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June 1991

Outbreak of Pellagra Among Mozambican Refugees—Malawi, 1990

Arch Dermatol. 1991;127(6):791-792. doi:10.1001/archderm.1991.01680050029002

Micronutrient deficiency disorders, including pellagra, have emerged as major problems in refugee populations that depend on international relief assistance for food supplies.1,2 This report summarizes an investigation of pellagra that occurred among Mozambican refugees in Malawi during 1990. Since 1987, approximately 900 000 Mozambicans have fled armed conflict in their homeland to seek refuge in neighboring Malawi. Approximately half are housed in refugee camps; the remainder live in villages integrated with the local Malawian population. Overall refugee relief assistance is coordinated by the Office of the United Nations High Commissioner for Refugees (UNHCR). Health care is provided by Malawian Ministry of Health personnel assisted by private voluntary organizations. During July-October 1989, 1169 cases of pellagra were detected among Mozambican refugees settled in 11 sites (including both camps and integrated villages) in southern Malawi.1 From February 1 through October 30, 1990, 17 878 cases were reported among 285 942 refugees (attack

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