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A Report on the Investigation into Recurrent Epidemics of Pellagra in ...

Source: www.fantaproject.org
Topic: Pellagra
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Sort Desciption: The pellagra patients presenting at clinics are of normal weight or are overweight. This is because deficiency of the nutrients niacin, riboflavin and pyridoxine ...

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The pellagra patients presenting at clinics are of normal weight or are overweight. This is because deficiency of the nutrients niacin, riboflavin and pyridoxine (so called 'type I nutrients') give rise to specific symptoms but do not cause loss of body weight (wasting). However, type I deficiency does cause severe illness including pellagra, kwashiorkor, immunoincompetence and death. The population is in nutritional crisis with a continued high mortality rate for over three years. This has recently increased sharply to crisis proportions (Crude Mortality Rate 4/10,000/day according to survey derived data). Although nutritional deficiencies underlie this excess mortality, it is not reflected in the rate of wasting (global malnutrition rate <-2Z scores weight for height).

A major proportion of the population is entirely dependent upon humanitarian aid. Almost 60% of the population receives humanitarian aid and over two-fifths of all food eaten in the area is flown in by the World Food Program. Without this sustained effort, the population would starve. However, problems associated with the distribution together with increasing reliance on maize and recent decreases in the amount of fortified blended foods have resulted in food rations with a niacin content low enough to cause overt clinical pellagra in otherwise healthy experimental subjects. In addition, evidence reveals that there is also an increase in edematous malnutrition (kwashiorkor), which is also related to a poor diet. Kwashiorkor is now the leading cause of death in the IDP camps. The recent pellagra epidemic is thus symptomatic of serious micronutrient deficiencies. Therefore, it is critical to take steps to improve the quality of the diet that is eaten in Kuito and the surrounding area.

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