title: Effectiveness of wetting method for control of konzo and reduction of cyanide poisoning by removal of cyanogens from cassava flour.
abstract: BACKGROUND
  Konzo is an irreversible paralysis of the legs that occurs mainly among children and young women in remote villages in tropical Africa and is associated with a monotonous diet of bitter cassava. Konzo was discovered in 1938 by Dr. G. Trolli in the Democratic Republic of Congo (DRC). It also occurs in Mozambique, Tanzania, Cameroon, Central African Republic, and Angola. It was first controlled in Kay Kalenge village, DRC, in 2011 with the use of a wetting method to remove cyanogens from cassava flour. Fourteen months later, another visit was made to Kay Kalenge.
  
  
  OBJECTIVE
  To determine whether Kay Kalenge women were still using the wetting method, whether there were new cases of konzo, and whether the wetting method had spread to other villages.
  
  
  METHODS
  Meetings were held with chiefs, leaders, and heads of mothers' groups, women from 30 households were interviewed, and three nearby villages were visited. Total cyanide and thiocyanate were analyzed in cassava flour and urine samples, respectively.
  
  
  RESULTS
  The women in Kay Kalenge village still used the wetting method. There were no new cases of konzo. The mean cyanide content of the flour samples was 9 ppm, and no child had a mean urinary thiocyanate content greater than 350 micromol/L. The use of the wetting method had spread naturally to three adjacent villages.
  
  
  CONCLUSIONS
  The wetting method has been readily accepted by rural women as a simple and useful method to control konzo by removing cyanide from cassava flour, and its use has spread to nearby villages. The wetting method should be promoted by health authorities to control konzo and reduce cyanide poisoning from high-cyanide cassava flour.
authors.forename: Jean Pierre
authors.initials: JP
authors.lastname: Banea
authors.forename: J Howard
authors.initials: JH
authors.lastname: Bradbury
authors.forename: Chretienne
authors.initials: C
authors.lastname: Mandombi
authors.forename: Damien
authors.initials: D
authors.lastname: Nahimana
authors.forename: Ian C
authors.initials: IC
authors.lastname: Denton
authors.forename: N'landa
authors.initials: N
authors.lastname: Kuwa
authors.forename: D
authors.initials: D
authors.lastname: Tshala Katumbay
mesh_terms: D002648:Child; D003296:Cooking / Q000379:methods*; D003486:Cyanides / Q000378:metabolism / Q000506:poisoning* / Q000652:urine; D015023:Democratic Republic of the Congo; D005260:Female; D005433:Flour / Q000032:analysis*; D005511:Food Handling / Q000379:methods; D006801:Humans; D002365:Manihot / Q000737:chemistry / Q000378:metabolism / Q000506:poisoning*; D016472:Motor Neuron Disease / Q000139:chemically induced / Q000517:prevention & control* / Q000652:urine; D009570:Nitriles / Q000737:chemistry / Q000378:metabolism / Q000506:poisoning*; D012424:Rural Population / Q000706:statistics & numerical data; D013861:Thiocyanates / Q000378:metabolism / Q000506:poisoning / Q000652:urine; D014867:Water
chemical_list: D003486:Cyanides; D009570:Nitriles; D013861:Thiocyanates; D014867:Water; C011206:cyanogen; C031760:thiocyanate