo, we surveyed and screened the population in the affected area by using the WHO criteria. Interviews and focus group discussions were done on diet and the occurrence of konzo. Serum samples were analyzed for prealbumin, albumin and thiocyanate; urine samples for linamarin, thiocyanate and sulfate. Serum samples were tested for HIV1-2 (Behring ELISA) and HTLV I-II antibodies (ELISA/Wellcome). Results: Of 2,723 inhabitants, 55 were affected by konzo i.e. a prevalence of 20 per thousand. The main symptom was a sudden onset of a non-progressive spastic paraparesis or a tetraparesis in severe cases. Bitter cassava was the staple diet. We found high exposure to cyanogenic compounds i.e., mean (± SD) concentration of serum thiocyanate 502 (±153) mmol/L, of urinary linamarin 482 (±322) mmol/L, and urinary thiocyanate 1128 (±670) mmol/L. The mean (± SD) urinary sulfate concentration was 4.0 ± 3.3 mmol/L. Most subjects had low proteins concentration in serum: of 38 subjects 37 and 28 were below the albumin and prealbumin reference values respectively. All 38 blood samples were negative to the tested retroviruses. Conclusion: This outbreak was compatible with konzo. Improving cassava processing might prevent the disease.
KW - Acute spastic paraparesis
KW - Cassava
KW - Cyanogens exposure
KW - Konzo
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M3 - Article
AN - SCOPUS:0008060953
SN - 1015-8618
VL - 20
JO - African Journal of Neurological Sciences
JF - African Journal of Neurological Sciences
IS - 1
ER -