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Int J Epidemiol. 1995 Oct;24(5):949-56.

Dietary determinants of a non-progressive spastic paraparesis (Konzo): a case-referent study in a high incidence area of Zaire.

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1
Department of Pediatrics, University Hospital, Uppsala, Sweden.

Abstract

BACKGROUND:

Konzo is an upper motor neuron disease in Africa, characterized by an abrupt onset of a permanent but non-progressive spastic paraparesis. It is named after the local designation in the first report from Zaire. Konzo has been attributed to a metabolic insult from the combined effect of high cyanide and low sulphur intake from several weeks of exclusive consumption of insufficiently processed bitter cassava roots.

METHODS:

The association between insufficient soaking of cassava roots and konzo is assessed in a matched case-referent study with multivariate conditional logistic regression including 57 case-referent pairs from a rural high incidence community of Zaire.

RESULTS:

In the multivariate analysis short processing of cassava in the form of only 2 nights soaking yielded an odds ratio of 11.0 (95% confidence interval 1.7-73) when controlling for poverty-related factors and diet. We also show a dose-response relationship for insufficient cassava soaking, both unadjusted and adjusted for potential confounders.

CONCLUSIONS:

This study supports a causal relationship between insufficient processing of bitter cassava and konzo.

PMID:
8557452
[Indexed for MEDLINE]
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