Food-aid cereals to reduce neurolathyrism related to grass-pea preparations during famine

Neurolathyrism is a spastic paraparesis that can be caused by excessive consumption of the drought-resistant grass pea (Lathyrus sativus). Devastating neurolathyrism epidemics have occurred during major famine crises in various parts of the world. We investigated in a case-control study the effects of food aid on risk of paralysis. Risk increased with consumption of boiled grass pea (adjusted odds ratio 2•78, 95% CI 1•09–7•13 with cereals; 5•22, 2•01–13•55 without cereal) and raw unripe green grass pea (1•96, 1•16–3•31; p=0•011), but not with the fermented pancake, unleavened bread, and gravy preparations. In a correlational study there was an inverse relation between the number of new cases and the amount of food-aid cereals distributed per person. During famine, cereals and nutritional information should reach people before they have grass pea as the only food.