Document 0441
 DOCN  M9650441
 TI    Dietary determinants of a non-progressive spastic paraparesis (Konzo): a
       case-referent study in a high incidence area of Zaire.
 DT    9605
 AU    Tylleskar T; Banea M; Bikangi N; Nahimana G; Persson LA; Rosling H;
       Department of Pediatrics, University Hospital, Uppsala, Sweden.
 SO    Int J Epidemiol. 1995 Oct;24(5):949-56. Unique Identifier : AIDSLINE
       MED/96128723
 AB    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.
 DE    Adolescence  Adult  Age of Onset  Aged  Case-Control Studies
       Cassava/*POISONING  Child  Child, Preschool  *Cookery  *Diet  Female
       Human  Logistic Models  Male  Middle Age  Multivariate Analysis
       Paraparesis, Tropical Spastic/EPIDEMIOLOGY/*ETIOLOGY  Rural Health
       Seasons  Socioeconomic Factors  Support, Non-U.S. Gov't
       Zaire/EPIDEMIOLOGY  JOURNAL ARTICLE

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