Banea M, Bikangi N, Nahimana G, Nunga M, Tylleskär T, Rosling H
Centre National de Planification de Nutrition Humaine, Kinshasa, Zaïre.
Ann Soc Belg Med Trop. 1992 Dec;72(4):295-309.
Konzo is a form of spastic paraparesis reported from several rural areas in Sub-Saharan Africa. It has been attributed to cyanide exposure from exclusive consumption of insufficiently processed bitter cassava roots. We have tested this attribution in a community based epidemiological survey in an area of Bandundu region in Zaire composed of two agro-ecological zones: savanna and forest. In the savanna area with poor soils we found 78 konzo cases in 1,936 inhabitants, a prevalence of 4%; but in the forest area only 9 cases in 5,531 inhabitants (0.2%). This geographical distribution as well as the temporal distribution coincide with frequent short-soaking of cassava roots (only one night) induced by an agro-ecological crisis. High levels of blood cyanide, mean 13.3 mumol/l (range: 0.1-76.3) and serum thiocyanate, mean (+/- SD) 401 (+/- 126) mumol/l, in a sample of 18 subjects from the savanna area confirm high cyanide exposure in this population with high prevalence of konzo. Prevention of konzo in Zaire is possible by promotion of sufficient soaking of cassava with strict adherence to traditional three nights soaking and the use of completely dry flour.
痉挛性截瘫是在撒哈拉以南非洲的几个农村地区发现的一种疾病。它被认为是由于长期食用加工不充分的苦木薯根而接触氰化物所致。我们在扎伊尔班顿杜地区一个由稀树草原和森林两个农业生态区组成的社区进行了一项流行病学调查，以验证这一说法。在土壤贫瘠的稀树草原地区，我们在1936名居民中发现了78例痉挛性截瘫病例，患病率为4%；而在森林地区，5531名居民中仅有9例（0.2%）。这种地理分布以及时间分布与农业生态危机导致木薯根经常短时间浸泡（仅一晚）的情况相符。来自稀树草原地区的18名受试者样本中的血氰水平较高，平均为13.3微摩尔/升（范围：0.1 - 76.3），血清硫氰酸盐平均（±标准差）为401（±126）微摩尔/升，这证实了该人群中氰化物接触水平较高且痉挛性截瘫患病率较高。在扎伊尔，通过推广充分浸泡木薯并严格遵守传统的三晚浸泡方法以及使用完全干燥的面粉，可以预防痉挛性截瘫。
