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Clinically unapparent infantile thiamin deficiency in Vientiane, Laos

Sengmanivong Khounnorath1, Karen Chamberlain, Ann M Taylor

  • 1Department of Pediatrics, Mahosot Hospital, and Faculty of Postgraduate Studies, University of Health Sciences, Vientiane, Lao People's Democratic Republic.

Plos Neglected Tropical Diseases
|March 23, 2011
PubMed

Insights

Subclinical thiamin deficiency is common in sick infants in Vientiane, potentially increasing mortality risk. Early thiamin treatment may be beneficial for infants over two months old.

Area of Science:

  • Nutritional Science
  • Pediatrics
  • Public Health

Background:

  • Beriberi affects breastfed infants in Vientiane, Lao PDR.
  • Subclinical thiamin deficiency may contribute to infant illnesses and mortality.
  • Thiamin supplementation could improve health outcomes.

Purpose of the Study:

  • To investigate the prevalence of biochemical thiamin deficiency in sick infants in Vientiane.
  • To identify risk factors associated with thiamin deficiency in this population.
  • To explore the relationship between thiamin deficiency and infant mortality.

Main Methods:

  • Prospective cohort study of 778 sick infants admitted over one year.
  • Erythrocyte transketolase (ETK) assays performed to assess thiamin status.
  • Biochemical deficiency defined by activation coefficient (α>31%) and basal ETK activity (<0.59 micromoles/min/gHb).

Main Results:

  • Biochemical thiamin deficiency was detected in 5.1% (α>31%) and 13.4% (basal ETK<0.59) of infants.
  • Infants aged 2 months or older showed higher frequencies of deficiency markers.
  • Mortality was higher in infants ≥2 months with low basal ETK activity (6.4% vs 0.7%, P=0.045).

Conclusions:

  • Clinically unapparent thiamin deficiency is prevalent in sick infants (≥2 months) in Vientiane.
  • This deficiency may be a contributing factor to infant mortality.
  • A lower clinical threshold for administering thiamin to sick infants may be warranted.
Abstract

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