{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T15:47:39Z","timestamp":1791474459558,"version":"4.3.4"},"reference-count":0,"publisher":"American Society of Tropical Medicine and Hygiene","issue":"6","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,6,2]]},"abstract":"<jats:title>Abstract.<\/jats:title><jats:p>In mid-June 2019, 3 months after cyclone Idai landfall in Mozambique, health authorities of Nhamatanda district reported an outbreak of Pellagra. Applying a mixed-method protocol, we carried out an investigation to characterize cases of pellagra, identify the associated factors for the outbreak using a case\u2013control study, and explore the perceived impact on food security (availability, access, and usage) before and after Idai. We collected data from 121 cases and 121 controls and conducted in-depth interviews with 69 heads of households. The cases were more likely to be female (<jats:italic>P<\/jats:italic> &lt; 0.01) and less educated (<jats:italic>P<\/jats:italic> &lt; 0.01) than controls. Insufficient consumption of chicken and peanut before cyclone Idai arrival were statistically associated with pellagra (<jats:italic>P<\/jats:italic> &lt; 0.05). From interviewed households\u2019 heads, 51% were experiencing food shortages even before the cyclone hit. Cyclone Idai served as a trigger to reduce niacin consumption below the threshold that protected Nhamatanda population from pellagra and caused a \u22482,300 case (707.9\/100,000 inhabitants) outbreak.<\/jats:p>","DOI":"10.4269\/ajtmh.20-1321","type":"journal-article","created":{"date-parts":[[2021,4,12]],"date-time":"2021-04-12T12:25:51Z","timestamp":1618230351000},"page":"2233-2237","source":"Crossref","is-referenced-by-count":11,"title":["Cyclone Idai as a Trigger for Pellagra Outbreak in Nhamatanda, Mozambique: A Case\u2013Control Study"],"prefix":"10.4269","volume":"104","author":[{"given":"V\u00e1nio Andr\u00e9","family":"Mugabe","sequence":"first","affiliation":[{"name":"1Instituto de Sa\u00fade Coletiva, Universidade Federal da Bahia, Salvador, Brazil;"},{"name":"2Universidade Licungo, Quelimane, Mozambique;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arlete","family":"Mahumane","sequence":"additional","affiliation":[{"name":"3Centro de Investiga\u00e7\u00e3o Operacional da Beira, Instituto Nacional de Sa\u00fade, Beira, Mozambique;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cynthia","family":"Sem\u00e1 Baltazar","sequence":"additional","affiliation":[{"name":"4Departamento de Vigil\u00e2ncia, Instituto Nacional de Sa\u00fade, Maputo, Mozambique;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"\u00c9rika Valeska","family":"Rossetto","sequence":"additional","affiliation":[{"name":"5MassGenics, Assigned to Mozambique Centers for Disease Control Prevention, Maputo, Mozambique;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cresc\u00eancio Sequeira","family":"Nhabomba","sequence":"additional","affiliation":[{"name":"3Centro de Investiga\u00e7\u00e3o Operacional da Beira, Instituto Nacional de Sa\u00fade, Beira, Mozambique;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Neusa","family":"Fataha","sequence":"additional","affiliation":[{"name":"4Departamento de Vigil\u00e2ncia, Instituto Nacional de Sa\u00fade, Maputo, Mozambique;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Unicia","family":"Nyamula","sequence":"additional","affiliation":[{"name":"3Centro de Investiga\u00e7\u00e3o Operacional da Beira, Instituto Nacional de Sa\u00fade, Beira, Mozambique;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ang\u00e9lica","family":"Sotomane","sequence":"additional","affiliation":[{"name":"3Centro de Investiga\u00e7\u00e3o Operacional da Beira, Instituto Nacional de Sa\u00fade, Beira, Mozambique;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wilson","family":"Irugula","sequence":"additional","affiliation":[{"name":"6Direc\u00e7\u00e3o Provincial de Sa\u00fade de Sofala, Beira, Mozambique;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Benigno","family":"Canze","sequence":"additional","affiliation":[{"name":"3Centro de Investiga\u00e7\u00e3o Operacional da Beira, Instituto Nacional de Sa\u00fade, Beira, Mozambique;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Osvaldo Frederico","family":"Inlamea","sequence":"additional","affiliation":[{"name":"4Departamento de Vigil\u00e2ncia, Instituto Nacional de Sa\u00fade, Maputo, Mozambique;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Uriel","family":"Kitron","sequence":"additional","affiliation":[{"name":"7Funda\u00e7\u00e3o Oswaldo Cruz, Salvador, Brazil;"},{"name":"8Emory University, Atlanta, Georgia;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guilherme Sousa","family":"Ribeiro","sequence":"additional","affiliation":[{"name":"1Instituto de Sa\u00fade Coletiva, Universidade Federal da Bahia, Salvador, Brazil;"},{"name":"7Funda\u00e7\u00e3o Oswaldo Cruz, Salvador, Brazil;"},{"name":"9Faculdade de Medicina, Universidade Federal da Bahia, Salvador, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eduardo","family":"Samo Gudo","sequence":"additional","affiliation":[{"name":"4Departamento de Vigil\u00e2ncia, Instituto Nacional de Sa\u00fade, Maputo, Mozambique;"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2795","container-title":["The American Journal of Tropical Medicine and Hygiene"],"original-title":[],"link":[{"URL":"https:\/\/www.ajtmh.org\/view\/journals\/tpmd\/104\/6\/article-p2233.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.ajtmh.org\/downloadpdf\/journals\/tpmd\/104\/6\/article-p2233.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,6,2]],"date-time":"2021-06-02T16:40:30Z","timestamp":1622652030000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ajtmh.org\/view\/journals\/tpmd\/104\/6\/article-p2233.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,6,2]]},"references-count":0,"journal-issue":{"issue":"6"},"URL":"https:\/\/doi.org\/10.4269\/ajtmh.20-1321","relation":{},"ISSN":["0002-9637","1476-1645"],"issn-type":[{"value":"0002-9637","type":"print"},{"value":"1476-1645","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,6,2]]}}}