title: The interaction of malnutrition and neurologic disability in Africa.
abstract: Malnutrition and neurodisability are both major public health problems in Africa. This review highlights key areas where they interact. This happens throughout life and starts with maternal malnutrition affecting fetal neurodevelopment with both immediate (eg, folate deficiency causing neural tube defects) and lifelong implications (eg, impaired cognitive function). Maternal malnutrition can also increase the risk of perinatal problems, including birth asphyxia, a major cause of neurologic damage and cerebral palsy. Macronutrient malnutrition can both cause and be caused by neurodisability. Mechanisms include decreased food intake, increased nutrient losses, and increased nutrient requirement. Specific micronutrient deficiencies can also lead to neurodisability, for example, blindness (vitamin A), intractable epilepsy (vitamin B6), and cognitive impairment (iodine and iron). Toxin ingestion (eg, from poorly processed cassava) can cause neurodisability including a peripheral polyneuropathy and a spastic paraparesis. We conclude that there is an urgent need for nutrition and disability programs to work more closely together.
authors.affiliation: Leonard Cheshire Disability and Inclusive Development Centre, University College London, UK; Malawi-Liverpool Wellcome Trust Clinical Research Programme, Malawi.
authors.forename: Marko
authors.initials: M
authors.lastname: Kerac
authors.affiliation: International Neurologic and Psychiatric Epidemiology Program, Michigan State University, MI.
authors.forename: Douglas G
authors.initials: DG
authors.lastname: Postels
authors.affiliation: Malawi-Liverpool Wellcome Trust Clinical Research Programme, Malawi; Department of Paediatrics and Child Health, College of Medicine, Malawi.
authors.forename: Mac
authors.initials: M
authors.lastname: Mallewa
authors.affiliation: Department of Paediatrics and Child Health, College of Medicine, Malawi.
authors.forename: Alhaji
authors.initials: A
authors.lastname: Alusine Jalloh
authors.affiliation: Leonard Cheshire Disability and Inclusive Development Centre, University College London, UK.
authors.forename: Wieger P
authors.initials: WP
authors.lastname: Voskuijl
authors.affiliation: Malawi-Liverpool Wellcome Trust Clinical Research Programme, Malawi.
authors.forename: Nora
authors.initials: N
authors.lastname: Groce
authors.affiliation: University of Liverpool, UK.
authors.forename: Melissa
authors.initials: M
authors.lastname: Gladstone
authors.affiliation: Department of Paediatrics and Child Health, College of Medicine, Malawi. Electronic address: emmolyneux@gmail.com.
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Molyneux
mesh_terms: D000349:Africa / Q000453:epidemiology; D006801:Humans; D044342:Malnutrition / Q000150:complications* / Q000453:epidemiology*; D009422:Nervous System Diseases / Q000453:epidemiology* / Q000209:etiology*