Julie L. Cliff
In 1981, we described a large epidemic of over one thousand cases of the spastic paraparesis konzo in Nampula province, northern Mozambique. The epidemic was associated with consumption of insufficiently processed bitter cassava during drought. Cases and controls had high concentrations of serum thiocyanate. Subsequent research showed that children in the epidemic area had increased thiocyanate and decreased inorganic sulfate excretion. Serial measurement of urinary thiocyanate concentrations showed a pronounced seasonal variation, with a peak coincidental with the cassava harvest and the epidemic outbreaks.

Since 1981, further konzo outbreaks have occurred during war and drought in cassava-staple districts. In Murrupula, sporadic cases and small outbreaks were reported from 1982–92. In 1988, 171 cases were notified in Namapa and Erati. Large epidemics occurred in war-devastated Mogincual in 1992 and 1993.

We have seen three outbreaks of acute intoxication following occasional cassava meals in non-cassava staple areas during periods of drought. They were associated with consumption of newly introduced bitter cassava to communities with no local knowledge of processing methods.

Cliff, Julie L. (1994). CASSAVA SAFETY IN TIMES OF WAR AND DROUGHT IN MOZAMBIQUE. Acta Hortic. 375, 373-378
DOI: 10.17660/ActaHortic.1994.375.37
Konzo, spastic paraparesis, cyanide, toxicology, natural disasters

Acta Horticulturae