Transcript The Epidemiology of neurolathyrism.

Neurolathyrism
Haileyesus Getahun
South Gonder Health
Department, Ethiopia
Neurolathyrism
• Synonym lathyrism
• Neurolathyrism (NL) is a
neurodegenerative disease
that is caused by heavy
consumption of grass pea,
Lathyrus sativus.
The Toxin
The pulse contains the
neurotoxin called -Noxalyl-,-diaminopropionic
acid (-ODAP).[Synonym oxalylaminoalanine(BOAA)]
Grass pea
• Resist water shortage and
water logging.
• Improves soil fertility.
• Needs no fertilizer.
• Gives high yield.
History of
Neurolathyrism
• Ancient disease.
• Often occurs in epidemics.
• Several epidemics occurred
in most parts of the world.
Prevalence
• Varies from country to
country.
• Often occur in inaccessible
areas.
• Not many epidemiological
studies.
Mean Prevalence
• Ethiopia 6 per 1000
• India 5.3 per 1000
• Bangladesh 1.4 per 1000.
Recent epidemics
• 1973 : China
• 1976: Bangladesh
• 1976: Ethiopia
• 1998: Nepal (non published)
• 1998: Afghanistan (non published)
• 1997-99: Ethiopia
Onset of the disease
• Mostly 3-6 months.
• Acute or chronic.
• Dose dependent.
• Critical level = 400gm/day.
Risk factors
• Heavy physical activity
• Male gender
• Young age (15-25 years)
• Micro nutrient deficiency
(Zn,Cu, Vit C, Vit A)
Clinical features
• Upper motor neuron disorder
with symmetrical spastic
paralysis.
• Sensation and sphincters are
spared.
Stages of the disease
• Stage I (No stick stage)
• Stage II (One stick stage)
• Stage III (Two sticks stage)
• Stage IV (Crawler stage)
Treatment
• No definitive treatment.
• The neuronal damages are
permanent.
• Symptomatic treatment with
muscle relaxants help.
Prevention
• Home based detoxifying
methods.
• New seed lines.
• Cultivation of alternate
crops.
Prevention
Although cultivation of the
grass pea is legally banned
in India and Nepal,
Neurolathyrism
continued to manifest itself.