Epidemiological Study of Lathyrism in Northwestern Districts of Bangladesh

Abstract

Two northwestern districts of Bangladesh with a population of 629,752 were surveyed from June 1991 to March 1993 to detect and follow up lathyrism patients. Out of 2,567 neurological patients, 882 were diagnosed as having lathyrism, giving a prevalence rate of 14.0/10,000. This prevalence was higher among young males: only 12.9% of the patients were female, and only 19.3% of the patients were over 30 years of age at onset of the disease. The average family size was 4.6 members. In the surveyed area, 730 families were evaluated: 622 families had only 1 affected member, and 108 families had 2–8 affected members. Most of the patients were working, while only 4% were not. The majority of the patients had a very low intake of animal protein. A few cases of human T-lymphotropic virus infection and osteolathyrism were found during this study.

3-N-oxalyl-L-2,3-diaminopropanoic acid, a multifunctional plant metabolite of toxic reputation

“…Some Bangladeshi farm labourers consume one kg of grass pea seed per day, which means a daily intake of about 5 g of β-ODAP, without ill effect. 3 Even during epidemic situations when grass pea becomes a survival food and sometimes the only food available, the great majority of the consumers (>94%) remain unaffected. This may be explained by the catabolic breakdown of β-ODAP in humans.…”

“…Neurolathyrism occurs after prolonged over-consumption of grass pea seed during several months as staple food in an unbalanced diet. 3 In recent history, epidemics have been reported in the Indian subcontinent, China and Ethiopia. The unusual drought tolerance of the grass pea plant has made it a survival food that has saved many human lives during drought triggered famines in Asia and Africa, and allowed the crop to survive agricultural developments since the Neolithicum.…”

Consumption of pesticide-treated wheat seed by a rural population in Malawi

“…1 Epidemics of lathyrism and neurolathyrism, a condition resulting in irreversible spastic paraparesis (extremity weakness) of the lower limbs resulting from ingestion of the grasspea (Lathyrus sativus), have occurred throughout history in times of drought and food shortages. 2,3 Konzo, a permanent spastic para-or tetraparesis, is reported to occur during dry seasons and is associated with consumption of improperly prepared cassava (Manihot esculenta). 4 Seeds, wheat seed in particular, may be used to prepare foodstuffs such as homemade bread by certain populations even when food is not scarce.…”

International Issues: Neurology in Bangladesh

“…Trainees have become most familiar with United States-based literature and often model their work on existent publications from major European and North American institutions. In this way, diseases common or especially seen in Bangladesh-including neurolathyrism, 4 lead poisoning, 5 leprosy, 6 and nutritional disorders 7 -are understudied.…”