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Spastic paraparesis: putative toxicants, determinants and contributing factors in public health

Praekunatham, Hirunwut (2016) Spastic paraparesis: putative toxicants, determinants and contributing factors in public health. Master Essay, University of Pittsburgh.

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Cassava is a staple food in many tropical countries, most notably Africa. Consumption of cassava, especially the bitter cassava varieties, can lead to a neurological disorder called “spastic paraparesis” or “konzo” in West Africa; most often epidemic outbreaks rather than isolated cases. Children and women of childbearing age are the most susceptible groups. Because of the irreversible neurological deficit caused by this disease, children and women with konzo suffer from lifelong disabilities starting at an early age. This essay aims to examine the public health determinants, including contributing factors, and identify the putative toxicant(s) that leads to spastic paraparesis. A non-systematic literature review was performed using papers retrieved from the MEDLINE database. Spastic paraparesis is strongly related to chronic consumption of cassava combined with a sulfur-containing amino acid deficiency. The majority of published studies suggest that cyanate is the most likely toxicant leading to motor deficit. Food crisis, provoked by economic stagnation, drought, war, and famine, is associated with insufficient food processing to remove cyanogens from cassava. Several public health interventions can be implemented to prevent the occurrence of konzo in communities that rely on cassava as a staple food, including conducting health education programs, promoting cultivation of low-toxin strains of cassava, and effectively conserving environments. The surveillance system for konzo should be strengthened in high-risk areas. Furthermore, a community-based rehabilitation program aimed at the disabled people should be established in the affected villages.


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Item Type: Other Thesis, Dissertation, or Long Paper (Master Essay)
Status: Unpublished
CreatorsEmailPitt UsernameORCID
Praekunatham, Hirunwuthip8@pitt.eduHIP8
ContributionContributors NameEmailPitt UsernameORCID
Committee ChairPeterson, Jamesjimmyp@pitt.eduUNSPECIFIEDUNSPECIFIED
Committee MemberAbad, Jorge Darwinjabad@pitt.eduUNSPECIFIEDUNSPECIFIED
Centers: Other Centers, Institutes, Offices, or Units > Center for Environmental and Occupational Health
Date: 26 April 2016
Date Type: Publication
Access Restriction: No restriction; Release the ETD for access worldwide immediately.
Publisher: University of Pittsburgh
Institution: University of Pittsburgh
Schools and Programs: School of Public Health > Environmental and Occupational Health
Degree: MPH - Master of Public Health
Thesis Type: Master Essay
Refereed: Yes
Date Deposited: 07 Sep 2016 20:02
Last Modified: 31 Jul 2020 19:10


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