E-Andjafono Daniel Okitundu Luwa, Ayanne Marie-Therese Sombo Safi, Makila-Mabe Guy Bumoko, Mayambu Jean-Pierre Banea, Ngoyi Dieudonné Mumba, Boivin Michael, Tamfum-Muyembe Jean-Jacques, Tshala-Katumbay Désiré
Département de Neurologie, Université de Kinshasa, République Démocratique du Congo.
Programme National de Nutrition, République Démocratique du Congo.
Pan Afr Med J. 2018 Oct 17;31:118. doi: 10.11604/pamj.2018.31.118.11640. eCollection 2018.
the aim of this study was to describe the socioemotional profile of children living in Konzo-affected areas, an epidemic toxico-nutritional palsy in sub-Saharan Africa.
we evaluated the socioemotional profile of 210 children, 123 with Konzo and 87 presumed to be healthy (4-17 years) based on a structured interview conducted with their parents during an epidemioclinic survey of Konzo in Congo-Kinshasa in 2011. Neurocognitive profile was identified by the KABC-II, the BOT-2 and the global neurological symptom index of Konzo. Associative tests were carried out by using chi-square test, logistic regression and, where applicable, generalized linear model, at the significance threshold of 0.05.
in general, irritability, physical violence or inhibition with or without sadness were found in 46.0%, 30.2%, 18.7% of children respectively, with an increased risk of Konzo (OR = 2.6; CI95%: 1.4-4.8; p = 0.001). Socioemotional disorder was associated with underweight (OR: 0.49; CI95%: 0.31-0.78; p = 0.002) and with an elevated global neurological symptom index of Konzo (OR: 1.33; CI 95%: 1.1-1.63; p = 0.019); furthermore it exacerbated cognitive impairment in children with Konzo (interaction neurological status-socioemotional disorders D = 6.297; p = 0.013). High cognitive performances were observed in children without Konzo but with socioemotional disorders. The average concentration (standard deviation ± SD) of urinary thiocyanate was higher (554.8 ± 371.6 µmol/l) among children with Konzo associated with socioemotional disorders.
children living in Konzo-affected areas have socioemotional disorders. Their psychopathological status and the effect of Konzo on cognition require in-depth studies.
本研究旨在描述生活在受Konzo影响地区儿童的社会情感状况，Konzo是撒哈拉以南非洲的一种流行性中毒性营养性麻痹症。
在2011年对刚果民主共和国金沙萨的Konzo进行的流行病学临床调查期间，我们通过与孩子父母进行结构化访谈，评估了210名儿童（4至17岁）的社会情感状况，其中123名患有Konzo，87名推测为健康儿童。通过考夫曼儿童成套评估测验第二版（KABC-II）、运动评估量表第二版（BOT-2）和Konzo的整体神经症状指数来确定神经认知状况。采用卡方检验、逻辑回归以及在适用情况下采用广义线性模型进行关联测试，显著性阈值为0.05。
总体而言，分别在46.0%、30.2%、18.7%的儿童中发现有易怒、身体暴力或有或无悲伤情绪的抑制现象，且患Konzo的风险增加（比值比=2.6；95%置信区间：1.4 - 4.8；p = 0.001）。社会情感障碍与体重不足相关（比值比：0.49；95%置信区间：0.31 - 0.78；p = 0.002）以及与Konzo的整体神经症状指数升高相关（比值比：1.33；95%置信区间：1.1 - 1.63；p = 0.019）；此外，它还加剧了患有Konzo儿童的认知障碍（神经状态与社会情感障碍的交互作用D = 6.297；p = 0.013）。在没有Konzo但有社会情感障碍的儿童中观察到较高的认知表现。与社会情感障碍相关的患有Konzo的儿童中，尿硫氰酸盐的平均浓度（标准差±SD）较高（554.8±371.6微摩尔/升）。
生活在受Konzo影响地区的儿童存在社会情感障碍。他们的心理病理状况以及Konzo对认知的影响需要深入研究。
