Prevalence, Associated Factors, and Social Status of Patients with Neurolathyrisim in Delanta, Amhara Region, Ethiopia: A Community-Based Cross- Sectional Study

Prevalence, Associated Factors, and Social Status of Patients with Neurolathyrisim in Delanta, Amhara Region, Ethiopia: A Community-Based Cross- Sectional Study | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Prevalence, Associated Factors, and Social Status of Patients with Neurolathyrisim in Delanta, Amhara Region, Ethiopia: A Community-Based Cross- Sectional Study Andualem Endrias Yesuf, Eden Efrem Mersiehazen, Bemnet Yazew Abegaz, and 3 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-4332232/v1 This work is licensed under a CC BY 4.0 License Status: Published Journal Publication published 11 Apr, 2026 Read the published version in BMC Neurology → Version 1 posted 16 You are reading this latest preprint version Abstract Background: Neurolathyrism, a debilitating neurodegenerative disorder associated with the consumption of the legume Lathyrus sativus, is a significant public health challenge globally, with a particular prevalence in various regions of Ethiopia. This research investigated the prevalence, associated factors, and social status of patients afflicted by neurolathyrism, specifically focusing on the Amhara region of Ethiopia. Objective of the study : To assess the prevalence, associated factors and social support status of patients with neurolathyrism in Delanta district, Ethiopia. Methodology: A community-basedcross-sectional survey was conducted from November to December 2022 among 480 randomly selected individuals in the Delanta district in the Amhara region. A multistage sampling technique was employed. The data were collected using a structured questionnaire after providing written informed consent from each participant. The collected data were cleaned and analyzed using the statistical software Epi version 7.2 and SPSS version 26.0, respectively. Descriptive statistics and multivariable logistic regression models were used. Statistical significance was determined using a P value < 0.05. Associations were measured by odds ratios (ORs). Predictors of nonadherence were identified using bivariable and multivariable logistic regression analysis. Factors with a P value of 0.2 or less in the bivariable analysis were selected for further multivariable analysis and entered into a logistic regression model. Results: Of the 470 individual study participants, 56 (11.9%) reported having neurolathyrism, and at the population level, the prevalence of neurolathyrism in the Delanta district was 6.6%. Age (AOR = 4.87 (CI 1.765-13.443), male sex (AOR = 23% (CI 0.003, 0.302), and educational status (AOR =33.8% (CI 0.025–4.498)) were the individual-level variables; family size (AOR = 30.8 (CI 0.139-0.682) and farm land lease (AOR = 29.3 (CI 0.106–0.811) were the household-level variables found to have significant associations with neurolathyrism. Seventeen-thirds (73%) of the neurolathyrism patients discontinued school because of a lack of support; among them, 21.4% were divorced after the disease. Conclusion In conclusion, our study has illuminated a concerning reality—the prevalence of neurolathyrism is notably high within the population under investigation. This finding underscores the pressing need for immediate attention and targeted interventions to address the burgeoning impact of this neurodegenerative disorder. The elevated prevalence rates identified in our study underscore the urgency of adopting a multifaceted approach to mitigating the risk factors associated with neurolathyrism. Considering that a significant number of victims suffer from irreversible damage from the disease in different seasons, policies and programs should focus on the prevention of lathyrism. Government officials should pronounce the problem as a major national public health problem and include it in the disease reporting system of the Ethiopian Ministry of Health. Neurolathyrisim prevalence associated factors social status neurological conditions Background Neurolathyrisim, a term coined to encompass neurological disorders affecting the peripheral nervous system( 1 ), has emerged as a significant public health concern globally ( 2 , 3 ). Neurolathyrism is a neurotoxic disorder caused by the consumption of grass (lathyrus sativus) ( 4 ), which contains the glutamate analog neurotoxin.( 5 , 6 ) The case definition for neurolathyrism was symmetrical spastic leg weakness, subacute or insidious onset, with no sensory deficit or history of grass pea consumption prior to or at the onset of paralysis.( 1 , 4 , 7 ) The degree of disability of patients was categorized into four groups as follows: Stage I, with a spastic gait with no need to use a walking stick and no Babinski sign (Acton's no stick stage); and Stage II, with a spastic gait with the need for one walking stick. She presented with ankle clonus and Babinski’s sign (one stick stage). Stage III: Spastic cross adductor gait with the need for two walking sticks. She presented with ankle clonus and Babinski signs (two-stick stage). Stage IV: She was bedridden with loss of leg use and contracture. The arms are strong, and pyramidal signs are present (crawler stage).( 6 ) Lathyrism is a disorder of the central motor pathways and has been known since the ancient Hindus and Hippocrates (460–377 BC) eras. In the eighteenth, nineteenth, and twentieth centuries, outbreaks of lathyrism occurred throughout Europe, North Africa, the Middle East, Afghanistan, Russia, China, and India.( 6 , 8 , 9 ) Lathyrism leads to spastic paraparesis and permanent disability( 1 ) and changes the general appearance of bones and joints, particularly at the knees and feet.( 10 ) In addition to its clinical consequences, this disease has diverse psychological, cultural, and economic impacts (psychosocial).( 2 , 11 , 12 ) The disease affects all individuals across the life span of 20–70 years.( 11 , 13 ) Currently, the distribution of lathyrism is confined to India, Pakistan, Bangladesh, and Ethiopia, with an estimated magnitude of 1.7–6%. This disorder is a historical and contemporary public health problem in Ethiopia.( 14 ) Three decades ago, the estimated annual incidence rate was 1.7/10,000, and the prevalence was 6/10,000 people.( 15 ) In fact, grass pea usually tends to replace staple cereal-based (the edible seeds or grains of the grass family, Gramineae) diets in rural northern and central Ethiopia during times of acute food shortage( 16 ), which makes this disease an important public health problem in the Ethiopian context, particularly in drought-prone areas of northern Ethiopia.( 12 , 16 ) It has been known in Ethiopia for many years, but documented historical accounts are lacking. Major epidemics struck the northwestern region of the country following the drought of the mid-1970s, and an epidemiological study in northwestern Ethiopia revealed that the prevalence of neurolathyrism varied between 0.6% and 3%. Subsequent peak occurrences of neurolathyrism cases were observed during the 1984/85 major famine and in 1994.( 12 ) Another epidemic affecting 2000 people in less than one district between 1997 and 1998 in the Amhara region of Ethiopia was reported. More recently, a study performed in 2019 reported that the prevalence of lathyrism was 5.5%.( 12 ) Although neurolathyrism is of public health importance in Ethiopia, a country with very poor economic development and an unreliable food security system, it is not receiving due attention from health, agriculture or political authorities.( 8 , 12 , 14 , 15 , 17 ) The reasons for this major neglect and peak occurrence of neurolathyrism cases are not known. In one study, it was reported that the presence of a neurolathyrism patient in the family was associated with illiteracy of the head of household, owning a grass pea farm and the exclusive cooking of grass pea foods using handmade traditional clay pots.( 6 ) The cultivation, distribution, and use of grass peas, home-based detoxifying methods (washing, soaking, and fermentation), mixing with other crops, toxin reduction in the seed lines through breeding and genetic engineering, and the exploration of alternate crops for grass peas have been attempted in the prevention of lathyrism.( 17 , 18 ) However, in the context of Ethiopia, the banning of grass peas, either for production or consumption, is not feasible because of frequent weather changes that force farmers to crop them as alternatives, leading to overconsumption.( 12 , 19 ) This community-based cross-sectional study design aims to provide a comprehensive assessment of Neurolathyrisim in Delanta. By investigating the prevalence rates, identifying associated factors, and exploring the social status of affected individuals, this research seeks to unveil the multifaceted dimensions of this condition within the local community. The findings of this study will not only contribute to the existing body of knowledge on neurological disorders but also inform healthcare practitioners, policymakers, and researchers about the specific challenges faced by individuals with Neurolathyrisim in Delanta. Moreover, understanding the social status and impact of Neurolathyrisim on affected individuals and their families will shed light on the broader implications of this condition. This knowledge can serve as a foundation for the development of community-based interventions, healthcare strategies, and public health campaigns aimed at reducing the burden of Neurolathyrisim in Delanta and similar regions. In conclusion, this research endeavors to bridge the existing gap in our understanding of Neurolathyrisim, particularly in the unique context of Delanta, Amhara Region, Ethiopia. The insights gained from this study have the potential to enhance healthcare delivery, promote community well-being, and contribute to the global discourse on neurological health disparities. Therefore, the main aim of this study was to assess the prevalence, associated factors and social support status of patients with neurolathyrism in the Delanta district, Ethiopia. Methods and Materials Study Design and Setting This community-based study was conducted from February 01 to March 30, 2023, to assess the prevalence, associated factors and social support status of patients with neurolathyrism in Delanta district, Ethiopia. The Amhara Region is one of the most populous regions in Ethiopia. As of the last available census in 2007, the region had a population of more than 17 million people. The estimated size of the population of this district is 139,618. The district has 31 rural and 2 urban Kebeles with an area of 126,879 square kilometers.( 9 ) The district is divided into 33 kebeles (the smallest administrative unit) and has an estimated population of 139,618. Study Participants and Sampling The study units were those purposely selected two rural kebeles that were affected by the neurolathyrism epidemic. All households living in the two Kebeles during the study period were eligible for the study. The sample size was calculated using the single population proportion formula,( 6 ) considering a rate (p) of 5.5%, a 95% confidence interval (CI), and a 3% margin of error( 6 ). By adding a 10% nonresponse rate, the final sample included 499 inhabitants of households resulting from the double proportion formula, with a power of 80%, confidence of 95%, educational status (p1 = 0.04, p2 = 0.12) and available grass pea farms (p1 = 0.04, p2 = 0.11). The proportion and largest percentage were 221, and with a nonresponse rate of 10% and adjusting for the design effect, the final sample size became 499 inhabitants of households. Data collection and quality control Structured questionnaires were used to collect the required primary quantitative data from all the selected households. The data collection tool was prepared in English and translated into the local language Amharic. The data collection tool was pretested to assess the participants’ completeness in capturing all the variables required as per the specific objectives of the study. Quality assurance audits were carried out during the data collection process by field supervisors as well as the research team members themselves. All the data collected, documents and reports were subject to regulatory audits and inspections without hindering confidentiality. Three days of training were given to both the data collectors and the supervisors by the researchers. The training included a discussion on the objectives of the study, contents of the data collection tools, data collection techniques, and maintaining the confidentiality of the responses. Moreover, the completeness of the completed questionnaires was checked by supervisors on a daily basis. Data Management and Analysis The collected quantitative data were first entered and cleaned using Epi Info version 7.2 statistical software and then exported to SPSS software version 26.0 for analyses. Various statistical methods, such as descriptive statistics such as frequency means and standard deviations (SDs) and binary logistic regression tests, were employed to identify the predictors of neuropathy . Results 1. Sociology-demographic characteristics of the study participants A total of 470 individuals were interviewed, for a response rate of 94.2%. Twenty-nine households with an estimated number of 29 (5.8%) individuals were nonrespondents. The minimum and maximum ages of the participants were 7 years and 103 years, respectively, with a mean ± SD of 33.9 ± 17.8 years. Approximately 80.6% of the participants were adults aged greater than 19 years. The male to female ratio of the study participants was 1:1. Fifty percent of the participants were females. Most of the participants (40%) had not received formal education, approximately 38.9% had not ever married, approximately 41.1% were farmers, and 40% had a family size of more than five (Table 1 ). Table 1 Socioeconomic characteristics of participants in the Delanta district Amhara region, Ethiopia. Variable Category Frequency percentage% Age of respondents less than 180 91 19.4 19–34 197 41.8 35–44 60 12.8 greater than 45 122 26.0 Marital status Unmarried 183 38.9 Married 246 52.3 Divorced 19 4.0 Widowed 22 4.7 Educational status Can’t read 109 23.2 Can read 79 16.8 1–5 74 15.7 6–8 56 11.9 9–12 57 12.1 more than 12 95 20.2 occupational status Farmer 193 41.1 Student 130 27.7 Merchant 22 4.7 government employed 83 17.7 Housewife 37 7.9 Other 5 1.1 Family size less than 5 279 59.4 5 and a above 191 40.6 2. Participants’ knowledge of neurolathyrism and grass pea More than half (56.8%) were aware that grass pea contains harmful substances. Two-fifths (40%) of them reported that the consumption of grass pea carries health risks. A high level of awareness of Yeguaya Beshita was observed among the surveyed population, with 97.9% indicating prior knowledge of the term. 'Yeguaya Beshita' likely refers to neurolathyrism, indicating widespread recognition of the disease within the community. In addition, 68.1% of the respondents reported having knowledge of the cause of the disease. This suggests a moderate level of understanding within the community regarding the etiology or contributing factors associated with neurolathyrism. A significant proportion (56.8%) of the surveyed population perceived grass pea to contain a harmful substance. Two-fifths (40%) of them reported that the consumption of grass pea carries health risks. This perception may influence dietary choices and agricultural practices, potentially impacting the prevalence of neurolathyrism in the community. Only a small percentage (5.5%) of respondents believed that Yeguaya Beshita was curable. This perception may also reflect a common belief in the chronic nature of neurolathyrism or a lack of awareness regarding available treatment options. A vast majority (86%) of respondents believe that Yeguaya Beshita is preventable. This highlights a positive attitude toward reducing the incidence of neurolathyrism through preventive measures and interventions. Two-thirds (67%) of the surveyed population reported knowledge of mechanisms to avoid the harmful substance associated with neurolathyrism. This indicates a moderate level of awareness regarding preventive measures aimed at reducing the risk of disease transmission (Table 2 ). Table 2 Knowledge about lathyrism among participants in the Delanta district Amhara region, Ethiopia. (n = 470) Questions Yes No I do not know Have you heard lathyrism disease before? 460 (97.8%) 4 (0.9%) 9 (1.3%) Does grass pea have a harmful substance? 267(56.8%) 179 (38.1%) 24 (5.1) Does lathyrism, ‘yeguaya beshita’ curable? 26 (5.5%) 424(90.2%) 20(4.3%) Is ‘yeguaya beshita’ preventable? 404 (86%) 50(10.6%) 16(3.4%) Do you know the harmful substance avoidance mechanism? 315(67%) 81(17.2%) 74(15.7) 3. Dietary Patterns and Food Preparation Methods The findings reveal significant insights into dietary habits and food preparation methods among individuals in the Delanta area of the Amhara Region, Ethiopia. One hundred percent of the participants reported using grass pea as their primary food source. This indicates a widespread reliance on grass pea within the studied population, suggesting its importance as a staple food item in the region. The majority of participants, 434 individuals (96.3%), reported consuming grass pea in the form of sauce. This indicates that preparing grass pea as a sauce is the most prevalent cooking method used by the population. Only 10 individuals (2.1%) reported consuming grass pea in the form of pancakes, 3 (0.6%) reported consuming it in its roasted form, 2 individuals (0.4%) reported consuming it raw. Similarly, only 3 individuals (0.6%) reported consuming it boiled, and a total of 8 individuals (1.8%) reported consuming it in the form of bread. 4. Prevalence of Neurolathyrism and Symptoms in Patients Among the surveyed patients, 11.9% were diagnosed with Lathyrism disease. This indicates that a significant portion of the population is affected by this condition. The median age of the patients was 41 years, with an interquartile range of 16–103 years. Eighteen of the patients were in the age range of 31 to 40. The majority of the patients were male (69.6%). The median family number within a household is 4, with an interquartile range of ( 1 – 8 ). Among those diagnosed with lathyrism, 16% reported experiencing stiffness. Stiffness can significantly impair mobility and reduce quality of life for affected individuals. All patients diagnosed with lathyrism (100%) reported experiencing walking difficulty. This underscores the debilitating nature of the disease and its impact on mobility. A majority of patients (62.5%) reported experiencing tingling or numbness sensations. These sensory symptoms are common manifestations of neurological damage associated with lathyrism. A significant proportion (57%) of patients exhibited a spastic gait characterized by stiff, jerky movements. Nearly one-fifth (19.6%) of patients reported toe walking, which can be indicative of muscle weakness or contractures in the lower limbs. All patients with lathyrism (100%) exhibited flexion of the spine. Spinal deformities are common in advanced stages of the disease and can further exacerbate mobility issues. A vast majority (96.4%) of patients relied on a walking stick for mobility assistance. Walking aids are essential for improving stability and independence in individuals with lathyrism. Among those using walking sticks, the majority (78.6%) used one stick, while a smaller proportion (17.8%) used two sticks. This reflects varying degrees of mobility impairment among patients. A small percentage (3.6%) of patients were bedridden due to complete loss of leg use and contracture. Severe cases of lathyrism can lead to permanent disability and loss of functional independence. 5. Psychosocial status of patients with Neurolathyrism. The findings revealed that 21.4% of the participants experienced divorce following the onset of the disease. Among those who divorced, 50% attributed their separation to issues related to stigma and conflict. Furthermore, 73.2% of the participants did not attend classes, indicating a significant disruption in educational activities. Additionally, 46.4% of them were attributed to a lack of support from their relative and society. 6. Multivariate analysis of factors associated with neurolathyrism in Delanta, Amhara Region, Ethiopia, 2022. The multivariable analysis revealed several significant findings regarding the associations between various individual- and household-level variables and neurolathyrism. Individuals with an age-adjusted odds ratio (AOR) of 4.87 (95% CI: 1.765–13.443) were significantly more likely to be associated with neurolathyrism, indicating that older individuals were almost five times more likely to have this condition than younger individuals were. Compared with males, females had an AOR of 31% (95% CI: 0.165–0.678), signifying that they were significantly less likely to be associated with neurolathyrism. Families with a smaller size had an AOR of 42.9 (95% CI: 0.218–0.843), indicating a significant association with neurolathyrism. This suggests that smaller families were significantly less likely to be associated with the condition compared to larger families. Households with a farmland lease had an AOR of 39.1 (95% CI: 0.154–0.765), suggesting a significant association with neurolathyrism. This indicates that households with a farmland lease were significantly less likely to be associated with the condition compared to those without a farmland lease (Tables 3 and 4 ). Table 3 Distribution and unadjusted ORs of neurolathyrisim-affected and nonaffected individuals. Variable Category Affected Nonaffected COR(CI) P Value Gender Male 39(69.6) 196(47.3) 2.55(1.39–4.65) .002 Female 17(30.4) 218(52.7) 1 Family number in a household Less than 5 41(73.2) 238(57.5) 2.02(1.084–3.76) 0.027 5 and above 15(26.8%) 176(42.5%) 1 Marital status Married 34(60.7) 212(51.2) 11.048(3.68–33.09) .000 Unmarried 9(16.1) 174(42.0) 3.563(1.39–9.13) .008 Divorced 5(8.9) 14(3.4) 1.600(0.419–6.11) .492 Widowed 8(14.3) 14(3.4) 1 Age 7–25 7(12.5) 175(42.3) 1 26–45 23(41.1) 160(38.6) 2.289(1.229–4.226) 0.09 > 46 26(46.4) 79(19.1) 8.228(3.427–19.754) < 0.01 Educational status Can’t read 26(46.4) 83(20.0) 4.59(2.39-8/79) < 0.01 Can read 12(21.4) 67(16.2) 1.74(0.8–3.7) 0.147 Attended school 18(32.1) 264(63.8) 1 Income 500 11(19.6) 115(27.8) 1 Farm land ownership Yes 46 (82.1) 266(64.3) 2.559(1.255–5.220) 010 No 10(17.9) 148(35.7) 1 Leasing the land Yes 14 (25) 38(9.2) 3.298(1.653–6.581) .001 No 42(75) 376(90.8) 1 Grass pea farm available Yes 47(83.9) 266(64.3) 2.906(1.3856.096-) 005 No 9(16.1) 148(35.7) 1 Cattle ownership Yes 36(64.3) 242(58.5) 2.906(1.385–6.096) .005 no 20(35.7) 172(41.5) 1 These findings suggest that age, sex, educational status, family size, and farm land lease are all significantly associated with neurolathyrism in the multivariable analysis after adjusting for potential confounding variables. These results may help in understanding the risk factors and developing targeted interventions for the prevention and management of neurolathyrism. Table 4 Multivariable analysis of factors associated with neurolathyrism in Delanta, Amhara Region, Ethiopia, 2022. Variables Neurolathyrism Not neurolathyrism AOR CI sex Female 17(30.4) 218(52.7) 1 1 Male 39(69.6) 196(47.3) 0.317 0.165–0.678 Family size Less than 5 41(73.2) 238(57.5) 0.429 0.218–0.843 Greater than 5 15(26.8) 176(42.5) 1 1 Farmland ownership Yes 46 (82.1) 266(64.3) 0.391 0.175–0.870 No 10(17.9) 148(35.7) 1 1 Leasing the land Yes 14 (25) 38(9.2) 0.343 0.154–0.765 No 42(75) 376(90.8) 1 1 Table 5 Multivariable analysis of factors associated with neurolathyrism in Delanta, Amhara Region, Ethiopia. Variables AOR CI P value Sex(male) 3.569 1.794–7.098 46) 2.690 1.064–9.341 0.038 Educational status (can’t read) 3.128 1.224–7.993 0.017 Family number (less than 5) 2.332 1.159–4.692 0.018 Farmland ownership(yes) 1.857 0.727–4.741 0.196 Leasing the land(yes) 2.734 1.23–6.06 0.013 Cattle ownership(yes) 1.017 0.488–2.12 0.96 Discussion This study on the prevalence, associated factors, and social status of patients with neurolathyrism in Delanta, Ethiopia, sheds light on the significant health burden posed by this condition and its wider societal implications. The findings revealed a considerable prevalence of neurolathyrism among the study participants, with 11.9% reporting being afflicted by the disease. At the population level, the prevalence of neurolathyrism in the Delanta district was estimated to be 6.6%. The identified prevalence rates underscore the importance of addressing neurolathyrism as a public health priority in the region. Neurolathyrism, primarily caused by the consumption of the legume Lathyrus sativus, can result in severe neurological impairment, significantly impacting the quality of life of affected individuals. The higher household prevalence compared to population prevalence suggests that the condition may disproportionately affect certain households or communities. This highlights the importance of targeting interventions at the household level to address specific risk factors and mitigate the impact of neurolathyrism on affected individuals and families. The findings also highlight the urgent need for targeted interventions aimed at the prevention, early detection, and management of neurolathyrism within the community. The above findings regarding the prevalence, associated factors, and social status of patients treated with Neurolathyrisim were supported by reports from previous studies conducted elsewhere. Various studies conducted in different countries reported that one of the consequences of Lathyrus sativus is severe neurological impairment, which significantly impacts the quality of life of affected individuals.( 12 , 14 , 19 , 20 ) This study further explored the factors associated with the incidence of neurolathyrism. At the individual level, age, sex, and educational status emerged as significant variables. Older individuals were found to be at greater risk of developing neurolathyrism, possibly due to prolonged exposure to risk factors or reduced adaptive capacity. Additionally, male sex was associated with increased odds of neurolathyrism, indicating potential gender-specific vulnerabilities. The biological underpinnings of male vulnerability to neurolathyrism warrant careful examination. Hormonal differences between sexes, genetic predispositions, and variations in metabolic pathways are among the factors that might contribute to this phenomenon. Additionally, sociocultural factors influencing dietary habits and access to alternative food sources may exacerbate this disparity. Educational status also played a significant role, with lower levels of education being associated with higher odds of the disease, highlighting the importance of health literacy and awareness in disease prevention. At the household level, family size and farmland leases were identified as significant determinants of neurolathyrism. Larger families may face increased challenges in ensuring dietary diversity and food security, potentially contributing to a greater prevalence of neurolathyrism. Similarly, farm land leases, reflecting socioeconomic status and access to resources, emerged as a significant factor, underscoring the socioeconomic determinants of health. The study also highlights the profound social consequences experienced by individuals affected by neurolathyrism. A significant proportion of patients discontinued their education due to lack of support, while a notable percentage experienced marital dissolution following the onset of the disease. These findings underscore the broader socioeconomic impact of neurolathyrism, including educational disruption and social isolation, further emphasizing the need for comprehensive support mechanisms for affected individuals and their families. In conclusion, the findings of this study provide valuable insights into the prevalence, associated factors, and social status of patients with neurolathyrism in the Delta, Ethiopia. By identifying key determinants at both the individual and household levels, this study offers valuable information for the development of targeted interventions aimed at the prevention and management of neurolathyrism. Moreover, the study highlights the importance of addressing the broader socioeconomic impact of the disease to ensure the well-being and inclusion of affected individuals within the community. Collaborative efforts involving healthcare professionals, policymakers, and community stakeholders are essential for addressing the multidimensional challenges posed by neurolathyrism and improving the health outcomes of affected populations. Limitations of the Study This cross-sectional study on the prevalence, associated factors, and social status of patients with Neurolathyrisim in Delanta, Amhara Region, Ethiopia, provides valuable insights into the epidemiology of this condition. However, it is essential to acknowledge the limitations inherent in the study methodology to ensure the appropriate interpretation and application of its findings. First, cross-sectional studies provide a snapshot of a population at a single point in time, making it challenging to establish temporal relationships between variables. In the context of neurolathyrisim, causality between associated factors and conditions cannot be determined due to the lack of longitudinal data. Second, the cross-sectional design does not allow for the establishment of causal relationships between exposure and outcome. Although the study identified associated factors, it cannot be conclusively determined whether these factors directly contribute to the development of Neurolathyrisim or are merely correlated. Third, the study's findings might not be generalizable to the broader population of Delanta or the Amhara Region due to the sampling method employed. The prevalence rates and associated factors identified may not accurately reflect the entire population's characteristics. Fourth, the diagnosis of neurolathyrisim might rely on clinical assessments or self-reported symptoms, which could introduce misclassification bias. Without standardized diagnostic criteria or confirmatory tests, the accuracy of prevalence estimates may be compromised. Moreover, the study may not have accounted for all potential confounding variables that could influence the association between these factors and Neurolathyrisim. Unmeasured confounders could distort the observed relationships, leading to spurious conclusions. Even participants may underreport or overreport certain information due to social desirability bias or recall bias. This could affect the validity of the data collected, particularly regarding sensitive topics or behaviors associated with Neurolathyrisim. Nevertheless, while the study of Neurolathyrisim in Delanta, Amhara Region, Ethiopia, provides valuable insights into the prevalence and associated factors of this condition, it is essential to interpret the findings within the context of its limitations. Future research employing longitudinal designs, probability sampling methods, and standardized diagnostic criteria can address some of these limitations and provide a more comprehensive understanding of Neurolathyrisim and its determinants. Conclusions The prevalence, associated factors and social support status of patients with neurolathyrism in Delanta district, Ethiopia, became evident. The findings of this study provide valuable insights into communities’ awareness, perceptions, and beliefs regarding neurolathyrism, as well as their knowledge of preventive measures. Addressing misconceptions and promoting an accurate understanding of the disease, its causes, and prevention strategies are essential for effective public health interventions aimed at reducing the burden of neurolathyrism within the population. These findings also highlight the diverse array of physical symptoms experienced by patients with lathyrism, ranging from mobility difficulties to sensory and motor impairments. Understanding these symptoms is crucial for healthcare professionals in diagnosing and managing the condition effectively, as well as for developing targeted interventions to improve the quality of life for affected individuals. Moreover, these findings underscore the multifaceted challenges faced by individuals dealing with disease, including social, emotional, and educational ramifications. Further research and interventions are warranted to address these complex issues and provide adequate support for affected Abbreviations BC, Before Christ; FMOH, Federal Ministry of Health; SPSS, Statistical Package of Social Sciences Declarations Ethics approval and consent to participate Ethical clearance and approval of the research protocol were obtained from the Amhara Regional Health Bureau (APHI-Amhara Public Health Institute Dessie Branch). Consent for publication Not applicable Availability of data and materials The datasets used and/or analyzed during the current study are available from the corresponding author upon reasonable request. Competing interests The authors declare that they have no competing interests. Funding The funding body had no role in the design of the study; the data acquisition, analysis, or interpretation; or the writing of the manuscript. Acknowledgments First, our gratitude goes to the Medical Research Lounge for their provision of the chance to conduct this research. Second, our gratitude goes to Dr. Tigist Workneh for facilitating the proposal write up. Finally, we are grateful for those who participated actively and positively from the inception to the final report of the research project. Author Contributions All authors made a significant contribution to the work reported, whether in the conception, study design, execution, acquisition of data, analysis and interpretation, or in all these areas; took part in drafting, revising, or critically reviewing the article; gave final approval of the version to be published; agreed on the journal to which the article has been submitted; and agreed to be accountable for all aspects of the work. References Van Moorhem M. Study of the etiology of neurolathyrism, a human neurodegenerative disease with nutritional causes [Internet] [dissertation]. Ghent University; 2011 [cited 2024 Apr 4]. Available from: http://hdl.handle.net/1854/LU-4096675 Singh SP, Bhawnani D, Parihar A, Verma N. An epidemiological study on incidence and determinants of Lathyrism. J Community Health Manag. 3(3):113–22. Tj N, Dl A. Neuroprotective versus tumorigenic protein kinase C activators. Trends Biochem Sci [Internet]. 2009 Mar [cited 2024 Apr 4];34(3). Available from: https://pubmed.ncbi.nlm.nih.gov/19233655/ Spencer PS, Palmer VS. Lathyrism: aqueous leaching reduces grass-pea neurotoxicity. Lancet Lond Engl. 2003 Nov 29;362(9398):1775–6. Spencer PS, Roy DN, Ludolph A, Hugon J, Dwivedi MP, Schaumburg HH. Lathyrism: evidence for role of the neuroexcitatory aminoacid BOAA. Lancet Lond Engl. 1986 Nov 8;2(8515):1066–7. Getahun H, Lambein F, Vanhoorne M, Van der Stuyft P. Pattern and associated factors of the neurolathyrism epidemic in Ethiopia. Trop Med Int Health TM IH. 2002 Feb;7(2):118–24. Khandare AL, Kumar RH, Meshram II, Arlappa N, Laxmaiah A, Venkaiah K, et al. Current scenario of consumption of Lathyrus sativus and lathyrism in three districts of Chhattisgarh State, India. Toxicon Off J Int Soc Toxinology. 2018 Aug;150:228–34. Getahun H, Haimanot RT. Psychosocial assessment of lathyrism patients in rural Estie district of South Gondar, northern Ethiopia. Ethiop Med J. 1998 Jan;36(1):9–18. Singh SS, Rao SLN. Lessons from neurolathyrism: A disease of the past & the future of Lathyrus sativus (Khesari dal). Indian J Med Res. 2013 Jul;138(1):32–7. Bick AS, Meiner Z, Gotkine M, Levin N. Using Advanced Imaging Methods to Study Neurolathyrism. Isr Med Assoc J IMAJ. 2016 Jun;18(6):341–5. Van Moorhem M, Lambein F, Leybaert L. Unraveling the mechanism of β-N-oxalyl-α,β-diaminopropionic acid (β-ODAP) induced excitotoxicity and oxidative stress, relevance for neurolathyrism prevention. Food Chem Toxicol Int J Publ Br Ind Biol Res Assoc. 2011 Mar;49(3):550–5. Hussien FM, Dagnaw MM, Ahmed AY, Hassen HY. Lathyrism and Socioeconomic Disparities: A Neglected Public Health Problem in Northeast Ethiopia. Am J Trop Med Hyg. 2021 Mar 8;104(5):1889–94. Singh SP, Bhawnani D, Chauhan V, Parihar A. Current epidemiological trends of the lathyrism and determinants of cropping pattern of Lathyrus sativus in Rewa division (M.P.), India - A time series study. J Community Health Manag. 3(4):158–64. Haimanot RT, Kidane Y, Wuhib E, Kalissa A, Alemu T, Zein ZA, et al. Lathyrism in rural northwestern Ethiopia: a highly prevalent neurotoxic disorder. Int J Epidemiol. 1990 Sep;19(3):664–72. Getahun H, Mekonnen A, TekleHaimanot R, Lambein F. Epidemic of neurolathyrism in Ethiopia. Lancet Lond Engl. 1999 Jul 24;354(9175):306–7. Getahun H, Lambein F, Vanhoorne M, Van der Stuyft P. Neurolathyrism risk depends on type of grass pea preparation and on mixing with cereals and antioxidants. Trop Med Int Health TM IH. 2005 Feb;10(2):169–78. Haimanot RT, Kidane Y, Wuhib E, Kassina A, Endeshaw Y, Alemu T, et al. The epidemiology of lathyrism in north and central Ethiopia. Ethiop Med J. 1993 Jan;31(1):15–24. Girma A, Tefera B, Dadi L. Grass pea and neurolathyrism: farmers’ perception on its consumption and protective measure in North Shewa, Ethiopia. Food Chem Toxicol Int J Publ Br Ind Biol Res Assoc. 2011 Mar;49(3):668–72. Guta DD, Damene S, Assen M, Satyal P. Factors influencing household grass pea consumption and implication for lathyrism in Wollo Zone, Ethiopia. Sci Afr. 2021 Sep 1;13:e00853. GBD 2016 Neurology Collaborators. Global, regional, and national burden of neurological disorders, 1990-2016: a systematic analysis for the Global Burden of Disease Study 2016. Lancet Neurol. 2019 May;18(5):459–80. Additional Declarations No competing interests reported. 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Neurolathyrism is a neurotoxic disorder caused by the consumption of grass (lathyrus sativus) (\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e), which contains the glutamate analog neurotoxin.(\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e, \u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e) The case definition for neurolathyrism was symmetrical spastic leg weakness, subacute or insidious onset, with no sensory deficit or history of grass pea consumption prior to or at the onset of paralysis.(\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e, \u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e, \u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e) The degree of disability of patients was categorized into four groups as follows: Stage I, with a spastic gait with no need to use a walking stick and no Babinski sign (Acton's no stick stage); and Stage II, with a spastic gait with the need for one walking stick. She presented with ankle clonus and Babinski\u0026rsquo;s sign (one stick stage). Stage III: Spastic cross adductor gait with the need for two walking sticks. She presented with ankle clonus and Babinski signs (two-stick stage). Stage IV: She was bedridden with loss of leg use and contracture. The arms are strong, and pyramidal signs are present (crawler stage).(\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e)\u003c/p\u003e \u003cp\u003eLathyrism is a disorder of the central motor pathways and has been known since the ancient Hindus and Hippocrates (460\u0026ndash;377 BC) eras. In the eighteenth, nineteenth, and twentieth centuries, outbreaks of lathyrism occurred throughout Europe, North Africa, the Middle East, Afghanistan, Russia, China, and India.(\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e, \u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e, \u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e)\u003c/p\u003e \u003cp\u003eLathyrism leads to spastic paraparesis and permanent disability(\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e) and changes the general appearance of bones and joints, particularly at the knees and feet.(\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e) In addition to its clinical consequences, this disease has diverse psychological, cultural, and economic impacts (psychosocial).(\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e, \u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e, \u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e) The disease affects all individuals across the life span of 20\u0026ndash;70 years.(\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e, \u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e) Currently, the distribution of lathyrism is confined to India, Pakistan, Bangladesh, and Ethiopia, with an estimated magnitude of 1.7\u0026ndash;6%. This disorder is a historical and contemporary public health problem in Ethiopia.(\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e)\u003c/p\u003e \u003cp\u003eThree decades ago, the estimated annual incidence rate was 1.7/10,000, and the prevalence was 6/10,000 people.(\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e) In fact, grass pea usually tends to replace staple cereal-based (the edible seeds or grains of the grass family, Gramineae) diets in rural northern and central Ethiopia during times of acute food shortage(\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e), which makes this disease an important public health problem in the Ethiopian context, particularly in drought-prone areas of northern Ethiopia.(\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e, \u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e) It has been known in Ethiopia for many years, but documented historical accounts are lacking. Major epidemics struck the northwestern region of the country following the drought of the mid-1970s, and an epidemiological study in northwestern Ethiopia revealed that the prevalence of neurolathyrism varied between 0.6% and 3%. Subsequent peak occurrences of neurolathyrism cases were observed during the 1984/85 major famine and in 1994.(\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e) Another epidemic affecting 2000 people in less than one district between 1997 and 1998 in the Amhara region of Ethiopia was reported. More recently, a study performed in 2019 reported that the prevalence of lathyrism was 5.5%.(\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e)\u003c/p\u003e \u003cp\u003eAlthough neurolathyrism is of public health importance in Ethiopia, a country with very poor economic development and an unreliable food security system, it is not receiving due attention from health, agriculture or political authorities.(\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e, \u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e, \u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e, \u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e, \u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e) The reasons for this major neglect and peak occurrence of neurolathyrism cases are not known.\u003c/p\u003e \u003cp\u003eIn one study, it was reported that the presence of a neurolathyrism patient in the family was associated with illiteracy of the head of household, owning a grass pea farm and the exclusive cooking of grass pea foods using handmade traditional clay pots.(\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e)\u003c/p\u003e \u003cp\u003eThe cultivation, distribution, and use of grass peas, home-based detoxifying methods (washing, soaking, and fermentation), mixing with other crops, toxin reduction in the seed lines through breeding and genetic engineering, and the exploration of alternate crops for grass peas have been attempted in the prevention of lathyrism.(\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e, \u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e) However, in the context of Ethiopia, the banning of grass peas, either for production or consumption, is not feasible because of frequent weather changes that force farmers to crop them as alternatives, leading to overconsumption.(\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e, \u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e)\u003c/p\u003e \u003cp\u003eThis community-based cross-sectional study design aims to provide a comprehensive assessment of Neurolathyrisim in Delanta. By investigating the prevalence rates, identifying associated factors, and exploring the social status of affected individuals, this research seeks to unveil the multifaceted dimensions of this condition within the local community. The findings of this study will not only contribute to the existing body of knowledge on neurological disorders but also inform healthcare practitioners, policymakers, and researchers about the specific challenges faced by individuals with Neurolathyrisim in Delanta.\u003c/p\u003e \u003cp\u003eMoreover, understanding the social status and impact of Neurolathyrisim on affected individuals and their families will shed light on the broader implications of this condition. This knowledge can serve as a foundation for the development of community-based interventions, healthcare strategies, and public health campaigns aimed at reducing the burden of Neurolathyrisim in Delanta and similar regions.\u003c/p\u003e \u003cp\u003eIn conclusion, this research endeavors to bridge the existing gap in our understanding of Neurolathyrisim, particularly in the unique context of Delanta, Amhara Region, Ethiopia. The insights gained from this study have the potential to enhance healthcare delivery, promote community well-being, and contribute to the global discourse on neurological health disparities. Therefore, the main aim of this study was to assess the prevalence, associated factors and social support status of patients with neurolathyrism in the Delanta district, Ethiopia.\u003c/p\u003e"},{"header":"Methods and Materials","content":"\u003cdiv id=\"Sec3\" class=\"Section2\"\u003e \u003ch2\u003eStudy Design and Setting\u003c/h2\u003e \u003cp\u003eThis community-based study was conducted from February 01 to March 30, 2023, to assess the prevalence, associated factors and social support status of patients with neurolathyrism in Delanta district, Ethiopia. The Amhara Region is one of the most populous regions in Ethiopia. As of the last available census in 2007, the region had a population of more than 17\u0026nbsp;million people. The estimated size of the population of this district is 139,618. The district has 31 rural and 2 urban Kebeles with an area of 126,879 square kilometers.(\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e) The district is divided into 33 kebeles (the smallest administrative unit) and has an estimated population of 139,618.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec4\" class=\"Section2\"\u003e \u003ch2\u003eStudy Participants and Sampling\u003c/h2\u003e \u003cp\u003eThe study units were those purposely selected two rural kebeles that were affected by the neurolathyrism epidemic. All households living in the two Kebeles during the study period were eligible for the study. The sample size was calculated using the single population proportion formula,(\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e) considering a rate (p) of 5.5%, a 95% confidence interval (CI), and a 3% margin of error(\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e). By adding a 10% nonresponse rate, the final sample included 499 inhabitants of households resulting from the double proportion formula, with a power of 80%, confidence of 95%, educational status (p1\u0026thinsp;=\u0026thinsp;0.04, p2\u0026thinsp;=\u0026thinsp;0.12) and available grass pea farms (p1\u0026thinsp;=\u0026thinsp;0.04, p2\u0026thinsp;=\u0026thinsp;0.11). The proportion and largest percentage were 221, and with a nonresponse rate of 10% and adjusting for the design effect, the final sample size became 499 inhabitants of households.\u003c/p\u003e\u003c/div\u003e \u003cdiv id=\"Sec5\" class=\"Section2\"\u003e \u003ch2\u003eData collection and quality control\u003c/h2\u003e \u003cp\u003eStructured questionnaires were used to collect the required primary quantitative data from all the selected households. The data collection tool was prepared in English and translated into the local language Amharic. The data collection tool was pretested to assess the participants\u0026rsquo; completeness in capturing all the variables required as per the specific objectives of the study. Quality assurance audits were carried out during the data collection process by field supervisors as well as the research team members themselves. All the data collected, documents and reports were subject to regulatory audits and inspections without hindering confidentiality. Three days of training were given to both the data collectors and the supervisors by the researchers. The training included a discussion on the objectives of the study, contents of the data collection tools, data collection techniques, and maintaining the confidentiality of the responses. Moreover, the completeness of the completed questionnaires was checked by supervisors on a daily basis.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec6\" class=\"Section2\"\u003e \u003ch2\u003eData Management and Analysis\u003c/h2\u003e \u003cp\u003eThe collected quantitative data were first entered and cleaned using Epi Info version 7.2 statistical software and then exported to SPSS software version 26.0 for analyses. Various statistical methods, such as descriptive statistics such as frequency means and standard deviations (SDs) and binary logistic regression tests, were employed to identify the predictors \u003cb\u003eof neuropathy\u003c/b\u003e.\u003c/p\u003e \u003c/div\u003e"},{"header":"Results","content":"\u003cdiv id=\"Sec8\" class=\"Section2\"\u003e \u003ch2\u003e1. Sociology-demographic characteristics of the study participants\u003c/h2\u003e \u003cp\u003eA total of 470 individuals were interviewed, for a response rate of 94.2%. Twenty-nine households with an estimated number of 29 (5.8%) individuals were nonrespondents. The minimum and maximum ages of the participants were 7 years and 103 years, respectively, with a mean\u0026thinsp;\u0026plusmn;\u0026thinsp;SD of 33.9\u0026thinsp;\u0026plusmn;\u0026thinsp;17.8 years. Approximately 80.6% of the participants were adults aged greater than 19 years. The male to female ratio of the study participants was 1:1. Fifty percent of the participants were females. Most of the participants (40%) had not received formal education, approximately 38.9% had not ever married, approximately 41.1% were farmers, and 40% had a family size of more than five (Table\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e).\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab1\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eSocioeconomic characteristics of participants in the Delanta district Amhara region, Ethiopia.\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"4\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003eVariable Category\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eFrequency\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003epercentage%\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"3\" rowspan=\"4\"\u003e \u003cp\u003eAge of respondents\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eless than 180\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e91\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e19.4\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e19\u0026ndash;34\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e197\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e41.8\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e35\u0026ndash;44\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e60\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e12.8\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003egreater than 45\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e122\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e26.0\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"3\" rowspan=\"4\"\u003e \u003cp\u003eMarital status\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eUnmarried\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e183\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e38.9\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMarried\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e246\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e52.3\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eDivorced\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e19\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e4.0\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eWidowed\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e22\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e4.7\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"5\" rowspan=\"6\"\u003e \u003cp\u003eEducational status\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eCan\u0026rsquo;t read\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e109\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e23.2\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eCan read\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e79\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e16.8\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1\u0026ndash;5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e74\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e15.7\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e6\u0026ndash;8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e56\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e11.9\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e9\u0026ndash;12\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e57\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e12.1\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003emore than 12\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e95\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e20.2\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"4\" rowspan=\"5\"\u003e \u003cp\u003eoccupational status\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eFarmer\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e193\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e41.1\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eStudent\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e130\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e27.7\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMerchant\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e22\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e4.7\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003egovernment employed\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e83\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e17.7\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eHousewife\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e37\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e7.9\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eOther\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e1.1\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eFamily size\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eless than 5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e279\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e59.4\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e5 and a above\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e191\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e40.6\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec9\" class=\"Section2\"\u003e \u003ch2\u003e2. Participants\u0026rsquo; knowledge of neurolathyrism and grass pea\u003c/h2\u003e \u003cp\u003eMore than half (56.8%) were aware that grass pea contains harmful substances. Two-fifths (40%) of them reported that the consumption of grass pea carries health risks. A high level of awareness of Yeguaya Beshita was observed among the surveyed population, with 97.9% indicating prior knowledge of the term. 'Yeguaya Beshita' likely refers to neurolathyrism, indicating widespread recognition of the disease within the community. In addition, 68.1% of the respondents reported having knowledge of the cause of the disease. This suggests a moderate level of understanding within the community regarding the etiology or contributing factors associated with neurolathyrism.\u003c/p\u003e \u003cp\u003eA significant proportion (56.8%) of the surveyed population perceived grass pea to contain a harmful substance. Two-fifths (40%) of them reported that the consumption of grass pea carries health risks. This perception may influence dietary choices and agricultural practices, potentially impacting the prevalence of neurolathyrism in the community. Only a small percentage (5.5%) of respondents believed that Yeguaya Beshita was curable. This perception may also reflect a common belief in the chronic nature of neurolathyrism or a lack of awareness regarding available treatment options. A vast majority (86%) of respondents believe that Yeguaya Beshita is preventable. This highlights a positive attitude toward reducing the incidence of neurolathyrism through preventive measures and interventions.\u003c/p\u003e \u003cp\u003eTwo-thirds (67%) of the surveyed population reported knowledge of mechanisms to avoid the harmful substance associated with neurolathyrism. This indicates a moderate level of awareness regarding preventive measures aimed at reducing the risk of disease transmission (Table\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e).\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab2\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eKnowledge about lathyrism among participants in the Delanta district Amhara region, Ethiopia. (n\u0026thinsp;=\u0026thinsp;470)\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"4\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eQuestions\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eI do not know\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHave you heard lathyrism disease before?\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e460 (97.8%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e4 (0.9%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e9 (1.3%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDoes grass pea have a harmful substance?\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e267(56.8%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e179 (38.1%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e24 (5.1)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eDoes\u003c/b\u003e lathyrism,\u003cb\u003e\u0026lsquo;yeguaya beshita\u0026rsquo; curable?\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e26 (5.5%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e424(90.2%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e20(4.3%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eIs \u0026lsquo;yeguaya beshita\u0026rsquo; preventable?\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e404 (86%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e50(10.6%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e16(3.4%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDo you know the harmful substance avoidance mechanism?\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e315(67%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e81(17.2%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e74(15.7)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec10\" class=\"Section2\"\u003e \u003ch2\u003e3. Dietary Patterns and Food Preparation Methods\u003c/h2\u003e \u003cp\u003eThe findings reveal significant insights into dietary habits and food preparation methods among individuals in the Delanta area of the Amhara Region, Ethiopia. One hundred percent of the participants reported using grass pea as their primary food source. This indicates a widespread reliance on grass pea within the studied population, suggesting its importance as a staple food item in the region. The majority of participants, 434 individuals (96.3%), reported consuming grass pea in the form of sauce. This indicates that preparing grass pea as a sauce is the most prevalent cooking method used by the population. Only 10 individuals (2.1%) reported consuming grass pea in the form of pancakes, 3 (0.6%) reported consuming it in its roasted form, 2 individuals (0.4%) reported consuming it raw. Similarly, only 3 individuals (0.6%) reported consuming it boiled, and a total of 8 individuals (1.8%) reported consuming it in the form of bread.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec11\" class=\"Section2\"\u003e \u003ch2\u003e4. Prevalence of Neurolathyrism and Symptoms in Patients\u003c/h2\u003e \u003cp\u003eAmong the surveyed patients, 11.9% were diagnosed with Lathyrism disease. This indicates that a significant portion of the population is affected by this condition.\u003c/p\u003e \u003cp\u003eThe median age of the patients was 41 years, with an interquartile range of 16\u0026ndash;103 years. Eighteen of the patients were in the age range of 31 to 40. The majority of the patients were male (69.6%). The median family number within a household is 4, with an interquartile range of (\u003cspan additionalcitationids=\"CR2 CR3 CR4 CR5 CR6 CR7\" citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eAmong those diagnosed with lathyrism, 16% reported experiencing stiffness. Stiffness can significantly impair mobility and reduce quality of life for affected individuals.\u003c/p\u003e \u003cp\u003eAll patients diagnosed with lathyrism (100%) reported experiencing walking difficulty. This underscores the debilitating nature of the disease and its impact on mobility. A majority of patients (62.5%) reported experiencing tingling or numbness sensations. These sensory symptoms are common manifestations of neurological damage associated with lathyrism. A significant proportion (57%) of patients exhibited a spastic gait characterized by stiff, jerky movements.\u003c/p\u003e \u003cp\u003eNearly one-fifth (19.6%) of patients reported toe walking, which can be indicative of muscle weakness or contractures in the lower limbs. All patients with lathyrism (100%) exhibited flexion of the spine. Spinal deformities are common in advanced stages of the disease and can further exacerbate mobility issues. A vast majority (96.4%) of patients relied on a walking stick for mobility assistance. Walking aids are essential for improving stability and independence in individuals with lathyrism. Among those using walking sticks, the majority (78.6%) used one stick, while a smaller proportion (17.8%) used two sticks. This reflects varying degrees of mobility impairment among patients. A small percentage (3.6%) of patients were bedridden due to complete loss of leg use and contracture. Severe cases of lathyrism can lead to permanent disability and loss of functional independence.\u003c/p\u003e\u003cp\u003e \u003cb\u003e5. Psychosocial status of patients with Neurolathyrism.\u003c/b\u003e \u003c/p\u003e \u003cp\u003eThe findings revealed that 21.4% of the participants experienced divorce following the onset of the disease. Among those who divorced, 50% attributed their separation to issues related to stigma and conflict. Furthermore, 73.2% of the participants did not attend classes, indicating a significant disruption in educational activities. Additionally, 46.4% of them were attributed to a lack of support from their relative and society.\u003c/p\u003e \u003cp\u003e \u003cb\u003e6. Multivariate analysis of factors associated with neurolathyrism in Delanta, Amhara Region, Ethiopia, 2022.\u003c/b\u003e \u003c/p\u003e \u003cp\u003eThe multivariable analysis revealed several significant findings regarding the associations between various individual- and household-level variables and neurolathyrism. Individuals with an age-adjusted odds ratio (AOR) of 4.87 (95% CI: 1.765\u0026ndash;13.443) were significantly more likely to be associated with neurolathyrism, indicating that older individuals were almost five times more likely to have this condition than younger individuals were. Compared with males, females had an AOR of 31% (95% CI: 0.165\u0026ndash;0.678), signifying that they were significantly less likely to be associated with neurolathyrism. Families with a smaller size had an AOR of 42.9 (95% CI: 0.218\u0026ndash;0.843), indicating a significant association with neurolathyrism. This suggests that smaller families were significantly less likely to be associated with the condition compared to larger families. Households with a farmland lease had an AOR of 39.1 (95% CI: 0.154\u0026ndash;0.765), suggesting a significant association with neurolathyrism. This indicates that households with a farmland lease were significantly less likely to be associated with the condition compared to those without a farmland lease (Tables\u0026nbsp;\u003cspan refid=\"Tab3\" class=\"InternalRef\"\u003e3\u003c/span\u003e and \u003cspan refid=\"Tab4\" class=\"InternalRef\"\u003e4\u003c/span\u003e).\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab3\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 3\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eDistribution and unadjusted ORs of neurolathyrisim-affected and nonaffected individuals.\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"6\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eVariable\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eCategory\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eAffected\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eNonaffected\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003eCOR(CI)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e \u003cp\u003eP Value\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eGender\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e39(69.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e196(47.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e2.55(1.39\u0026ndash;4.65)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u003cb\u003e.002\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eFemale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e17(30.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e218(52.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eFamily number in a household\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eLess than 5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e41(73.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e238(57.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e2.02(1.084\u0026ndash;3.76)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.027\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e5 and above\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e15(26.8%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e176(42.5%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"3\" rowspan=\"4\"\u003e \u003cp\u003eMarital status\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMarried\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e34(60.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e212(51.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e11.048(3.68\u0026ndash;33.09)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e.000\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eUnmarried\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e9(16.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e174(42.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e3.563(1.39\u0026ndash;9.13)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e.008\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eDivorced\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e5(8.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e14(3.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1.600(0.419\u0026ndash;6.11)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e.492\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eWidowed\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e8(14.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e14(3.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003eAge\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e7\u0026ndash;25\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e7(12.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e175(42.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e26\u0026ndash;45\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e23(41.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e160(38.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e2.289(1.229\u0026ndash;4.226)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.09\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u0026gt;\u0026thinsp;46\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e26(46.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e79(19.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e8.228(3.427\u0026ndash;19.754)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.01\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003eEducational status\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eCan\u0026rsquo;t read\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e26(46.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e83(20.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e4.59(2.39-8/79)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.01\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eCan read\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e12(21.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e67(16.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1.74(0.8\u0026ndash;3.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.147\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eAttended school\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e18(32.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e264(63.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eIncome\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;500\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e45(80.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e299(72.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1.573(0.78\u0026ndash;3.148)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.2\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u0026gt;\u0026thinsp;500\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e11(19.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e115(27.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eFarm land ownership\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e46 (82.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e266(64.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e2.559(1.255\u0026ndash;5.220)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e010\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e10(17.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e148(35.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eLeasing the land\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e14 (25)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e38(9.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e3.298(1.653\u0026ndash;6.581)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e42(75)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e376(90.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eGrass pea farm available\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e47(83.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e266(64.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e2.906(1.3856.096-)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e005\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e9(16.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e148(35.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eCattle ownership\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e36(64.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e242(58.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e2.906(1.385\u0026ndash;6.096)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e.005\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eno\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e20(35.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e172(41.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eThese findings suggest that age, sex, educational status, family size, and farm land lease are all significantly associated with neurolathyrism in the multivariable analysis after adjusting for potential confounding variables. These results may help in understanding the risk factors and developing targeted interventions for the prevention and management of neurolathyrism.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab4\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 4\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eMultivariable analysis of factors associated with neurolathyrism in Delanta, Amhara Region, Ethiopia, 2022.\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"6\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eVariables\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eNeurolathyrism\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eNot neurolathyrism\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003eAOR\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e \u003cp\u003eCI\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e\u003cb\u003esex\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eFemale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e17(30.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e218(52.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e39(69.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e196(47.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.317\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.165\u0026ndash;0.678\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e\u003cb\u003eFamily size\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eLess than 5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e41(73.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e238(57.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.429\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.218\u0026ndash;0.843\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eGreater than 5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e15(26.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e176(42.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e\u003cb\u003eFarmland ownership\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e46 (82.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e266(64.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.391\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.175\u0026ndash;0.870\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e10(17.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e148(35.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e\u003cb\u003eLeasing the land\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e14 (25)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e38(9.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.343\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.154\u0026ndash;0.765\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e42(75)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e376(90.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab5\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 5\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eMultivariable analysis of factors associated with neurolathyrism in Delanta, Amhara Region, Ethiopia.\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"4\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eVariables\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eAOR\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eCI\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eP value\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSex(male)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e3.569\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e1.794\u0026ndash;7.098\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.01\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAge(\u0026gt;\u0026thinsp;46)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e2.690\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e1.064\u0026ndash;9.341\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.038\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eEducational status (can\u0026rsquo;t read)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e3.128\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e1.224\u0026ndash;7.993\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.017\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFamily number (less than 5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e2.332\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e1.159\u0026ndash;4.692\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.018\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFarmland ownership(yes)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e1.857\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.727\u0026ndash;4.741\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.196\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eLeasing the land(yes)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e2.734\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e1.23\u0026ndash;6.06\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.013\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCattle ownership(yes)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e1.017\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.488\u0026ndash;2.12\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.96\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003c/div\u003e"},{"header":"Discussion","content":"\u003cp\u003eThis study on the prevalence, associated factors, and social status of patients with neurolathyrism in Delanta, Ethiopia, sheds light on the significant health burden posed by this condition and its wider societal implications. The findings revealed a considerable prevalence of neurolathyrism among the study participants, with 11.9% reporting being afflicted by the disease. At the population level, the prevalence of neurolathyrism in the Delanta district was estimated to be 6.6%.\u003c/p\u003e \u003cp\u003eThe identified prevalence rates underscore the importance of addressing neurolathyrism as a public health priority in the region. Neurolathyrism, primarily caused by the consumption of the legume Lathyrus sativus, can result in severe neurological impairment, significantly impacting the quality of life of affected individuals. The higher household prevalence compared to population prevalence suggests that the condition may disproportionately affect certain households or communities. This highlights the importance of targeting interventions at the household level to address specific risk factors and mitigate the impact of neurolathyrism on affected individuals and families. The findings also highlight the urgent need for targeted interventions aimed at the prevention, early detection, and management of neurolathyrism within the community.\u003c/p\u003e \u003cp\u003eThe above findings regarding the prevalence, associated factors, and social status of \u003cb\u003epatients treated\u003c/b\u003e with Neurolathyrisim were supported by reports from previous studies conducted elsewhere. Various studies conducted in different countries reported that one of the consequences of Lathyrus sativus is severe neurological impairment, which significantly impacts the quality of life of affected individuals.(\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e, \u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e, \u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e, \u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e)\u003c/p\u003e \u003cp\u003eThis study further explored the factors associated with the incidence of neurolathyrism. At the individual level, age, sex, and educational status emerged as significant variables. Older individuals were found to be at greater risk of developing neurolathyrism, possibly due to prolonged exposure to risk factors or reduced adaptive capacity. Additionally, male sex was associated with increased odds of neurolathyrism, indicating potential gender-specific vulnerabilities. The biological underpinnings of male vulnerability to neurolathyrism warrant careful examination. Hormonal differences between sexes, genetic predispositions, and variations in metabolic pathways are among the factors that might contribute to this phenomenon. Additionally, sociocultural factors influencing dietary habits and access to alternative food sources may exacerbate this disparity.\u003c/p\u003e \u003cp\u003eEducational status also played a significant role, with lower levels of education being associated with higher odds of the disease, highlighting the importance of health literacy and awareness in disease prevention.\u003c/p\u003e \u003cp\u003eAt the household level, family size and farmland leases were identified as significant determinants of neurolathyrism. Larger families may face increased challenges in ensuring dietary diversity and food security, potentially contributing to a greater prevalence of neurolathyrism. Similarly, farm land leases, reflecting socioeconomic status and access to resources, emerged as a significant factor, underscoring the socioeconomic determinants of health.\u003c/p\u003e \u003cp\u003eThe study also highlights the profound social consequences experienced by individuals affected by neurolathyrism. A significant proportion of patients discontinued their education due to lack of support, while a notable percentage experienced marital dissolution following the onset of the disease. These findings underscore the broader socioeconomic impact of neurolathyrism, including educational disruption and social isolation, further emphasizing the need for comprehensive support mechanisms for affected individuals and their families.\u003c/p\u003e \u003cp\u003eIn conclusion, the findings of this study provide valuable insights into the prevalence, associated factors, and social status of patients with neurolathyrism in the Delta, Ethiopia. By identifying key determinants at both the individual and household levels, this study offers valuable information for the development of targeted interventions aimed at the prevention and management of neurolathyrism. Moreover, the study highlights the importance of addressing the broader socioeconomic impact of the disease to ensure the well-being and inclusion of affected individuals within the community. Collaborative efforts involving healthcare professionals, policymakers, and community stakeholders are essential for addressing the multidimensional challenges posed by neurolathyrism and improving the health outcomes of affected populations.\u003c/p\u003e \u003cdiv id=\"Sec13\" class=\"Section2\"\u003e \u003ch2\u003eLimitations of the Study\u003c/h2\u003e \u003cp\u003eThis cross-sectional study on the prevalence, associated factors, and social status of patients with Neurolathyrisim in Delanta, Amhara Region, Ethiopia, provides valuable insights into the epidemiology of this condition. However, it is essential to acknowledge the limitations inherent in the study methodology to ensure the appropriate interpretation and application of its findings.\u003c/p\u003e \u003cp\u003eFirst, cross-sectional studies provide a snapshot of a population at a single point in time, making it challenging to establish temporal relationships between variables. In the context of neurolathyrisim, causality between associated factors and conditions cannot be determined due to the lack of longitudinal data. Second, the cross-sectional design does not allow for the establishment of causal relationships between exposure and outcome. Although the study identified associated factors, it cannot be conclusively determined whether these factors directly contribute to the development of Neurolathyrisim or are merely correlated. Third, the study's findings might not be generalizable to the broader population of Delanta or the Amhara Region due to the sampling method employed. The prevalence rates and associated factors identified may not accurately reflect the entire population's characteristics. Fourth, the diagnosis of neurolathyrisim might rely on clinical assessments or self-reported symptoms, which could introduce misclassification bias. Without standardized diagnostic criteria or confirmatory tests, the accuracy of prevalence estimates may be compromised.\u003c/p\u003e \u003cp\u003eMoreover, the study may not have accounted for all potential confounding variables that could influence the association between these factors and Neurolathyrisim. Unmeasured confounders could distort the observed relationships, leading to spurious conclusions. Even participants may underreport or overreport certain information due to social desirability bias or recall bias. This could affect the validity of the data collected, particularly regarding sensitive topics or behaviors associated with Neurolathyrisim. Nevertheless, while the study of Neurolathyrisim in Delanta, Amhara Region, Ethiopia, provides valuable insights into the prevalence and associated factors of this condition, it is essential to interpret the findings within the context of its limitations. Future research employing longitudinal designs, probability sampling methods, and standardized diagnostic criteria can address some of these limitations and provide a more comprehensive understanding of Neurolathyrisim and its determinants.\u003c/p\u003e \u003c/div\u003e"},{"header":"Conclusions","content":"\u003cp\u003eThe prevalence, associated factors and social support status of patients with neurolathyrism in Delanta district, Ethiopia, became evident. The findings of this study provide valuable insights into communities\u0026rsquo; awareness, perceptions, and beliefs regarding neurolathyrism, as well as their knowledge of preventive measures. Addressing misconceptions and promoting an accurate understanding of the disease, its causes, and prevention strategies are essential for effective public health interventions aimed at reducing the burden of neurolathyrism within the population.\u003c/p\u003e \u003cp\u003eThese findings also highlight the diverse array of physical symptoms experienced by patients with lathyrism, ranging from mobility difficulties to sensory and motor impairments. Understanding these symptoms is crucial for healthcare professionals in diagnosing and managing the condition effectively, as well as for developing targeted interventions to improve the quality of life for affected individuals. Moreover, these findings underscore the multifaceted challenges faced by individuals dealing with disease, including social, emotional, and educational ramifications. Further research and interventions are warranted to address these complex issues and provide adequate support for affected\u003c/p\u003e"},{"header":"Abbreviations","content":"\u003cp\u003eBC, Before Christ; FMOH, Federal Ministry of Health; SPSS, Statistical Package of Social Sciences\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eEthics approval and consent to participate\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eEthical clearance and approval of the research protocol were obtained from\u0026nbsp;the Amhara Regional Health Bureau\u0026nbsp;(APHI-Amhara Public Health Institute Dessie Branch).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConsent for publication\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNot applicable\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAvailability of data and materials\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe datasets used and/or analyzed during the current study are available from the corresponding author upon reasonable request.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCompeting interests\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors declare that they have no competing interests.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe funding body had no role in the design of the study; the data acquisition, analysis, or interpretation; or the writing of the manuscript.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAcknowledgments\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eFirst, our gratitude goes to the Medical Research Lounge for their provision of the chance to conduct this research. Second, our gratitude goes to Dr. Tigist Workneh for facilitating the proposal write up. Finally, we are grateful for those who participated actively and positively from the inception to the final report of the research project.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthor\u003c/strong\u003e \u003cstrong\u003eContributions\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eAll authors made a significant contribution to the work reported, whether in the conception, study design, execution, acquisition of data, analysis and interpretation, or in all these areas; took part in drafting, revising, or critically reviewing the article; gave final approval of the version to be published; agreed on the journal to which the article has been submitted; and agreed to be accountable for all aspects of the work.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n\u003cli\u003eVan Moorhem M. Study of the etiology of neurolathyrism, a human neurodegenerative disease with nutritional causes [Internet] [dissertation]. Ghent University; 2011 [cited 2024 Apr 4]. Available from: http://hdl.handle.net/1854/LU-4096675\u003c/li\u003e\n\u003cli\u003eSingh SP, Bhawnani D, Parihar A, Verma N. An epidemiological study on incidence and determinants of Lathyrism. J Community Health Manag. 3(3):113\u0026ndash;22.\u003c/li\u003e\n\u003cli\u003eTj N, Dl A. Neuroprotective versus tumorigenic protein kinase C activators. Trends Biochem Sci [Internet]. 2009 Mar [cited 2024 Apr 4];34(3). Available from: https://pubmed.ncbi.nlm.nih.gov/19233655/\u003c/li\u003e\n\u003cli\u003eSpencer PS, Palmer VS. Lathyrism: aqueous leaching reduces grass-pea neurotoxicity. Lancet Lond Engl. 2003 Nov 29;362(9398):1775\u0026ndash;6.\u003c/li\u003e\n\u003cli\u003eSpencer PS, Roy DN, Ludolph A, Hugon J, Dwivedi MP, Schaumburg HH. Lathyrism: evidence for role of the neuroexcitatory aminoacid BOAA. Lancet Lond Engl. 1986 Nov 8;2(8515):1066\u0026ndash;7.\u003c/li\u003e\n\u003cli\u003eGetahun H, Lambein F, Vanhoorne M, Van der Stuyft P. Pattern and associated factors of the neurolathyrism epidemic in Ethiopia. Trop Med Int Health TM IH. 2002 Feb;7(2):118\u0026ndash;24.\u003c/li\u003e\n\u003cli\u003eKhandare AL, Kumar RH, Meshram II, Arlappa N, Laxmaiah A, Venkaiah K, et al. Current scenario of consumption of Lathyrus sativus and lathyrism in three districts of Chhattisgarh State, India. Toxicon Off J Int Soc Toxinology. 2018 Aug;150:228\u0026ndash;34.\u003c/li\u003e\n\u003cli\u003eGetahun H, Haimanot RT. Psychosocial assessment of lathyrism patients in rural Estie district of South Gondar, northern Ethiopia. Ethiop Med J. 1998 Jan;36(1):9\u0026ndash;18.\u003c/li\u003e\n\u003cli\u003eSingh SS, Rao SLN. Lessons from neurolathyrism: A disease of the past \u0026amp; the future of Lathyrus sativus (Khesari dal). Indian J Med Res. 2013 Jul;138(1):32\u0026ndash;7.\u003c/li\u003e\n\u003cli\u003eBick AS, Meiner Z, Gotkine M, Levin N. Using Advanced Imaging Methods to Study Neurolathyrism. Isr Med Assoc J IMAJ. 2016 Jun;18(6):341\u0026ndash;5.\u003c/li\u003e\n\u003cli\u003eVan Moorhem M, Lambein F, Leybaert L. Unraveling the mechanism of \u0026beta;-N-oxalyl-\u0026alpha;,\u0026beta;-diaminopropionic acid (\u0026beta;-ODAP) induced excitotoxicity and oxidative stress, relevance for neurolathyrism prevention. Food Chem Toxicol Int J Publ Br Ind Biol Res Assoc. 2011 Mar;49(3):550\u0026ndash;5.\u003c/li\u003e\n\u003cli\u003eHussien FM, Dagnaw MM, Ahmed AY, Hassen HY. Lathyrism and Socioeconomic Disparities: A Neglected Public Health Problem in Northeast Ethiopia. Am J Trop Med Hyg. 2021 Mar 8;104(5):1889\u0026ndash;94.\u003c/li\u003e\n\u003cli\u003eSingh SP, Bhawnani D, Chauhan V, Parihar A. Current epidemiological trends of the lathyrism and determinants of cropping pattern of Lathyrus sativus in Rewa division (M.P.), India - A time series study. J Community Health Manag. 3(4):158\u0026ndash;64.\u003c/li\u003e\n\u003cli\u003eHaimanot RT, Kidane Y, Wuhib E, Kalissa A, Alemu T, Zein ZA, et al. Lathyrism in rural northwestern Ethiopia: a highly prevalent neurotoxic disorder. Int J Epidemiol. 1990 Sep;19(3):664\u0026ndash;72.\u003c/li\u003e\n\u003cli\u003eGetahun H, Mekonnen A, TekleHaimanot R, Lambein F. Epidemic of neurolathyrism in Ethiopia. Lancet Lond Engl. 1999 Jul 24;354(9175):306\u0026ndash;7.\u003c/li\u003e\n\u003cli\u003eGetahun H, Lambein F, Vanhoorne M, Van der Stuyft P. Neurolathyrism risk depends on type of grass pea preparation and on mixing with cereals and antioxidants. Trop Med Int Health TM IH. 2005 Feb;10(2):169\u0026ndash;78.\u003c/li\u003e\n\u003cli\u003eHaimanot RT, Kidane Y, Wuhib E, Kassina A, Endeshaw Y, Alemu T, et al. The epidemiology of lathyrism in north and central Ethiopia. Ethiop Med J. 1993 Jan;31(1):15\u0026ndash;24.\u003c/li\u003e\n\u003cli\u003eGirma A, Tefera B, Dadi L. Grass pea and neurolathyrism: farmers\u0026rsquo; perception on its consumption and protective measure in North Shewa, Ethiopia. Food Chem Toxicol Int J Publ Br Ind Biol Res Assoc. 2011 Mar;49(3):668\u0026ndash;72.\u003c/li\u003e\n\u003cli\u003eGuta DD, Damene S, Assen M, Satyal P. Factors influencing household grass pea consumption and implication for lathyrism in Wollo Zone, Ethiopia. Sci Afr. 2021 Sep 1;13:e00853.\u003c/li\u003e\n\u003cli\u003eGBD 2016 Neurology Collaborators. Global, regional, and national burden of neurological disorders, 1990-2016: a systematic analysis for the Global Burden of Disease Study 2016. Lancet Neurol. 2019 May;18(5):459\u0026ndash;80.\u003c/li\u003e\n\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":true,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"bmc-neurology","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"nurl","sideBox":"Learn more about [BMC Neurology](http://bmcneurol.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/nurl","title":"BMC Neurology","twitterHandle":"BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"Neurolathyrisim, prevalence, associated factors, social status, neurological conditions","lastPublishedDoi":"10.21203/rs.3.rs-4332232/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-4332232/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e\u003cstrong\u003eBackground: \u003c/strong\u003eNeurolathyrism, a debilitating neurodegenerative disorder associated with the consumption of the legume Lathyrus sativus, is a significant public health challenge globally, with a particular prevalence in various regions of Ethiopia. This research investigated the prevalence, associated factors, and social status of patients afflicted by neurolathyrism, specifically focusing on the Amhara region of Ethiopia.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eObjective of the study\u003c/strong\u003e: To assess the prevalence, associated factors and social support status of patients with neurolathyrism in Delanta district, Ethiopia.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eMethodology: \u003c/strong\u003eA community-basedcross-sectional survey was conducted from November to December 2022 among 480 randomly selected individuals in the Delanta district in the Amhara region. A multistage sampling technique was employed. The data were collected using a structured questionnaire after providing written informed consent from each participant. The collected data were cleaned and analyzed using the statistical software Epi version 7.2 and SPSS version 26.0, respectively. Descriptive statistics and multivariable logistic regression models were used. Statistical significance was determined using a P value \u003cu\u003e\u0026lt;\u003c/u\u003e0.05. Associations were measured by odds ratios (ORs). Predictors of nonadherence were identified using bivariable and multivariable logistic regression analysis. Factors with a P value of 0.2 or less in the bivariable analysis were selected for further multivariable analysis and entered into a logistic regression model.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eResults: \u003c/strong\u003eOf the 470 individual study participants, 56 (11.9%) reported having neurolathyrism, and at the population level, the prevalence of neurolathyrism in the Delanta district was 6.6%. Age (AOR = 4.87 (CI 1.765-13.443), male sex (AOR = 23% (CI 0.003, 0.302), and educational status (AOR =33.8% (CI 0.025–4.498)) were the individual-level variables; family size (AOR = 30.8 (CI 0.139-0.682) and farm land lease (AOR = 29.3 (CI 0.106–0.811) were the household-level variables found to have significant associations with neurolathyrism. Seventeen-thirds (73%) of the neurolathyrism patients discontinued school because of a lack of support; among them, 21.4% were divorced after the disease.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConclusion\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eIn conclusion, our study has illuminated a concerning reality—the prevalence of neurolathyrism is notably high within the population under investigation. This finding underscores the pressing need for immediate attention and targeted interventions to address the burgeoning impact of this neurodegenerative disorder. The elevated prevalence rates identified in our study underscore the urgency of adopting a multifaceted approach to mitigating the risk factors associated with neurolathyrism. Considering that a significant number of victims suffer from irreversible damage from the disease in different seasons, policies and programs should focus on the prevention of lathyrism. Government officials should pronounce the problem as a major national public health problem and include it in the disease reporting system of the Ethiopian Ministry of Health.\u003c/p\u003e","manuscriptTitle":"Prevalence, Associated Factors, and Social Status of Patients with Neurolathyrisim in Delanta, Amhara Region, Ethiopia: A Community-Based Cross- Sectional Study","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2024-05-03 11:06:28","doi":"10.21203/rs.3.rs-4332232/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"decision","content":"Revision requested","date":"2025-07-26T10:54:38+00:00","index":"","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2025-07-22T05:41:12+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"141364062630511084202068805529793362196","date":"2025-07-20T09:39:02+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"14744697775335684104369397098633481150","date":"2025-07-20T07:31:44+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2025-06-24T08:40:49+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"282504854433832243558655562133238964463","date":"2025-06-12T08:48:47+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"281348398719954151209843048641774272151","date":"2025-04-06T11:49:32+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2024-09-15T11:48:35+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"281968893037221472868615832524543634120","date":"2024-09-06T13:32:55+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"3929907200706924782329270218430797432","date":"2024-08-28T14:56:03+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"89689185005118955713357213883161378162","date":"2024-08-22T16:22:59+00:00","index":"hide","fulltext":""},{"type":"reviewersInvited","content":"","date":"2024-08-22T15:22:33+00:00","index":"","fulltext":""},{"type":"editorInvited","content":"","date":"2024-04-29T19:34:16+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2024-04-28T23:26:12+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2024-04-28T23:26:12+00:00","index":"","fulltext":""},{"type":"submitted","content":"BMC Neurology","date":"2024-04-27T03:49:30+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"bmc-neurology","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"nurl","sideBox":"Learn more about [BMC Neurology](http://bmcneurol.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/nurl","title":"BMC Neurology","twitterHandle":"BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"69555af9-16b8-46f8-91b7-b015bd687c20","owner":[],"postedDate":"May 3rd, 2024","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"published-in-journal","subjectAreas":[],"tags":[],"updatedAt":"2026-04-13T16:09:46+00:00","versionOfRecord":{"articleIdentity":"rs-4332232","link":"https://doi.org/10.1186/s12883-026-04871-z","journal":{"identity":"bmc-neurology","isVorOnly":false,"title":"BMC Neurology"},"publishedOn":"2026-04-11 15:58:28","publishedOnDateReadable":"April 11th, 2026"},"versionCreatedAt":"2024-05-03 11:06:28","video":"","vorDoi":"10.1186/s12883-026-04871-z","vorDoiUrl":"https://doi.org/10.1186/s12883-026-04871-z","workflowStages":[]},"version":"v1","identity":"rs-4332232","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-4332232","identity":"rs-4332232","version":["v1"]},"buildId":"cBFmMYwuxLRRLfASyISRj","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}