{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T13:20:43Z","timestamp":1788355243117,"version":"build-2803163510"},"reference-count":40,"publisher":"American Society of Tropical Medicine and Hygiene","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,9,2]]},"abstract":"<jats:title>ABSTRACT.<\/jats:title>\n                  <jats:p>Konzo, a neurodegenerative disease prevalent in Nampula Province, Mozambique, presents debilitating symptoms known locally as \u201cmantakassa\u201d (\u201cthat which breaks legs\u201d). Although the biomedical literature attributes its cause to insufficiently processed cassava amid food insecurity, traditional narratives often cite supernatural explanations, like witchcraft. This review analyzed the existing literature to understand social perceptions of konzo, focusing on traditional leaders\u2019 perspectives and their implications for public health. It found that konzo cases cluster within families owing to shared dietary habits and socioeconomic vulnerabilities, disproportionately affecting women and children. Community narratives often link the disease to spiritual causes, differing from biomedical views. Health care workers noted low diagnostic accuracy and limited knowledge of the condition. Notably, the role of traditional healers, often the first line of care in rural areas, remains underdocumented, highlighting a critical knowledge gap. Further research into their understanding of konzo is essential for developing culturally sensitive health interventions and improving public health strategies.<\/jats:p>","DOI":"10.4269\/ajtmh.26-0017","type":"journal-article","created":{"date-parts":[[2026,7,28]],"date-time":"2026-07-28T14:40:41Z","timestamp":1785249641000},"page":"436-442","source":"Crossref","is-referenced-by-count":0,"title":["Social Perceptions of Konzo Disease in Nampula Province, Mozambique"],"prefix":"10.4269","volume":"115","author":[{"given":"Litos","family":"Raimundo","sequence":"first","affiliation":[{"name":"Faculty of Science and Technology, Fernando Pessoa University, Porto, Portugal;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniela","family":"Rodrigues","sequence":"additional","affiliation":[{"name":"CIAS\u2014Research Centre for Anthropology and Health\u2014Group of Human Biology, Health and Society, University of Coimbra, Coimbra, Portugal;"},{"name":"Department of Life Sciences, University of Coimbra, Coimbra, Portugal;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria-Raquel G.","family":"Silva","sequence":"additional","affiliation":[{"name":"CIAS\u2014Research Centre for Anthropology and Health\u2014Group of Human Biology, Health and Society, University of Coimbra, Coimbra, Portugal;"},{"name":"FP-I3ID and FCS-UFP\u2014Faculty of Health Sciences, Fernando Pessoa University, Porto, Portugal;"},{"name":"Molecular Oncology and Viral Pathology Group, Research Centre of IPO-Porto (CI-IPOP) & RISE@CI-IPOP (Health Research Network), Portuguese Oncology Institute of Porto (IPO-Porto)\/Porto Comprehensive Cancer Centre Raquel Seruca (Porto.CCC), Porto, Portugal;"},{"name":"CHRC\u2014Comprehensive Health Research Centre\u2014Group of Sleep, Chronobiology and Sleep Disorders, Nova Medical School, Nova University of Lisbon, Lisbon, Portugal;"},{"name":"RISE-Health, Fernando Pessoa University, Porto, Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2795","reference":[{"key":"b1","series-title":"Brain Disord Endem Afr","first-page":"87","article-title":"Konzo: A distinct neurological disease associated with food (cassava) cyanogenic poisoning","volume":"145","author":"Kashala-Abotnes","year":"2019"},{"issue":"10","key":"b2","series-title":"Neurology","first-page":"949","article-title":"Cassava food toxins, konzo disease, and neurodegeneration in sub-Sahara Africans","volume":"80","author":"Tshala-Katumbay","year":"2013"},{"issue":"30","key":"b3","series-title":"Wkly Epidemiol Rec","first-page":"225","article-title":"Food safety: Konzo\u2014A distinct type of upper motoneuron disease","volume":"71","year":"1996"},{"issue":"6","key":"b4","series-title":"PLoS Negl Trop Dis","first-page":"e1051","article-title":"Konzo: From poverty, cassava, and cyanogen intake to toxico-nutritional neurological disease","volume":"5","author":"Nzwalo","year":"2011"},{"issue":"3","key":"b5","series-title":"Bull World Health Organ","first-page":"477","article-title":"Mantakassa: An epidemic of spastic paraparesis associated with chronic cyanide intoxication in a cassava staple area of Mozambique. 1. Epidemiology and clinical and laboratory findings in patients","volume":"62","year":"1984"},{"issue":"3","key":"b6","series-title":"Food Chem Toxicol","first-page":"631","article-title":"Konzo and continuing cyanide intoxication from cassava in Mozambique","volume":"49","author":"Cliff","year":"2011"},{"issue":"4","key":"b7","series-title":"Food Sci Nutr","first-page":"555","article-title":"Use of the wetting method on cassava flour in three konzo villages in Mozambique reduces cyanide intake and may prevent konzo in future droughts","volume":"4","author":"Nhassico","year":"2015"},{"issue":"3","key":"b8","series-title":"Acta Trop","first-page":"357","article-title":"Persistent konzo and cyanogen toxicity from cassava in northern Mozambique","volume":"82","author":"Ernesto","year":"2002"},{"issue":"11","key":"b9","series-title":"Trop Med Int Health","first-page":"1068","article-title":"Konzo associated with war in Mozambique","volume":"2","author":"Cliff","year":"1997"},{"key":"b10","article-title":"Konzo: Problema de Sa\u00fade P\u00fablica em Nampula, Dados de 2015\u20132017.","author":"Muloliwa","year":"2018"},{"issue":"2","key":"b11","series-title":"Rev Mocambicana Cienc Sa\u00fade","first-page":"26","article-title":"Estigma, Sofrimento Mental e Exclus\u00e3o Social: A Tr\u00edade Experimentada por Doentes de Konzo em Nampula","volume":"9","author":"Muloliwa","year":"2023"},{"key":"b12","series-title":"Pan Afr Med J","first-page":"213","article-title":"Persistence of konzo epidemics in Kahemba, Democratic Republic of Congo: Phenomenological and socio-economic aspects","volume":"18","author":"Okitundu Luwa E-Andjafono","year":"2014"},{"issue":"2","key":"b13","series-title":"Campbell Syst Rev","first-page":"e1230","article-title":"PRISMA2020: An R package and Shiny app for producing PRISMA 2020-compliant flow diagrams, with interactivity for optimised digital transparency and open synthesis","volume":"18","author":"Haddaway","year":"2022"},{"issue":"2","key":"b14","series-title":"Afr Stud","first-page":"205","article-title":"The aetiology of diseases in central Mozambique: With a special focus on HIV\/AIDS","volume":"76","author":"Bagnol","year":"2017"},{"issue":"2","key":"b15","series-title":"Food Nutr Bull","first-page":"1","article-title":"Shortcuts in cassava processing and risk of dietary cyanide exposure in Zaire","volume":"14","author":"Banea","year":"1992"},{"issue":"3","key":"b16","series-title":"Food Chem Toxicol","first-page":"539","article-title":"Uptake of wetting method in Africa to reduce cyanide poisoning and konzo from cassava","volume":"49","author":"Bradbury","year":"2011"},{"issue":"3","key":"b17","series-title":"FOOD Chem Toxicol","first-page":"673","article-title":"Recurrence of konzo in southern Tanzania: Rehabilitation and prevention using the wetting method","volume":"49","author":"Mlingi","year":"2011"},{"issue":"4","key":"b18","series-title":"Hist\u00f3ria Ci\u00eanc Sa\u00fade-Manguinhos","first-page":"925","article-title":"Antropologia, etnografia e narrativa: Caminhos que se cruzam na compreens\u00e3o do processo sa\u00fade-doen\u00e7a","volume":"17","author":"Costa","year":"2010"},{"issue":"22","key":"b19","series-title":"Int J Environ Res Public Health","first-page":"15420","article-title":"Community Health Workers\u2019 Knowledge, Attitudes, and Practices towards Epilepsy in Sofala, Central Mozambique","volume":"19","author":"Cumbe","year":"2022"},{"issue":"2","key":"b20","series-title":"Africa","first-page":"159","article-title":"Therapeutic efficacy and consensus among the Aluund of south-western Zaire","volume":"61","author":"Boeck","year":"1991"},{"key":"b21","article-title":"Beyond the Confinement of Af\u00dfiction: A Discursive Field of Exp\u00e9rience.","author":"Dijk","year":"2006"},{"issue":"1","key":"b22","series-title":"Ecol Food Nutr","first-page":"17","article-title":"Insufficient processing of cassava induced acute intoxications and the paralytic disease Konzo in a rural area of Mozambique","volume":"27","author":"Essers","year":"1992"},{"issue":"7","key":"b23","series-title":"Cad Sa\u00fade P\u00fablica","first-page":"e00212320","article-title":"\u201cXilala is only treated with a good hand\u201d: A study on the treatment of malnutrition in Mozambique","volume":"37","author":"Gove","year":"2021"},{"issue":"4","key":"b24","series-title":"Sa\u00fade E Soc","first-page":"567","article-title":"Sa\u00fade e doen\u00e7a em Mo\u00e7ambique","volume":"18","author":"Granjo","year":"2009"},{"key":"b25","article-title":"Rosemary Elizabeth Galli, People\u2019s Spaces and States Spaces. Land and Governance in Mozambique. Oxford, Lexington Books, 2003, 328 p.","author":"Gret","year":"2003"},{"key":"b26","article-title":"\u2018When You Leave, They Will Kill Me\u2019: Navigating Politics in and of the Field in Northern Mozambique.","author":"Howell","year":"2017"},{"issue":"10","key":"b27","series-title":"Nervenarzt","first-page":"946","article-title":"Endemische spastische Paraparese (Konzo)","volume":"73","author":"Kaiser","year":"2002"},{"key":"b28","series-title":"Antioxid Foods Its Appl","first-page":"182","article-title":"Traditional foods as putative sources of antioxidants with health benefits in Konzo","volume":"2018","author":"Kapepula","year":"2018"},{"key":"b29","series-title":"Catholic Pentecostalism and the Paradoxes of Africanization","first-page":"i","article-title":"Preliminary material","author":"Lado","year":"2026"},{"key":"b30","article-title":"Rethinking Indigenous Medicine: Illness (Mis)Representation and Political Economy of Health in Mozambique\u2019s Public Health Field.","author":"Mahumana","year":"2015"},{"key":"b31","article-title":"Sa\u00fade e doen\u00e7a na cultura Nyungwe: um olhar antropol\u00f3gico-teol\u00f3gico.","author":"Maia","year":"2011"},{"issue":"1","key":"b32","series-title":"Probl Manag 21st Century","first-page":"78","article-title":"The management of disease in a traditional medicine perspective: The case of Nampula, North of Mozambique","volume":"17","author":"Nhaueleque","year":"2022"},{"key":"b33","series-title":"Cad Pagu.","first-page":"177","article-title":"\u201cAs mulheres s\u00e3o m\u00e1s\u201d: pessoa, g\u00eanero e doen\u00e7a no sul de Mo\u00e7ambique","volume":"35","author":"Passador","year":"2010"},{"key":"b34","article-title":"Spastic Paraparesis: Putative Toxicants, Determinants and Contributing Factors in Public Health.","author":"Praekunatham","year":"2016"},{"issue":"21","key":"b35","series-title":"ABRIL\u2013NEPA UFF","first-page":"35","article-title":"Entre o veneno e o rem\u00e9dio, a literatura: Narrativas da doen\u00e7a e da cura na fic\u00e7\u00e3o de Mia Couto","volume":"10","author":"Welton Ferreira dos Santos Junior","year":"2018"},{"key":"b36","series-title":"Neurotoxicology","first-page":"54","article-title":"Konzo risk factors, determinants and etiopathogenesis: What is new? A systematic review","volume":"85","author":"Baguma","year":"2021"},{"key":"b37","doi-asserted-by":"crossref","DOI":"10.1177\/156482651403500104","article-title":"Effectiveness of Wetting Method for Control of Konzo and Reduction of Cyanide Poisoning by Removal of Cyanogens from Cassava Flour.","author":"Banea","year":"2014"},{"key":"b38","article-title":"Sa\u00fade e Doen\u00e7a em Mo\u00e7ambique Health and Illness in Mozambique.","author":"Granjo","year":"2009"},{"issue":"3","key":"b39","series-title":"Res Soc Dev","first-page":"e56810313708","article-title":"Representa\u00e7\u00f5es Sociais de usu\u00e1rios sobre Doen\u00e7as Negligenciadas","volume":"10","author":"Santos","year":"2021"},{"issue":"1","key":"b40","series-title":"South Sudan Med J","first-page":"4","article-title":"Making cassava flour safe using the wetting method","volume":"8","author":"Bradburya","year":"2016"}],"container-title":["The American Journal of Tropical Medicine and Hygiene"],"original-title":[],"link":[{"URL":"https:\/\/www.ajtmh.org\/view\/journals\/tpmd\/115\/3\/article-p436.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.ajtmh.org\/downloadpdf\/journals\/tpmd\/115\/3\/article-p436.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/www.ajtmh.org\/downloadpdf\/journals\/tpmd\/115\/3\/article-p436.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T12:54:12Z","timestamp":1788353652000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ajtmh.org\/view\/journals\/tpmd\/115\/3\/article-p436.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,2]]},"references-count":40,"journal-issue":{"issue":"3"},"URL":"https:\/\/doi.org\/10.4269\/ajtmh.26-0017","relation":{},"ISSN":["0002-9637","1476-1645"],"issn-type":[{"value":"0002-9637","type":"print"},{"value":"1476-1645","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,2]]}}}