Konzo risk factors, determinants and etiopathogenesis: What is new? A systematic review

Baguma, Marius; Nzabara, Fabrice; Balemba, Ghislain Maheshe; Malembaka, Espoir Bwenge; Migabo, Christiane; Mudumbi, Germain; Bito, Virginie; Cliff, Julie; Rigo, Jean-Michel; Chabwine, Joëlle Nsimire

doi:10.1016/j.neuro.2021.05.001

Cited by 9 publications

(17 citation statements)

References 133 publications

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“…Chronic ingestion of unproperly processed (toxic) cassava products is associated with a number of disorders, among which include malnutrition, pancreatitis, thyroid dysfunction, and neurological diseases (e.g., tropical ataxic neuropathy and konzo) [16,20,21]. Thus, the appropriateness of cassava processing constitutes a key element to ensure the safe consumption of cassava products [22], which contributes to prevent the above-mentioned pathological conditions, especially konzo [23].…”

Section: Introductionmentioning

confidence: 99%

“…Thus, the appropriateness of cassava processing constitutes a key element to ensure the safe consumption of cassava products [22], which contributes to prevent the above-mentioned pathological conditions, especially konzo [23]. Konzo is a crippling neurological disease characterized by a spastic non-progressive paraparesis (or tetraparesis in severely diseased patients) of abrupt onset and irreversible course [20,24], affecting poor African communities under severe food deprivation conditions and predominantly consuming toxic cassava [18,20].…”

Section: Introductionmentioning

confidence: 99%

“…The former Bandundu province, in the western part of the Democratic Republic of the Congo (DRC), constitutes the major focus of konzo worldwide, accounting for more than half of all konzo cases and reported epidemics [20]. The disease has been known by local communities since the end of the 19th century [25].…”

Section: Introductionmentioning

confidence: 99%

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Impact of Seasonal Variation and Processing Methods on the Cassava-Derived Dietary Cyanide Poisoning, Nutritional Status, and Konzo Appearance in South-Kivu, Eastern D.R. Congo

et al. 2022

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This study aimed at evaluating the impact of seasons on the nutritional status and on dietary cassava-related cyanide exposure in Burhinyi and Idjwi, two areas in the eastern Democratic Republic of the Congo, witnessing similarly high cassava-derived cyanide poisoning but differently affected by konzo and malnutrition. Cyanide content in cassava roots and flour, and urinary thiocyanate levels (uSCN) of 54 subjects (40 from Burhinyi and 14 from Idjwi, aged 28.7 (12.1) years, 63% women) were measured during the rainy season (RS) and dry season (DS), using picrate paper kits A and D1. Local processing methods proved to be efficient in removing cyanogenic compounds in fresh cassava roots during the RS. However, the cyanide content in flour samples significantly increased during DS, with ~50% of samples containing unsafe levels (>10 ppm) of cyanide content. Strikingly, the uSCN (µmol/L), from being comparably high in RS (~172.0), slightly decreased during DS in Burhinyi (~103.2; p = 0,3547), but not in Idjwi (~172; p = 0,1113). Furthermore, serum proteins and albumin levels significantly decreased during the DS, witnessing a worsening of nutritional status, in Burhinyi but not in Idjwi. The consumption of bitter cassava roots (OR = 5.43, p = 0.0144) and skipping heap fermentation (OR = 16.67, p = 0.0021) were independently associated with very high uSCN levels during the DS. Thus, restoring the traditional processing methods, and complying with them in either season should ensure the safe consumption of cassava.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Impact of Seasonal Variation and Processing Methods on the Cassava-Derived Dietary Cyanide Poisoning, Nutritional Status, and Konzo Appearance in South-Kivu, Eastern D.R. Congo

et al. 2022

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“…The World Health Organization (WHO) classifies konzo as a neurological disease characterized by sudden onset of spastic paraparesis in a formerly healthy individual and strongly correlated with the monotonous consumption of insufficiently processed bitter cassava (Manihot esculenta Crantz) and malnutrition, specifically a diet deficient in sulfur amino acids [1][2][3][4]. Cassava is a fibrous tuber and the predominant food source for many regions throughout Sub-Saharan Africa, including Angola, Cameroon, Central African Republic, Democratic Republic of the Congo (DRC), Mozambique, United Republic of Tanzania, and Zambia, which are the only countries in the world where konzo is endemic [1,3,4]. In addition to konzo, consumption of cyanogenic cassava has also been associated with other complex neurodegenerative syndromes in Sub-Saharan Africa, including tropical ataxic neuropathy (TAN) and motor neuron-cerebellar-Parkinson-dementia syndrome [1,5,6].…”

Section: Introductionmentioning

confidence: 99%

“…In addition to konzo, consumption of cyanogenic cassava has also been associated with other complex neurodegenerative syndromes in Sub-Saharan Africa, including tropical ataxic neuropathy (TAN) and motor neuron-cerebellar-Parkinson-dementia syndrome [1,5,6]. Konzo is predominantly linked to rural regions in the seven aforementioned countries in Sub-Saharan Africa that lack healthcare infrastructure and resources [1,3,4]. The mean annual incidence rate of konzo diagnosis is 0.9 per 100,000 [1].…”

Section: Introductionmentioning

confidence: 99%

DNA methylation patterns associated with konzo in Sub-Saharan Africa

et al. 2022

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Konzo, a disease characterized by sudden, irreversible spastic paraparesis, affecting up to 10% of the population in some regions of Sub-Saharan Africa during outbreaks, is strongly associated with dietary exposure to cyanogenic bitter cassava. The molecular mechanisms underlying the development of konzo remain largely unknown. Here, through an analysis of 16 individuals with konzo and matched healthy controls from the same outbreak zones, we identified 117 differentially methylated loci involved in numerous biological processes that may identify cyanogenic-sensitive regions of the genome, providing the first study of epigenomic alterations associated with a clinical phenotype of konzo.

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Cyanide in cassava: Understanding the drivers, impacts of climate variability, and strategies for food security

Nyaika,

Abayomi,

Parmar

et al. 2024

Food and Energy Security

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The consumption of cassava, a vital staple food for more than 1 billion people worldwide, holds particular significance in sub‐Saharan Africa (SSA). Expansion in cassava production in SSA is driven by increasing market demand, local consumption, and adaptability to diverse environments. However, cyanide concentration in cassava tubers and products across SSA ranges from 9 to 1148 ppm – most exceed the World Health Organisation's recommended safe level of 10 ppm. Such variation and high cyanide concentrations in cassava products are expected to be exacerbated by climate‐induced increases in the frequency, intensity and occurrence of drought, heat waves and biotic stresses, further jeopardising regional food security. Thus, it is essential to examine cassava production and cyanide toxicity under climate change and their implications for food security in SSA. In this review, we look at the drivers of cassava production and spatial variation in cyanide concentrations across SSA, impacts of climate variability and biotic stresses on cassava cyanide concentrations in SSA, and crop management practices for reducing cyanogenic glucosides in cassava tubers. We surmise that urgent actions are required to adopt improved cassava varieties and management strategies that reduce cassava cyanide toxicity amid climate‐induced challenges in SSA.

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Konzo risk factors, determinants and etiopathogenesis: What is new? A systematic review

Cited by 9 publications

References 133 publications

Impact of Seasonal Variation and Processing Methods on the Cassava-Derived Dietary Cyanide Poisoning, Nutritional Status, and Konzo Appearance in South-Kivu, Eastern D.R. Congo

Impact of Seasonal Variation and Processing Methods on the Cassava-Derived Dietary Cyanide Poisoning, Nutritional Status, and Konzo Appearance in South-Kivu, Eastern D.R. Congo

DNA methylation patterns associated with konzo in Sub-Saharan Africa

Cyanide in cassava: Understanding the drivers, impacts of climate variability, and strategies for food security

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