Recurrence of konzo in southern Tanzania: rehabilitation and prevention using the wetting method

There have been four konzo outbreaks in Tanzania from 1985 to 2002/2003 with a total of 363 cases of konzo. Every outbreak of konzo resulted from large cyanogen intakes from bitter cassava during drought, which caused food shortages and led to people using short-cut methods of cassava processing. Rehabilitation of the 214 konzo subjects from the two most recent outbreaks of konzo in southern Tanzania was carried out by screening konzo subjects and included provision of crutches and wheel chairs. The wetting method was taught to 216 women activists from the konzo-prone villages, in the first large scale community based intervention to reduce cyanogen intake. Using cassava cyanide kits, the average total cyanide content was reduced by the wetting method about 4-fold, in agreement with previous studies. This model to help prevent konzo requires the widespread education of women activists to use the wetting method.