{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,19]],"date-time":"2026-03-19T08:23:04Z","timestamp":1773908584421,"version":"3.50.1"},"reference-count":32,"publisher":"MDPI AG","issue":"8","license":[{"start":{"date-parts":[[2021,7,29]],"date-time":"2021-07-29T00:00:00Z","timestamp":1627516800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Nutrients"],"abstract":"<jats:p>This comparative cross-sectional study aimed to better understand the respective contributions of protein malnutrition and cassava-derived cyanide poisoning in the development of konzo. We compared data on nutritional status and cyanide exposure of school-age adolescent konzo-diseased patients to those of non-konzo subjects of similar age from three areas in the Eastern Democratic Republic of the Congo. Our results show that konzo patients had a high prevalence of both wasting (54.5%) and stunting (72.7%), as well as of cyanide poisoning (81.8%). Controls from Burhinyi and those from Idjwi showed a similar profile with a low prevalence of wasting (3.3% and 6.5%, respectively) and intermediate prevalence of stunting (26.7% and 23.9%, respectively). They both had a high prevalence of cyanide poisoning (50.0% and 63.0%, respectively), similar to konzo-patients. On the other hand, controls from Bukavu showed the lowest prevalence of both risk factors, namely chronic malnutrition (12.1%) and cyanide poisoning (27.6%). In conclusion, cassava-derived cyanide poisoning does not necessarily coexist with konzo outbreaks. The only factor differentiating konzo patients from healthy individuals exposed to cyanide poisoning appeared to be their worse nutritional status. This further suggests that, besides the known role of cyanide poisoning in the pathogenesis of konzo, malnutrition may be a key factor for the disease occurrence.<\/jats:p>","DOI":"10.3390\/nu13082628","type":"journal-article","created":{"date-parts":[[2021,7,29]],"date-time":"2021-07-29T21:21:21Z","timestamp":1627593681000},"page":"2628","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Revisiting Konzo Risk Factors in Three Areas Differently Affected by Spastic Paraparesis in Eastern Democratic Republic of the Congo Discloses a Prominent Role of the Nutritional Status\u2014A Comparative Cross-Sectional Study"],"prefix":"10.3390","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4934-4846","authenticated-orcid":false,"given":"Marius","family":"Baguma","sequence":"first","affiliation":[{"name":"Faculty of Medicine, Universit\u00e9 Catholique de Bukavu (UCB), Bukavu 285, Democratic Republic of the Congo"},{"name":"Department of Internal Medicine, H\u00f4pital Provincial G\u00e9n\u00e9ral de R\u00e9f\u00e9rence de Bukavu (HPGRB), Bukavu 285, Democratic Republic of the Congo"},{"name":"Biomedical Research Institute (BIOMED), Faculty of Health and Life Sciences, UHasselt\u2014Hasselt University, 3590 Diepenbeek, Belgium"},{"name":"Center for Tropical Diseases & Global Health (CTDGH), Universit\u00e9 Catholique de Bukavu (UCB), Bukavu 285, Democratic Republic of the Congo"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9306-0253","authenticated-orcid":false,"given":"Espoir Bwenge","family":"Malembaka","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Universit\u00e9 Catholique de Bukavu (UCB), Bukavu 285, Democratic Republic of the Congo"},{"name":"Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, W6030, Baltimore, MD 21205, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Esto","family":"Bahizire","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Universit\u00e9 Catholique de Bukavu (UCB), Bukavu 285, Democratic Republic of the Congo"},{"name":"Center for Tropical Diseases & Global Health (CTDGH), Universit\u00e9 Catholique de Bukavu (UCB), Bukavu 285, Democratic Republic of the Congo"},{"name":"Center for Research in Natural Sciences of Lwiro, Bukavu 285, Democratic Republic of the Congo"},{"name":"Department of Medical Microbiology, University of Nairobi, Nairobi 00100, Kenya"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2743-6096","authenticated-orcid":false,"given":"Germain Zabaday","family":"Mudumbi","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, H\u00f4pital Provincial G\u00e9n\u00e9ral de R\u00e9f\u00e9rence de Bukavu (HPGRB), Bukavu 285, Democratic Republic of the Congo"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dieudonn\u00e9 Bahati","family":"Shamamba","sequence":"additional","affiliation":[{"name":"Plant Pathology Laboratory, Faculty of Agronomy, Universit\u00e9 Catholique de Bukavu (UCB), Bukavu 285, Democratic Republic of the Congo"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alain-Narcisse","family":"Matabaro","sequence":"additional","affiliation":[{"name":"Department of Medical Biology, H\u00f4pital Provincial G\u00e9n\u00e9ral de R\u00e9f\u00e9rence de Bukavu (HPGRB), Bukavu 285, Democratic Republic of the Congo"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0031-526X","authenticated-orcid":false,"given":"Jean-Michel","family":"Rigo","sequence":"additional","affiliation":[{"name":"Biomedical Research Institute (BIOMED), Faculty of Health and Life Sciences, UHasselt\u2014Hasselt University, 3590 Diepenbeek, Belgium"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0052-1511","authenticated-orcid":false,"given":"Alfred Kongnyu","family":"Njamnshi","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine and Specialties\/Neuroscience, Faculty of Medicine and Biomedical Sciences, The University of Yaound\u00e9 I, Yaound\u00e9 P.O. Box 25625, Cameroon"},{"name":"Brain Research Africa Initiative (BRAIN), Yaound\u00e9 P.O. Box 25625, Cameroon"},{"name":"Brain Research Africa Initiative (BRAIN), Th\u00f4nex, 1226 Geneva, Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joelle Nsimire","family":"Chabwine","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Universit\u00e9 Catholique de Bukavu (UCB), Bukavu 285, Democratic Republic of the Congo"},{"name":"Neurology Unit, Department of Neuroscience and Movement Science, Faculty of Science and Medicine, University of Fribourg, 1700 Fribourg, Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2021,7,29]]},"reference":[{"key":"ref_1","unstructured":"World Health Organization (1996). Konzo\u2014A distinct type of upper motoneuron disease. Wkly. Epidemiol. 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