Epidemiology of pellagra
Pellagra has occurred in many geographic areas as one of the commonest world-wide afflictions.
Once a formidable and widespread deficiency disease among a malnourished population subsisting mainly on maize diets, pellagra has declined in all parts of the world. Although today the condition is rather uncommon, occasional cases are found. It is still endemic in remote areas of the world where green vegetables, fruit, and animal proteins are unobtainable. Pellagra was endemic in Egypt until the gradual replacement of maize with wheat brought about improvements. In areas of Africa, south of the Sahara, namely in Nyasaland (Malawi) and Basutoland (Lesotho), as well as in areas of South Africa where maize is still a basic food, pellagra continues to be a problem.
The disease is particularly common in areas populated by the Bantu tribe in South Africa and is
endemic in a few areas of Western Africa, notably Angola. Besides Africa, a significant number of cases have been reported in Asia.
The disease is endemic in the deltas of some rivers in China. However, most reports related to pellagra in Asia have come from India. While pellagra is historically a disease of a maize-eating population, it has been reported in the Telangana area of Andhra Pradesh in India and in some
segments of the population who eat a cereal known as jowar (Sorghum vulgare); these people consume very little milk or other foods of animal origin.
Amino-acid imbalance caused by an excess of leucine is the cause of pellagra in both jowar and maize eaters. Excess of leucine appears to interfere in the conversion of tryptophan to niacin. Pellagra is an endemic disease among the population of India whose basic diet is maize or jowar (Sorghum vulgare).
A striking fall in the incidence of pellagra occurred in the USA following the discovery of nicotinic acid’s role; nowadays it is rarely encountered. In the European countries it appears nowadays sporadically.
Pellagra has occurred in many geographic areas as one of the commonest world-wide afflictions.
Once a formidable and widespread deficiency disease among a malnourished population subsisting mainly on maize diets, pellagra has declined in all parts of the world. Although today the condition is rather uncommon, occasional cases are found. It is still endemic in remote areas of the world where green vegetables, fruit, and animal proteins are unobtainable. Pellagra was endemic in Egypt until the gradual replacement of maize with wheat brought about improvements. In areas of Africa, south of the Sahara, namely in Nyasaland (Malawi) and Basutoland (Lesotho), as well as in areas of South Africa where maize is still a basic food, pellagra continues to be a problem.
The disease is particularly common in areas populated by the Bantu tribe in South Africa and is
endemic in a few areas of Western Africa, notably Angola. Besides Africa, a significant number of cases have been reported in Asia.
The disease is endemic in the deltas of some rivers in China. However, most reports related to pellagra in Asia have come from India. While pellagra is historically a disease of a maize-eating population, it has been reported in the Telangana area of Andhra Pradesh in India and in some
segments of the population who eat a cereal known as jowar (Sorghum vulgare); these people consume very little milk or other foods of animal origin.
Amino-acid imbalance caused by an excess of leucine is the cause of pellagra in both jowar and maize eaters. Excess of leucine appears to interfere in the conversion of tryptophan to niacin. Pellagra is an endemic disease among the population of India whose basic diet is maize or jowar (Sorghum vulgare).
A striking fall in the incidence of pellagra occurred in the USA following the discovery of nicotinic acid’s role; nowadays it is rarely encountered. In the European countries it appears nowadays sporadically.
Fonte:
Review Pellagra and skin
Kaliaperumal Karthikeyan, MD, and Devinder Mohan Thappa, MD, DHA, MNAMS
From the Department of Dermatology and STD, Jawaharlal Institute of
Postgraduate Medical Education and Research, Pondicherry – 605 006, India
Por: Pollana Roberta Alves Campos
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