Konzo outbreak in the Western Province of Zambia

Neurology
Omar K SiddiqiElizabeth Chizema-Kawesha

Abstract

To identify the etiology of an outbreak of spastic paraparesis among women and children in the Western Province of Zambia suspected to be konzo. We conducted an outbreak investigation of individuals from Mongu District, Western Province, Zambia, who previously developed lower extremity weakness. Cases were classified with the World Health Organization definition of konzo. Active case finding was conducted through door-to-door evaluation in affected villages and sensitization at local health clinics. Demographic, medical, and dietary history was used to identify common exposures in all cases. Urine and blood specimens were taken to evaluate for konzo and alternative etiologies. We identified 32 cases of konzo exclusively affecting children 6 to 14 years of age and predominantly females >14 years of age. Fourteen of 15 (93%) cases ≥15 years of age were female, 11 (73%) of whom were breastfeeding at the time of symptom onset. Cassava was the most commonly consumed food (median [range] 14 [4-21] times per week), while protein-rich foods were consumed <1 time per week for all cases. Of the 30 patients providing urine specimens, median thiocyanate level was 281 (interquartile range 149-522) μmol/L, and 73% of urine samples had thiocy...Continue Reading

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Citations

Mar 24, 2020·Nature Reviews. Neurology·Heather Wood
May 9, 2021·Neurotoxicology·Marius BagumaJoëlle Nsimire Chabwine
Oct 8, 2021·Seminars in Neurology·Elia Sechi, Eoin P Flanagan

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