Skip to main content
NCBI home page
Bulletin of the World Health Organization logoLink to Bulletin of the World Health Organization
. 1991;69(5):581–589.

Epidemiological evidence from Zaire for a dietary etiology of konzo, an upper motor neuron disease.

T Tylleskär 1, M Banea 1, N Bikangi 1, L Fresco 1, L A Persson 1, H Rosling 1
PMCID: PMC2393256  PMID: 1959159

Abstract

A clear association between seasonal outbreaks of a paralytic disease called konzo and toxic effects from consumption of insufficiently processed bitter cassava roots has been demonstrated in Bandundu region, Zaire. A community-based survey of 6764 inhabitants identified 110 live and 24 dead konzo-affected persons with a history of isolated non-progressive spastic paraparesis of abrupt onset. The start of these annual outbreaks of konzo in 1974 coincided with the completion of a new tarmac road to the capital, which facilitated the transport of cassava and made it the main cash crop. The extensive cassava sales encouraged the consumption by the peasant families of roots that had not been adequately processed; frequent acute cyanide intoxications resulted when the naturally occurring cyanogens in the roots were eaten. The disease mainly appeared in the dry season when there was high consumption of insufficiently processed cassava and the diet lacked supplementary foods with sulfur-containing amino acids which promote cyanide detoxification. These results, which confirm the earlier findings in East Africa, show that, owing to the high cyanide and low sulfur dietary intake, there is an increased risk of konzo outbreaks in cassava-growing areas during periods of adverse agro-economic changes.

Full text

PDF
581

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Carton H., Kayembe K., Kabeya, Odio, Billiau A., Maertens K. Epidemic spastic paraparesis in Bandundu (Zaire). J Neurol Neurosurg Psychiatry. 1986 Jun;49(6):620–627. doi: 10.1136/jnnp.49.6.620. [DOI] [PMC free article] [PubMed] [Google Scholar]
  2. Cliff J., Lundqvist P., Mårtensson J., Rosling H., Sörbo B. Association of high cyanide and low sulphur intake in cassava-induced spastic paraparesis. Lancet. 1985 Nov 30;2(8466):1211–1213. doi: 10.1016/s0140-6736(85)90742-1. [DOI] [PubMed] [Google Scholar]
  3. Cock J. H. Cassava: a basic energy source in the tropics. Science. 1982 Nov 19;218(4574):755–762. doi: 10.1126/science.7134971. [DOI] [PubMed] [Google Scholar]
  4. Howlett W. P., Brubaker G. R., Mlingi N., Rosling H. Konzo, an epidemic upper motor neuron disease studied in Tanzania. Brain. 1990 Feb;113(Pt 1):223–235. doi: 10.1093/brain/113.1.223. [DOI] [PubMed] [Google Scholar]
  5. Kayembe K., Goubau P., Desmyter J., Vlietinck R., Carton H. A cluster of HTLV-1 associated tropical spastic paraparesis in Equateur (Zaire): ethnic and familial distribution. J Neurol Neurosurg Psychiatry. 1990 Jan;53(1):4–10. doi: 10.1136/jnnp.53.1.4. [DOI] [PMC free article] [PubMed] [Google Scholar]
  6. Ludolph A. C., Hugon J., Dwivedi M. P., Schaumburg H. H., Spencer P. S. Studies on the aetiology and pathogenesis of motor neuron diseases. 1. Lathyrism: clinical findings in established cases. Brain. 1987 Feb;110(Pt 1):149–165. doi: 10.1093/brain/110.1.149. [DOI] [PubMed] [Google Scholar]
  7. Osuntokun B. O. Cassava diet, chronic cyanide intoxication and neuropathy in the Nigerian Africans. World Rev Nutr Diet. 1981;36:141–173. doi: 10.1159/000393156. [DOI] [PubMed] [Google Scholar]
  8. Rodgers-Johnson P. E., Garruto R. M., Gajdusek D. C. Tropical myeloneuropathies--a new aetiology. Trends Neurosci. 1988 Dec;11(12):526–532. doi: 10.1016/0166-2236(88)90176-2. [DOI] [PubMed] [Google Scholar]
  9. Ward N. A. Poliomyelitis: a review. Trop Doct. 1983 Jan;13(1):21–28. doi: 10.1177/004947558301300108. [DOI] [PubMed] [Google Scholar]

Articles from Bulletin of the World Health Organization are provided here courtesy of World Health Organization

RESOURCES