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Dietary cyanogen exposure and early child neurodevelopment: An observational study from the Democratic Republic of Congo
BACKGROUND: Dietary cyanogen exposure from ingesting bitter (toxic) cassava as a main source of food in sub-Saharan Africa is related to neurological impairments in sub-Saharan Africa. We explored possible association with early child neurodevelopmental outcomes. METHODS: We undertook a cross-sectio...
Autores principales: | , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Public Library of Science
2018
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5903613/ https://www.ncbi.nlm.nih.gov/pubmed/29664942 http://dx.doi.org/10.1371/journal.pone.0193261 |
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author | Kashala-Abotnes, Espérance Sombo, Marie-Thérèse Okitundu, Daniel L. Kunyu, Marcel Bumoko Makila-Mabe, Guy Tylleskär, Thorkild Sikorskii, Alla Banea, Jean-Pierre Mumba Ngoyi, Dieudonné Tshala-Katumbay, Désiré Boivin, Michael J. |
author_facet | Kashala-Abotnes, Espérance Sombo, Marie-Thérèse Okitundu, Daniel L. Kunyu, Marcel Bumoko Makila-Mabe, Guy Tylleskär, Thorkild Sikorskii, Alla Banea, Jean-Pierre Mumba Ngoyi, Dieudonné Tshala-Katumbay, Désiré Boivin, Michael J. |
author_sort | Kashala-Abotnes, Espérance |
collection | PubMed |
description | BACKGROUND: Dietary cyanogen exposure from ingesting bitter (toxic) cassava as a main source of food in sub-Saharan Africa is related to neurological impairments in sub-Saharan Africa. We explored possible association with early child neurodevelopmental outcomes. METHODS: We undertook a cross-sectional neurodevelopmental assessment of 12–48 month-old children using the Mullen Scale of Early Learning (MSEL) and the Gensini Gavito Scale (GGS). We used the Hopkins Symptoms Checklist-10 (HSCL-10) and Goldberg Depression Anxiety Scale (GDAS) to screen for symptoms of maternal depression-anxiety. We used the cyanogen content in household cassava flour and urinary thiocyanate (SCN) as biomarkers of dietary cyanogen exposure. We employed multivariable generalized linear models (GLM) with Gamma link function to determine predictors of early child neurodevelopmental outcomes. RESULTS: The mean (SD) and median (IQR) of cyanogen content of cassava household flour were above the WHO cut-off points of 10 ppm (52.18 [32·79]) and 50 (30–50) ppm, respectively. Mean (SD) urinary levels of thiocyanate and median (IQR) were respectively 817·81 (474·59) and 688 (344–1032) μmole/l in mothers, and 617·49 (449·48) and 688 (344–688) μmole/l in children reflecting individual high levels as well as a community-wide cyanogenic exposure. The concentration of cyanide in cassava flour was significantly associated with early child neurodevelopment, motor development and cognitive ability as indicated by univariable linear regression (p < 0.05). After adjusting for biological and socioeconomic predictors at multivariable analyses, fine motor proficiency and child neurodevelopment remained the main predictors associated with the concentration of cyanide in cassava flour: coefficients of -0·08 to -.15 (p < 0·01). We also found a significant association between child linear growth, early child neurodevelopment, cognitive ability and motor development at both univariable and multivariable linear regression analyses coefficients of 1.44 to 7.31 (p < 0·01). CONCLUSION: Dietary cyanogen exposure is associated with early child neurodevelopment, cognitive abilities and motor development, even in the absence of clinically evident paralysis. There is a need for community-wide interventions for better cassava processing practices for detoxification, improved nutrition, and neuro-rehabilitation, all of which are essential for optimal development in exposed children. |
format | Online Article Text |
id | pubmed-5903613 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2018 |
publisher | Public Library of Science |
record_format | MEDLINE/PubMed |
spelling | pubmed-59036132018-05-06 Dietary cyanogen exposure and early child neurodevelopment: An observational study from the Democratic Republic of Congo Kashala-Abotnes, Espérance Sombo, Marie-Thérèse Okitundu, Daniel L. Kunyu, Marcel Bumoko Makila-Mabe, Guy Tylleskär, Thorkild Sikorskii, Alla Banea, Jean-Pierre Mumba Ngoyi, Dieudonné Tshala-Katumbay, Désiré Boivin, Michael J. PLoS One Research Article BACKGROUND: Dietary cyanogen exposure from ingesting bitter (toxic) cassava as a main source of food in sub-Saharan Africa is related to neurological impairments in sub-Saharan Africa. We explored possible association with early child neurodevelopmental outcomes. METHODS: We undertook a cross-sectional neurodevelopmental assessment of 12–48 month-old children using the Mullen Scale of Early Learning (MSEL) and the Gensini Gavito Scale (GGS). We used the Hopkins Symptoms Checklist-10 (HSCL-10) and Goldberg Depression Anxiety Scale (GDAS) to screen for symptoms of maternal depression-anxiety. We used the cyanogen content in household cassava flour and urinary thiocyanate (SCN) as biomarkers of dietary cyanogen exposure. We employed multivariable generalized linear models (GLM) with Gamma link function to determine predictors of early child neurodevelopmental outcomes. RESULTS: The mean (SD) and median (IQR) of cyanogen content of cassava household flour were above the WHO cut-off points of 10 ppm (52.18 [32·79]) and 50 (30–50) ppm, respectively. Mean (SD) urinary levels of thiocyanate and median (IQR) were respectively 817·81 (474·59) and 688 (344–1032) μmole/l in mothers, and 617·49 (449·48) and 688 (344–688) μmole/l in children reflecting individual high levels as well as a community-wide cyanogenic exposure. The concentration of cyanide in cassava flour was significantly associated with early child neurodevelopment, motor development and cognitive ability as indicated by univariable linear regression (p < 0.05). After adjusting for biological and socioeconomic predictors at multivariable analyses, fine motor proficiency and child neurodevelopment remained the main predictors associated with the concentration of cyanide in cassava flour: coefficients of -0·08 to -.15 (p < 0·01). We also found a significant association between child linear growth, early child neurodevelopment, cognitive ability and motor development at both univariable and multivariable linear regression analyses coefficients of 1.44 to 7.31 (p < 0·01). CONCLUSION: Dietary cyanogen exposure is associated with early child neurodevelopment, cognitive abilities and motor development, even in the absence of clinically evident paralysis. There is a need for community-wide interventions for better cassava processing practices for detoxification, improved nutrition, and neuro-rehabilitation, all of which are essential for optimal development in exposed children. Public Library of Science 2018-04-17 /pmc/articles/PMC5903613/ /pubmed/29664942 http://dx.doi.org/10.1371/journal.pone.0193261 Text en © 2018 Kashala-Abotnes et al http://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. |
spellingShingle | Research Article Kashala-Abotnes, Espérance Sombo, Marie-Thérèse Okitundu, Daniel L. Kunyu, Marcel Bumoko Makila-Mabe, Guy Tylleskär, Thorkild Sikorskii, Alla Banea, Jean-Pierre Mumba Ngoyi, Dieudonné Tshala-Katumbay, Désiré Boivin, Michael J. Dietary cyanogen exposure and early child neurodevelopment: An observational study from the Democratic Republic of Congo |
title | Dietary cyanogen exposure and early child neurodevelopment: An observational study from the Democratic Republic of Congo |
title_full | Dietary cyanogen exposure and early child neurodevelopment: An observational study from the Democratic Republic of Congo |
title_fullStr | Dietary cyanogen exposure and early child neurodevelopment: An observational study from the Democratic Republic of Congo |
title_full_unstemmed | Dietary cyanogen exposure and early child neurodevelopment: An observational study from the Democratic Republic of Congo |
title_short | Dietary cyanogen exposure and early child neurodevelopment: An observational study from the Democratic Republic of Congo |
title_sort | dietary cyanogen exposure and early child neurodevelopment: an observational study from the democratic republic of congo |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5903613/ https://www.ncbi.nlm.nih.gov/pubmed/29664942 http://dx.doi.org/10.1371/journal.pone.0193261 |
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