Clinically Unapparent Infantile Thiamin Deficiency in Vientiane, Laos

Title
Clinically Unapparent Infantile Thiamin Deficiency in Vientiane, Laos
Authors
Khounnorath, Sengmanivong; Chamberlain, Karen; Taylor, Ann M.; Soukaloun, Douangdao; Mayxay, Mayfong; Lee, Sue J.; Phengdy, Bounthom; Luangxay, Khonsavanh; Sisouk, Kongkham; Soumphonphakdy, Bandit; Latsavong, Khaysy; Akkhavong, Kongsin; White, Nicholas J.; Newton, Paul N.
Keywords
ERYTHROCYTE TRANSKETOLASE, CHILDREN, VITAMIN-B1, BERIBERI, POPULATION, ANALYZER, BLOOD
Issue Date
2011
Publisher
PUBLIC LIBRARY SCIENCE
Citation
PLOS NEGLECTED TROPICAL DISEASES; vol.5 issue 2
Abstract
Background: 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. Methodology/Principal Findings: 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 (alpha>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 alpha>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. Conclusions/Significance: 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.
URI
http://hdl.handle.net/11267/2192
ISSN
1935-2727
Appears in Collections:
5.Mahosot Hospital > Journal articles
Files in This Item:

qrcode

Items in LAOSpace are protected by copyright, with all rights reserved, unless otherwise indicated.