# Caregiver Early Child Development Training for Preventing Konzo from Toxic Cassava in the DR Congo

> **NIH NIH R21** · MICHIGAN STATE UNIVERSITY · 2020 · $160,076

## Abstract

Project Summary
Konzo is a neurological disease associated with chronic reliance on poorly processed cyanogenic cassava as
the main source of food. We found that school-age children from konzo areas present with poor neurocognition
compared to those from nearby non-konzo areas, persisting and worsening even 4 years after initial
assessment. Our most recent work has extended these findings to children as young as a year in age,
suggesting that the neurodevelopmental impact from cassava cyanide neurotoxicity may begin as soon as
children are weaned from breast milk to cassava porridge. The “wetting method (WTM)” is a simple and
effective method of detoxifying cassava flour prior to eating that is being taught to rural women in a clinical-trial
study by our group in the Democratic Republic of Congo (DRC). The present proposal seeks to combine a
curriculum of mediational intervention for sensitizing caregivers (MISC) with a WTM training program
(MISC/WTM). MISC is an early childhood development (ECD) caregiver training program previously
demonstrated in clinical trials by Boivin and colleagues to improve health, neurodevelopmental, and caregiver
mental health outcomes in rural Ugandan HIV-affected households. Training 66 randomly selected moms from
a cohort of 100 on MISC/WTM (while the remaining 34 get WTM only) will better sensitize mothers to their
children’s development, leading to better WTM adherence while providing practical ECD benefits. Specific
Aims 1. To establish the feasibility of adding a biweekly 1-year MISC/WTM training program for mothers and
their 1 through 4 year-old children, led by peer trainers from the community. MISC has been previously
implemented for HIV-affected households in Uganda, but not for konzo communities in the DRC. Study Aim
2. To document whether better adherence to WTM through MISC will lead to lower household flour cassava
cyanogenic content and lower urinary thiocyanate (U-SCN) levels in the mother/child dyads. We will also test
for improved child outcomes on the Fagan Test of Infant Intelligence (with automated eye tracking), Mullen
Scales of Learning (MSEL), the Early Childhood Vigilance Test of attention (ECVT; eye tracking), and the
Color-Object Association Test (COAT). Caregiver depression/anxiety and corresponding functionality for
activities of daily caregiving should also significantly improve. Specific Aim 3. To explore whether reductions
in cyanogenic exposure from cassava and improved child’s neurodevelopmental outcomes are mediated by
improvements in caregiver emotional wellbeing and caregiving functionality immediately post MISC
intervention and at 6-month follow-up. Overall Impact. Our DRC/USA partnerships will be the first to
implement an evidence-based ECD program for at-risk children in the DR Congo, strengthening DRC Ministry
of Health efforts to prevent konzo. If MISC strengthens the programmatic efforts to prevent konzo, the public
health impact will be enormous, given the scope of risk in ...

## Key facts

- **NIH application ID:** 10017701
- **Project number:** 5R21HD098588-02
- **Recipient organization:** MICHIGAN STATE UNIVERSITY
- **Principal Investigator:** Michael Joseph Boivin
- **Activity code:** R21 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $160,076
- **Award type:** 5
- **Project period:** 2019-09-12 → 2022-08-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10017701

## Citation

> US National Institutes of Health, RePORTER application 10017701, Caregiver Early Child Development Training for Preventing Konzo from Toxic Cassava in the DR Congo (5R21HD098588-02). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/10017701. Licensed CC0.

---

*[NIH grants dataset](/datasets/nih-grants) · CC0 1.0*