This comparative cross-sectional study aimed to better understand the respective contributions of protein malnutrition and cassava-derived cyanide poisoning in the development of konzo. We compared data on nutritional status and cyanide exposure of school-age adolescent konzo-diseased patients to those of non-konzo subjects of similar age from three areas in the Eastern Democratic Republic of the Congo. Our results show that konzo patients had a high prevalence of both wasting (54.5%) and stunting (72.7%), as well as of cyanide poisoning (81.8%). Controls from Burhinyi and those from Idjwi showed a similar profile with a low prevalence of wasting (3.3% and 6.5%, respectively) and intermediate prevalence of stunting (26.7% and 23.9%, respectively). They both had a high prevalence of cyanide poisoning (50.0% and 63.0%, respectively), similar to konzo-patients. On the other hand, controls from Bukavu showed the lowest prevalence of both risk factors, namely chronic malnutrition (12.1%) and cyanide poisoning (27.6%). In conclusion, cassava-derived cyanide poisoning does not necessarily coexist with konzo outbreaks. The only factor differentiating konzo patients from healthy individuals exposed to cyanide poisoning appeared to be their worse nutritional status. This further suggests that, besides the known role of cyanide poisoning in the pathogenesis of konzo, malnutrition may be a key factor for the disease occurrence.
In Africa, there is still observed a land related legal plurality despite innovations undertaken since colonial times. In DR Congo, while by law land remains the property of the State, it remains difficult to manage rural lands, ignoring customary practices. In fact, alongside the “modern” land administration, the majority of rural lands are covered by customary contracts. Meanwhile, these contracts have evolved due to different socio-political issues in the DRC and particularly in its eastern part. This study aimed at understanding these changes and thus the impact resulted in agricultural activities, especially the small farmers’ technology choice. The study is based on households’ surveys in the Mbinga Sud zone as well as from other stakeholders on land in the Kalehe territory, South Kivu province, eastern DRC. Through this study, it is noted that customary land contracts have sufficiently evolved due to the population growth, innovations taken in land administration in the country, the wars that occurred in the eastern DR Congo, the attractiveness of rural land by elites and rich businessmen leading to land concentration etc. Given this situation, some practices such as purchase and lease of land were thus developed to cope with weak customary land acquisition mechanisms, the land scarcity and / or land depletion and the fear of land grabbing by the strongest. These changes also have an impact on some agricultural practices, including the fertilization of farms, the choice of crops and varieties to grow as well as many other cultivation techniques.
Received: 3 June 2021 / Accepted: 4 September 2021 / Published: 5 November 2021
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