Between February and October 1990, 18276 cases of pellagra dermatitis (due to niacin deficiency) were reported among 285942 Mozambican refugees in Malawi. Overall, 6.3% of the refugee population developed pellagra and the attack rate was 7.8 times higher among women than men. This outbreak followed a 5-month cessation of groundnut distribution (the major source of niacin) to refugees. A matched-pair case-control study confirmed the protective role of the daily consumption of groundnuts (Odds Ratio [OR]=0.08), as well as the independent role of garden ownership (OR=0.34), and home maize milling (OR=0.3). Recommended corrective action included early case finding and treatment, distribution of niacin tablets, prompt identification of groundnut supply on the world market, fortification with niacin of the food ration and diversification of the food basket through access to local markets. © 1992 International Epidemiological Association.

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Studies Research Methodology biology lifestyle Food Supplementation refugee Africa south of the Sahara physiology Migrants population Nutrition Programs nutritional disease Population Dynamics Research Report human sex difference Refugees Developing Countries controlled study comparative study priority journal diet nicotinic acid niacin deficiency pellagra nicotinic acid deficiency Epidemiologic Methods Vitamins peanut Nutrition Disorders maize Portuguese Speaking Africa Residence Characteristics Niacin Vitamin B Complex health spatial distribution Epidemics Adolescent male Diseases female Mozambique Child, Preschool Africa Refugee Camps health services Disease Outbreaks Article nutrition major clinical study adult Deficiency Diseases migration Eastern Africa diet supplementation Sex Factors Case Control Studies Geographic Factors Sex Distribution Demographic Factors English Speaking Africa normal human Case-Control Studies Delivery of Health Care Population Characteristics case control study dietary intake primary health care Malawi Child