Neuroepidemiology of konzo a spastic para-tetraparesis of acute onset in a new area of the Democratic Republic of Congo

Désiré Tshala-Katumbay, Jean Pierre Banea-Mayambu, Théodore Kazadi-Kayembe, Raphaël Nunga-Matadi, Fidèle Bikangi-Nkiabungu, Karin Edebol Eeg-Olofsson, Thorkild Tylleskär

Research output: Contribution to journalArticlepeer-review

19 Scopus citations


Background: Konzo is an acute non-progressive spastic paraparesis associated with a consumption of insufficiently processed bitter cassava, and a low intake of sulfur amino acids. Method: To determine whether an outbreak of spastic paraparesis in the Democratic Republic of Congo was compatible with konzo, we surveyed and screened the population in the affected area by using the WHO criteria. Interviews and focus group discussions were done on diet and the occurrence of konzo. Serum samples were analyzed for prealbumin, albumin and thiocyanate; urine samples for linamarin, thiocyanate and sulfate. Serum samples were tested for HIV1-2 (Behring ELISA) and HTLV I-II antibodies (ELISA/Wellcome). Results: Of 2,723 inhabitants, 55 were affected by konzo i.e. a prevalence of 20 per thousand. The main symptom was a sudden onset of a non-progressive spastic paraparesis or a tetraparesis in severe cases. Bitter cassava was the staple diet. We found high exposure to cyanogenic compounds i.e., mean (± SD) concentration of serum thiocyanate 502 (±153) mmol/L, of urinary linamarin 482 (±322) mmol/L, and urinary thiocyanate 1128 (±670) mmol/L. The mean (± SD) urinary sulfate concentration was 4.0 ± 3.3 mmol/L. Most subjects had low proteins concentration in serum: of 38 subjects 37 and 28 were below the albumin and prealbumin reference values respectively. All 38 blood samples were negative to the tested retroviruses. Conclusion: This outbreak was compatible with konzo. Improving cassava processing might prevent the disease.

Original languageEnglish (US)
JournalAfrican Journal of Neurological Sciences
Issue number1
StatePublished - 2001
Externally publishedYes


  • Acute spastic paraparesis
  • Cassava
  • Cyanogens exposure
  • Konzo

ASJC Scopus subject areas

  • Neurology
  • Clinical Neurology


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