Appearance of konzo in South-Kivu, a wartorn area in the Democratic Republic of Congo

Chabwine, Joëlle Nsimire; Masheka, C; Balol'ebwami, Z; Maheshe, B; Balegamire, Safari Joseph; Rutega, B; Lóla, M; Mutendela, K; Bonnet, M.S.; Shangalume, O; Balegamire, J M; Nemery, Benoît

doi:10.1016/j.fct.2010.07.050

Cited by 29 publications

(62 citation statements)

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“…In contrast to TAN and MNCPD, konzo still occurs in sub-Saharan Africa [8]–[12]. We recently showed that older children, females, and those undernourished were at higher risk for motor and cognitive deficits among populations that rely almost exclusively on cassava as staple diet [9], [13].…”

Section: Introductionmentioning

confidence: 99%

Serum 8,12-iso-iPF2α-VI Isoprostane Marker of Oxidative Damage and Cognition Deficits in Children with Konzo

et al. 2014

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We sought to determine whether motor and cognitive deficits associated with cassava (food) cyanogenic poisoning were associated with high concentrations of F2-isoprostanes, well-established indicators of oxidative damage. Concentrations of serum F2-isoprostanes were quantified by LC-MS/MS and anchored to measures of motor proficiency and cognitive performance, which were respectively assessed through BOT-2 (Bruininks/Oseretsky Test, 2nd Edition) and KABC-II (Kaufman Assessment Battery for Children, 2nd edition) testing of 40 Congolese children (21 with konzo and 19 presumably healthy controls, overall mean age (SD): 9.3 (3.2) years). Exposure to cyanide was ascertained by concentrations of its main metabolite thiocyanate (SCN) in plasma and urine. Overall, SCN concentrations ranged from 91 to 325 and 172 to 1032 µmol/l in plasma and urine, respectively. Serum isoprostanes ranged from 0.1 to 0.8 (Isoprostane-III), 0.8 to 8.3 (total Isoprostane-III), 0.1 to 1.5 (Isoprostane-VI), 2.0 to 9.0 (total Isoprostane-VI), or 0.2 to 1.3 ng/ml (8,12-iso-iPF2α-VI isoprostane). Children with konzo poorly performed at the BOT-2 and KABC-II testing relative to presumably healthy children (p<0.01). Within regression models adjusting for age, gender, motor proficiency, and other biochemical variables, 8,12-iso-iPF2α-VI isoprostane was significantly associated with the overall cognitive performance (β = −32.36 (95% CI: −51.59 to −13.03; P<0.001). This model explained over 85% of variation of the KABC-II score in children with konzo, but was not significant in explaining the motor proficiency impairment. These findings suggest that cognitive deficits and, possibly, brain injury associated with cassava poisoning is mediated in part by oxidative damage in children with konzo. 8,12-iso-iPF2α-VI isoprostane appears to be a good marker of the neuropathogenic mechanisms of konzo and may be used to monitor the impact of interventional trials to prevent the neurotoxic effects of cassava cyanogenic poisoning.

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Section: Introductionmentioning

confidence: 99%

Serum 8,12-iso-iPF2α-VI Isoprostane Marker of Oxidative Damage and Cognition Deficits in Children with Konzo

et al. 2014

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“…Very high concentrations of urine thiocyanate were recorded in cases of konzo in Mozambique (Ministry of Health Mozambique, 1984), in Democratic Republic of the Congo (Chabwine et al, 2011) and in Tanzania (Howlett et al, 1990). Further, concentrations of urine thiocyanate have not been shown to be lower in cases of endemic ataxic polyneuropathy and konzo than controls.…”

Section: Discussionmentioning

confidence: 93%

Normative concentrations of urine thiocyanate in cassava eating communities in Nigeria

Oluwole

Oludiran

2013

International Journal of Food Sciences and Nutrition

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Exposure to cyanide is a major public health problem where highly cyanogenic cassava foods are consumed. Thiocyanate (SCN), the biomarker of exposure to cyanide is present in several foods, and produced endogenously. Concentrations of urine SCN were measured in endemic and non-endemic areas of ataxic polyneuropathy in Nigeria. Cassava food consumption in the endemic area was twice that of non-endemic areas. Geometrical mean (95% CI) urine SCN was 20 µmol/l (18-24) for no consumption of cassava foods, 56 µmol/l (49-64) for daily consumption, 56 µmol/l (48-65) for twice daily consumption and 85 µmol/l (62-117) for thrice daily consumption. 95th percentile reference limit was 125 µmol/l for no consumption of cassava food, but 360 µmol/l for thrice daily consumption. Urine SCN is a useful biomarker of exposure to cyanide from cassava foods. There is strong ecological association of exposure to cyanide and endemicity of ataxic polyneuropathy.

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“…Konzo epidemics also result from war when local village people are forced from their homes and gardens and forced to eat unprocessed high cyanide cassava from the bush (Cliff et al, 1997;Nhassico et al, 2008;Chabwine et al, 2011). Konzo outbreaks also occur in Central Africa when peeled cassava roots are not immersed in water for the 3 to 4 days necessary to allow the enzyme linamarase to break down fully the cyanogenic glucoside, but are short soaked for only 1 to 2 days.…”

Section: Author(s) Agree That This Article Remain Permanently Open Acmentioning

confidence: 99%

Health factors associated with persistent konzo in four villages in the Democratic Republic of Congo (DRC)

Banea¹,

Bradbury²,

Nahimana³

et al. 2016

Afr. J. Food Sci.

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Persistent konzo is low level incidence of konzo that is not associated with konzo epidemics due to drought or war. It has been reported from Mozambique and Tanzania. Various health factors associated with persistent konzo in four villages in Kasanji Health Area, Bandundu Province, DRC were studied, where there were 38 konzo cases in a population of 2283, with mean percentage konzo prevalence of 1.7%. Konzo occurred over the years since 1951 with 0 to 3 cases per year. Anthropometric measurements of children aged 0.5 to 14 y showed that 47% were stunted, 24% underweight, 16% had chronic energy deficiency and 16 to 24% suffered malnutrition. There was no significant difference between children from konzo households or from non-konzo households. The % konzo prevalence (%K) calculated from the equation %K = 0.06 %T + 0.035 %M, where %T = percentage of school children with urinary thiocyanate levels >350 µmol/L and %M = percentage of malnutrition, gave %K = 1.6 from non-konzo households and %K = 2.2 from konzo households, which agrees with the actual mean value of 1.7. However, the equation does not apply when either %T or %M is zero or for very high values of %K > 9.5. The value of %K is nearly twice as sensitive to changes in %T as to changes in %M, which partly explains the greater ease of prevention of konzo by reducing %T to zero, using the wetting method to remove cyanogens from cassava flour, than by reducing %M by broad based methods.

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Appearance of konzo in South-Kivu, a wartorn area in the Democratic Republic of Congo

Cited by 29 publications

References 20 publications

Serum 8,12-iso-iPF2α-VI Isoprostane Marker of Oxidative Damage and Cognition Deficits in Children with Konzo

Serum 8,12-iso-iPF2α-VI Isoprostane Marker of Oxidative Damage and Cognition Deficits in Children with Konzo

Normative concentrations of urine thiocyanate in cassava eating communities in Nigeria

Health factors associated with persistent konzo in four villages in the Democratic Republic of Congo (DRC)

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