Konzo and dietary pattern in cassava-consuming populations of Popokabaka, Democratic Republic of Congo

Food frequencies and 24 h diet recall were registered from 487 randomly selected heads of household in Popokabaka (Bandundu Province, DRC) where the first cases of konzo were reported more than seventy years ago. Konzo is still occurring in this area with a prevalence of 1.4%. High prevalence of konzo was found to be associated with female gender (P = 0.0024), unmarried status (P = 0.030), illiteracy (P = 0.021), farmer as main occupation (P < 0.05) and with consumption of cassava from own farm land (P = 0.045).The diet was largely dominated by cassava. Luku, cassava flour stiff porridge, was consumed at least once during the day in 99.2% of households. A median of 304 g (max. 592 g; min. 120 g) of cassava flour providing 1070 kcal (max. 2085 kcal; min. 422 kcal)/day/person was used to prepare luku. Saka-saka (pounded cassava leaves) (40%), cowpeas (30%), sesame (23.2%), mbondi (Salacia pynaertii) (18.1%), mushrooms (17.7%) and mfumbwa (Gnetum africanum) (11.3%) were consumed as side-dishes with luku. These results showed that major foods consumed are of poor quality in protein, especially in sulphur containing amino acids.