Sociodemographic and clinical aspects of intentional karuho intoxication in Bunia City, Democratic Republic of the Congo

Introduction In eastern Democratic Republic of Congo, particularly in Bunia, a phenomenon locally referred to as karuho is widely reported and interpreted as intentional poisoning or a culturally defined illness. Due to the absence of standardized biomedical diagnostic criteria, many cases are managed in traditional or tradimodern treatment centers. Purpose This study aimed to describe the sociodemographic and clinical profile of karuho-positive patients using a syndromic approach. Methods A descriptive cross-sectional study was conducted from May 5, 2024, to January 2, 2025, among 345 consecutive patients diagnosed as karuho-positive in four tradimodern treatment centers in Bunia, DRC. Data on sociodemographic characteristics, medical history, vital signs, and clinical manifestations were collected using a structured questionnaire and clinical examination. Data were analyzed using the Statistical Package for the Social Sciences (SPSS) version 20 and presented as frequencies and percentages. A comparative syndromic analysis was performed against selected infectious and chronic diseases. Results A total of 345 participants were included, with a male predominance (58.8%). The most affected age group was 30–44 years (37.1%), followed by those aged ≥60 years (33.3%). Most participants had secondary (39.7%) or university education (33.1%). Nearly half were married (49.9%), and 27.5% were unemployed. The most frequent clinical manifestations were asthenia (67.2%), headache (62.9%), epigastric pain (57.4%), chest pain (50.1%), and fever (47.0%). Gastrointestinal symptoms included nausea (38.0%), vomiting (25.8%), diarrhea (15.1%), constipation (18.0%), and abdominal pain (16.2%). Neurological manifestations included agitation (12.5%), confusion (12.2%), somnolence (13.0%), and coma (0.9%). Medical history was dominated by reported liver disease (79.1%), followed by exertional dyspnea (31.3%), peripheral neuropathy (15.1%), hypertension (12.8%), and pneumonia (10.7%). Elevated blood pressure (>140 mmHg) was observed in 78.3% of participants. Other findings included tachycardia (16.5%), bradycardia (4.1%), oxygen desaturation (4.6%), and fever (2.6%). Pulmonary rales (10.4%), jaundice (3.5%), dry skin (3.5%), and peripheral edema (2.9%) were the most common physical findings. Comparative analysis showed strong clinical overlap between karuho symptoms and those of malaria, typhoid fever, tuberculosis, HIV infection, Helicobacter pylori infection, and selected cancers. Conclusion Karuho presents as a non-specific multisystem syndrome with prominent gastrointestinal, respiratory, neurological, and general systemic manifestations. Its clinical profile closely overlaps with common infectious and chronic diseases in tropical settings, suggesting that many cases may represent misinterpreted or undiagnosed medical conditions rather than a distinct pathological entity. Further laboratory studies are needed to determine its true nature.