Postpartum thiamine deficiency in a Karen displaced population

McGready, Rose; Simpson, Julie A.; Cho, Thein; Dubowitz, Lilly; Changbumrung, Supranee; Böhm, Volker; Munger, Ron; Sauberlich, Howerde E.; White, Nicholas J.; Nosten, François

doi:10.1093/ajcn/74.6.808

Cited by 87 publications

(97 citation statements)

References 25 publications

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“…Il est établi que les épidémies de béribéri touchent plutôt des populations défavorisées ou migratoires [13,15,18,19,25,[28][29][30]35]. Dans notre étude, huit patients sur 11 étaient des migrants, mais cinq sur 11 bénéficiaient d'une couverture sociale traduisant un revenu minimum.…”

Section: Discussionunclassified

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Shoshin béribéri: réémergence d’une pathologie ancienne ? À propos d’une série de 11 cas à Mayotte

Restier

Carsalade²,

Abdou³

et al. 2011

Bull. Soc. Pathol. Exot.

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In the French island of Mayotte in the Indian Ocean, the health and food situation remains contrasted. For a very long time dry beriberi women in postpartum had been suspected and treated. But in 2004 the first infantile epidemic of beriberi was scientifically authenticated and a program of thiaminic supplementation for the pregnant women and infants was set up. In this context, we describe an epidemic of 11 cases of shoshin beriberi among adults between January 2008 and Februar 2009. Over 11 cases of shoshin beriberi, 5 cases were confirmed biologically and 6 were probable. The sex ratio M/W was 0.37. The median age was 34 years. The clinic picture was typical: severe acute dyspnea, an agitation/drowsiness, right cardiac failure: polynevritis of the lower limbs was noted in 9 cases over 11. Biologically it was characterized by a lactic acidosis (average pH: 7.08, lactates: 12.08 mmol/l). The evolution was favorable in the 8 cases which could benefit from early thiaminic refill. The outbreak of an epidemic of shoshin beriberi among adults mainly in groups not having benefited from supplementation shows the effectiveness of the program but also its limits. We compare our series with others: the period from April to June when the food is less diversified, is confirmed as a higher risk period. The programs of nutritional education must be increased and a B1 vitamin supplementation for broader people during the rain season might be discussed.

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Section: Discussionunclassified

“…La première forme est due à une carence aiguë en vitamine B1, parfois favorisée par une surconsommation méta-bolique (grossesse, allaitement, apport glucosé exclusif important ou épisode infectieux) [5,13,17,22,30], le plus souvent sur un terrain de carence thiaminique subaiguë.…”

Section: Définitionsunclassified

Shoshin béribéri: réémergence d’une pathologie ancienne ? À propos d’une série de 11 cas à Mayotte

Restier

Carsalade²,

Abdou³

et al. 2011

Bull. Soc. Pathol. Exot.

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“…It was suggested that thiamine deficiency in infancy causes long-lasting language impairment. Similarly, in a study of the offspring of Korean mothers suffering with thiamine deficiency, visual alertness was better in infants whose mothers had received thiamine supplements (28) . It is accepted that the thiamine requirements of the mother are increased during pregnancy and lactation, and that in the third trimester of pregnancy the vitamin is preferentially taken up by the fetus (29) .…”

Section: Thiaminementioning

confidence: 92%

Vitamins and neural and cognitive developmental outcomes in children

Benton

2011

Proc. Nutr. Soc.

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The role of vitamin status in the development of the brain and the subsequent functioning of the brain was considered. There are data with a range of vitamins, from animal studies and human studies in developing countries, suggesting that a clinical deficiency during the critical period when the brain is developing causes permanent damage. To date there is, however, with the exception of cases of clinical deficiency such as those that might be associated with a vegan diet, little evidence that variations in the diet of those living in industrialised countries have a lasting developmental influence. Similarly, later in life clinical deficiencies of various vitamins disrupt cognition although there is to date limited evidence that variations in the intake of single vitamins in industrialised societies influence functioning. It may well be, however, unreasonable to expect that vitamins examined in isolation will be associated with differences in cognitive functioning. The output of the brain reflects millions of metabolic processes, each potentially susceptible to any of a range of vitamins. A diet poor in one respect is likely to be poor in other respects as well. As such, the preliminary reports in double-blind placebo-controlled trials that aspects of cognition and behaviour respond to supplementation with multi-micronutrients may indicate the way forward.

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“…B-vitamins including thiamine, riboflavin, niacin, pantothenic acid, vitamin B 6 , biotin, and folates are essential nutrients for maternal health during pregnancy and lactation and particularly important for the growth of infant [5][6][7]. Their deficiency can affect pregnancy outcome [5,8], as well as dermal [9,10], blood [8], nervous [11], and digestive system [5,6], even mortality of infant [8,9].…”

Section: Introductionmentioning

confidence: 99%

Regional, socioeconomic, and dietary factors influencing B-vitamins in human milk of urban Chinese lactating women at different lactation stages

et al. 2017

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Background: Adequate B-vitamins concentrations in human milk are considered to be a prerequisite for healthy development of infants in early life. This study aims to determine the concentrations of B-vitamins in human milk from Chinese women and the relationships between their concentrations and different geographical origin, lactation stages, socioeconomic characteristics, and dietary intake. Methods: Human milk was obtained from 443 healthy lactating women from Beijing (n = 150), Suzhou (n = 146), and Guangzhou (n = 147) cities. Thiamine, riboflavin, vitamin B 3 (nicotinamide and nicotinic acid), and vitamin B 6 (pyridoxal, pyridoxine, and pyridoxamine) in human milk were analyzed by high performance liquid chromatography-tandem mass spectrometry. Pantothenic acid, biotin, and folates in human milk were analyzed by microbiological assay. The information from one 24-h dietary recall and socioeconomic characteristics were collected by interview and structured questionnaire, respectively. 34, 7.58, 8.60, 9.34, 10.20 (μg/100 g); biotin 0.462, 0.834, 0.606, 0.523, 0.464 (μg/100 g); folates 0.730, 2.390, 2.440, 2.420, 2.330 (μg/100 g). The levels of B-vitamins presented regional differences and varied significantly among different lactation stages. The inversely associations of thiamine, vitamin B 6 , and folates with maternal BMI were found in multivariate analyses (p < 0.05), as well as higher pantothenic acid, folates, and biotin concentrations in lactating women with supplement intake when compared with those without (p < 0.05). Riboflavin concentrations associated with regular exercise was found in multivariate analyses (p < 0.05).

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Postpartum thiamine deficiency in a Karen displaced population

Abstract: Biochemical postpartum thiamine deficiency is still common in Karen refugee women. This situation may be improved by educating lactating women to reduce their consumption of thiaminase-containing foods and by implementing an effective thiamine supplementation program.

Cited by 87 publications

References 25 publications

Shoshin béribéri: réémergence d’une pathologie ancienne ? À propos d’une série de 11 cas à Mayotte

Shoshin béribéri: réémergence d’une pathologie ancienne ? À propos d’une série de 11 cas à Mayotte

Vitamins and neural and cognitive developmental outcomes in children

Regional, socioeconomic, and dietary factors influencing B-vitamins in human milk of urban Chinese lactating women at different lactation stages

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