{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,11]],"date-time":"2026-07-11T18:47:05Z","timestamp":1783795625599,"version":"3.55.0"},"reference-count":15,"publisher":"American Society of Tropical Medicine and Hygiene","issue":"5","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2017,5,3]]},"abstract":"<jats:p>Pellagra is a deficiency of niacin or its amino acid precursor, tryptophan, which presents with the classic four Ds: the characteristic dermatitis, diarrhea, dementia, and eventually death if left untreated. The incidence of pellagra is quite rare presently because of increased awareness and strategies such as vitamin fortification. However, the deficiency is still present in cultures that rely on maize as their primary source of sustenance. We report a recent outbreak in a catchment area in Kasese, Malawi, of 691 cases of pellagra which were successfully treated with niacin supplementation. We present this short report to highlight the importance of educating providers of at-risk populations about this diagnosis and to consider solutions for these populations to prevent further deficiencies.<\/jats:p>","DOI":"10.4269\/ajtmh.16-0423","type":"journal-article","created":{"date-parts":[[2017,2,21]],"date-time":"2017-02-21T01:40:35Z","timestamp":1487641235000},"page":"1244-1247","source":"Crossref","is-referenced-by-count":16,"title":["An Outbreak of Pellagra in the Kasese Catchment Area, Dowa, Malawi"],"prefix":"10.4269","volume":"96","author":[{"given":"George","family":"Matapandeu","sequence":"first","affiliation":[{"name":"Orant Charities, Primary Care Clinic, Kasese, Dowa, Malawi."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samuel H.","family":"Dunn","sequence":"additional","affiliation":[{"name":"Department of Family and Community Medicine, University of Texas Southwestern, Dallas, Texas."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patti","family":"Pagels","sequence":"additional","affiliation":[{"name":"Department of Family and Community Medicine, University of Texas Southwestern, Dallas, Texas."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2795","reference":[{"key":"ref1","series-title":"Int J Dermatol","first-page":"1","article-title":"Pellagra: dermatitis, dementia, and diarrhea","volume":"43","author":"Hegyi","year":"2004"},{"key":"ref2","series-title":"South Med J","first-page":"272","article-title":"Pellagra in the United States: a historical perspective","volume":"93","author":"Rajakumar","year":"2000"},{"key":"ref3","series-title":"Pellagra and Its Prevention and Control in Major Emergencies","author":"World Health Organization","year":"2000"},{"key":"ref4","series-title":"J Am Med Assoc","first-page":"364","article-title":"Pellagra among chronic alcoholic addicts: a clinical and laboratory study","volume":"90","author":"Klauder","year":"1928"},{"key":"ref5","series-title":"Malawi Med J","first-page":"19","article-title":"Case report: a forgotten dermatological disease","volume":"24","author":"Segula","year":"2012"},{"key":"ref6","series-title":"Clin Exp Dermatol","first-page":"167","article-title":"Isoniazid induced pellagra despite pyridoxine supplementation","volume":"24","author":"Darvay","year":"1999"},{"key":"ref7","series-title":"Am J Gastroenterol","first-page":"932","article-title":"Pellagra in an immunocompetent patient with cytomegalovirus colitis","volume":"96","author":"Lu","year":"2001"},{"key":"ref8","series-title":"Int J Epidemiol","first-page":"504","article-title":"An outbreak of pellagra related to changes in dietary niacin among-Mozambican refugees in Malawi","volume":"22","author":"Malfait","year":"1993"},{"key":"ref9","series-title":"Am J Clin Nutr","first-page":"218","article-title":"Low and deficient niacin status and pellagra are endemic in postwar Angola","volume":"85","author":"Seal","year":"2007"},{"key":"ref10","series-title":"Annu Rev Nutr","first-page":"115","article-title":"Nicotinic acid, nicotinamide, and nicotinamide riboside: a molecular evaluation of NAD+ precursor vitamins in human nutrition","volume":"28","author":"Bogan","year":"2008"},{"key":"ref11","series-title":"Ann N Y Acad Sci","first-page":"105","article-title":"Global maize production, utilization, and consumption","volume":"1312","author":"Ranum","year":"2014"},{"key":"ref12","series-title":"Sociedad Mexicana de Ciencia de Superficies y de Vacio","first-page":"20","article-title":"Recent advances on the understanding of the nixtamalization process","volume":"10","author":"Caballero-Briones","year":"2000"},{"key":"ref13","series-title":"USDA National Nutrient Database for Standard Reference, release 27","author":"Haytowitz","year":"2015"},{"key":"ref14","series-title":"J Am Acad Dermatol","first-page":"1","article-title":"Nutritional deficiency and the skin","volume":"21","author":"Miller","year":"1989"},{"key":"ref15","series-title":"Nutr Anthropol","first-page":"1","article-title":"Pellagra and nutrition policy lessons from the Great Irish Famine to the new South Africa","volume":"22","author":"Brenton","year":"1998"}],"container-title":["The American Society of Tropical Medicine and Hygiene"],"original-title":[],"link":[{"URL":"https:\/\/www.ajtmh.org\/view\/journals\/tpmd\/96\/5\/article-p1244.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.ajtmh.org\/downloadpdf\/journals\/tpmd\/96\/5\/article-p1244.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/www.ajtmh.org\/downloadpdf\/journals\/tpmd\/96\/5\/article-p1244.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,8,7]],"date-time":"2024-08-07T22:26:21Z","timestamp":1723069581000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ajtmh.org\/view\/journals\/tpmd\/96\/5\/article-p1244.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2017,5,3]]},"references-count":15,"journal-issue":{"issue":"5"},"URL":"https:\/\/doi.org\/10.4269\/ajtmh.16-0423","relation":{},"ISSN":["0002-9637","1476-1645"],"issn-type":[{"value":"0002-9637","type":"print"},{"value":"1476-1645","type":"electronic"}],"subject":[],"published":{"date-parts":[[2017,5,3]]}}}