Clinically unapparent infantile thiamin deficiency in Vientiane, Laos.
<h4>Background</h4>Beriberi occurs in Vientiane, Lao PDR, among breastfed infants. Clinical disease may be the tip of an iceberg with subclinical thiamin deficiency contributing to other illnesses. Thiamin treatment could improve outcome.<h4>Methodology/principal findings</h4>...
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2011
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oai:doaj.org-article:20e0b7ac3fe342aa8ddccda259515dcb2021-11-18T09:13:32ZClinically unapparent infantile thiamin deficiency in Vientiane, Laos.1935-27271935-273510.1371/journal.pntd.0000969https://doaj.org/article/20e0b7ac3fe342aa8ddccda259515dcb2011-02-01T00:00:00Zhttps://www.ncbi.nlm.nih.gov/pmc/articles/pmid/21423705/?tool=EBIhttps://doaj.org/toc/1935-2727https://doaj.org/toc/1935-2735<h4>Background</h4>Beriberi occurs in Vientiane, Lao PDR, among breastfed infants. Clinical disease may be the tip of an iceberg with subclinical thiamin deficiency contributing to other illnesses. Thiamin treatment could improve outcome.<h4>Methodology/principal findings</h4>A cohort of 778 sick infants admitted during one year without clinical evidence of beriberi were studied prospectively and erythrocyte transketolase assays (ETK) performed. Biochemical thiamin deficiency was defined both in terms of the activation coefficient (α>31%) and basal ETK activity <0.59 micromoles/min/gHb. Of the 778 infants, median (range) age was 5 (0-12) months, 79.2% were breastfed, 5.1% had α>31% and 13.4 % basal ETK<0.59 micromoles/min/gHb. Infants≥2 months old had a higher frequency of biochemical markers of thiamin deficiency. Mortality was 5.5% but, among infants ≥2 months old, mortality was higher in those with basal ETK<0.59 micromoles/min/gHb (3/47, 6.4%) than in those with basal ETK≥0.59 micromoles/min/gHb (1/146, 0.7%) (P=0.045, relative risk=9.32 (95%CI 0.99 to 87.5)). Multivariate regression analysis indicated that infant age≥2 months and fewer maternal years of schooling were independently associated with infant basal ETK<0.59 micromoles/min/gHb.<h4>Conclusions/significance</h4>Clinically unapparent thiamin deficiency is common among sick infants (≥2 months old) admitted to hospital in Vientiane. This may contribute to mortality and a low clinical threshold for providing thiamin to sick infants may be needed.Sengmanivong KhounnorathKaren ChamberlainAnn M TaylorDouangdao SoukalounMayfong MayxaySue J LeeBounthom PhengdyKhonsavanh LuangxayKongkham SisoukBandit SoumphonphakdyKhaysy LatsavongKongsin AkkhavongNicholas J WhitePaul N NewtonPublic Library of Science (PLoS)articleArctic medicine. Tropical medicineRC955-962Public aspects of medicineRA1-1270ENPLoS Neglected Tropical Diseases, Vol 5, Iss 2, p e969 (2011) |
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Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 |
| spellingShingle |
Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 Sengmanivong Khounnorath Karen Chamberlain Ann M Taylor Douangdao Soukaloun Mayfong Mayxay Sue J Lee Bounthom Phengdy Khonsavanh Luangxay Kongkham Sisouk Bandit Soumphonphakdy Khaysy Latsavong Kongsin Akkhavong Nicholas J White Paul N Newton Clinically unapparent infantile thiamin deficiency in Vientiane, Laos. |
| description |
<h4>Background</h4>Beriberi occurs in Vientiane, Lao PDR, among breastfed infants. Clinical disease may be the tip of an iceberg with subclinical thiamin deficiency contributing to other illnesses. Thiamin treatment could improve outcome.<h4>Methodology/principal findings</h4>A cohort of 778 sick infants admitted during one year without clinical evidence of beriberi were studied prospectively and erythrocyte transketolase assays (ETK) performed. Biochemical thiamin deficiency was defined both in terms of the activation coefficient (α>31%) and basal ETK activity <0.59 micromoles/min/gHb. Of the 778 infants, median (range) age was 5 (0-12) months, 79.2% were breastfed, 5.1% had α>31% and 13.4 % basal ETK<0.59 micromoles/min/gHb. Infants≥2 months old had a higher frequency of biochemical markers of thiamin deficiency. Mortality was 5.5% but, among infants ≥2 months old, mortality was higher in those with basal ETK<0.59 micromoles/min/gHb (3/47, 6.4%) than in those with basal ETK≥0.59 micromoles/min/gHb (1/146, 0.7%) (P=0.045, relative risk=9.32 (95%CI 0.99 to 87.5)). Multivariate regression analysis indicated that infant age≥2 months and fewer maternal years of schooling were independently associated with infant basal ETK<0.59 micromoles/min/gHb.<h4>Conclusions/significance</h4>Clinically unapparent thiamin deficiency is common among sick infants (≥2 months old) admitted to hospital in Vientiane. This may contribute to mortality and a low clinical threshold for providing thiamin to sick infants may be needed. |
| format |
article |
| author |
Sengmanivong Khounnorath Karen Chamberlain Ann M Taylor Douangdao Soukaloun Mayfong Mayxay Sue J Lee Bounthom Phengdy Khonsavanh Luangxay Kongkham Sisouk Bandit Soumphonphakdy Khaysy Latsavong Kongsin Akkhavong Nicholas J White Paul N Newton |
| author_facet |
Sengmanivong Khounnorath Karen Chamberlain Ann M Taylor Douangdao Soukaloun Mayfong Mayxay Sue J Lee Bounthom Phengdy Khonsavanh Luangxay Kongkham Sisouk Bandit Soumphonphakdy Khaysy Latsavong Kongsin Akkhavong Nicholas J White Paul N Newton |
| author_sort |
Sengmanivong Khounnorath |
| title |
Clinically unapparent infantile thiamin deficiency in Vientiane, Laos. |
| title_short |
Clinically unapparent infantile thiamin deficiency in Vientiane, Laos. |
| title_full |
Clinically unapparent infantile thiamin deficiency in Vientiane, Laos. |
| title_fullStr |
Clinically unapparent infantile thiamin deficiency in Vientiane, Laos. |
| title_full_unstemmed |
Clinically unapparent infantile thiamin deficiency in Vientiane, Laos. |
| title_sort |
clinically unapparent infantile thiamin deficiency in vientiane, laos. |
| publisher |
Public Library of Science (PLoS) |
| publishDate |
2011 |
| url |
https://doaj.org/article/20e0b7ac3fe342aa8ddccda259515dcb |
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