Pellagra and its prevention and control in major emergencies
Pellagra is due to a lack of the vitamin niacin and/or its precursor tryptophan, an essential amino acid. The disease is classically associated with a diet based on non-alkali-treated maize. When diets are inadequate in niacin-and/or tryptophan, the lead time for developing signs of pellagra is about 2 to 3 times.
Since 1988 outbreaks of pellagra have been reported among refugees and internally displaced people in Angolo, Ethiopia, Malawi, Nepal, Swaziland, Zimbabwe and the former Zaire. It Angolo and Malawi, this deficiency disease was considered to be just as prevalent in the communities surrounding refugee camps as in the camps themselves.
This document discusses the causes of such outbreaks and the risk factors involved, describes pellagra's signs and symptoms and their devastating impact, and proposes a number of preventive interventions. Also included are a review of the literature on the epidemiology of pellagra and the functions and properties of niacin and tryptophan, and a description of the food sources and availability of this vitamin.
This is the third volume in an occasional WHO series on the prevention and control of micronutrient deficiencies during emergencies. Reviews concerning scurvy and thiamine deficiency are also available.