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High prevalence of thiamine (vitamin B1) deficiency in early childhood among a nationally representative sample of Cambodian women of childbearing age and their children

Identifieur interne : 000A86 ( Main/Exploration ); précédent : 000A85; suivant : 000A87

High prevalence of thiamine (vitamin B1) deficiency in early childhood among a nationally representative sample of Cambodian women of childbearing age and their children

Auteurs : Kyly C. Whitfield [Canada] ; Geoffry Smith [Singapour] ; Chhoun Chamnan [Cambodge] ; Crystal D. Karakochuk [Canada] ; Prak Sophonneary [Cambodge] ; Khov Kuong [Cambodge, Danemark] ; Marjoleine Amma Dijkhuizen [Danemark] ; Rathavuth Hong [États-Unis] ; Jacques Berger [France] ; Tim J. Green [Australie] ; Frank Tammo Wieringa [France]

Source :

RBID : PMC:5600402

Descripteurs français

English descriptors

Abstract

Background

Thiamine deficiency is thought to be an issue in Cambodia and throughout Southeast Asia due to frequent clinical reports of infantile beriberi. However the extent of this public health issue is currently unknown due to a lack of population-representative data. Therefore we assessed the thiamine status (measured as erythrocyte thiamine diphosphate concentrations; eThDP) among a representative sample of Cambodian women of childbearing age (15–49 y) and their young children (6–69 mo).

Methodology/Principle findings

Samples for this cross-sectional analysis were collected as part of a national micronutrient survey linked to the Cambodian Demographic and Health Survey (CDHS) 2014. One-sixth of households taking part in the CDHS were randomly selected and re-visited for additional blood sampling for eThDP analysis (719 women and 761 children). Thiamine status was assessed using different cut-offs from literature.

Women were mean (SD) 30 (6) y, and children (46% girls) were 41 (17) mo. Women had lower mean (95% CI) eThDP of 150 nmol/L (146–153) compared to children, 174 nmol/L (171–179; P < 0.001). Using the most conservative cut-off of eThDP < 120 nmol/L, 27% of mothers and 15% of children were thiamine deficient, however prevalence rates of deficiency were as high as 78% for mothers and 58% for children using a cut-off of < 180 nmol/L. Thiamine deficiency was especially prevalent among infants aged 6–12 mo: 38% were deficient using the most conservative cut-off (< 120 nmol/L).

Conclusions/Significance

There is a lack of consensus on thiamine status cut-offs; more research is required to set clinically meaningful cut-offs. Despite this, there is strong evidence of suboptimal thiamine status among Cambodian mothers and their children, with infants <12 mo at the highest risk. Based on eThDP from this nationally-representative sample, immediate action is required to address thiamine deficiency in Cambodia, and likely throughout Southeast Asia.


Url:
DOI: 10.1371/journal.pntd.0005814
PubMed: 28873391
PubMed Central: 5600402


Affiliations:


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Le document en format XML

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<term>Male</term>
<term>Middle Aged</term>
<term>Prevalence</term>
<term>Random Allocation</term>
<term>Young Adult</term>
</keywords>
<keywords scheme="MESH" xml:lang="fr">
<term>Adolescent</term>
<term>Adulte</term>
<term>Adulte d'âge moyen</term>
<term>Attribution aléatoire</term>
<term>Enfant</term>
<term>Enfant d'âge préscolaire</term>
<term>Femelle</term>
<term>Humains</term>
<term>Jeune adulte</term>
<term>Mâle</term>
<term>Nourrisson</term>
<term>Prévalence</term>
<term>Érythrocytes</term>
<term>Études transversales</term>
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<front>
<div type="abstract" xml:lang="en">
<sec id="sec001">
<title>Background</title>
<p>Thiamine deficiency is thought to be an issue in Cambodia and throughout Southeast Asia due to frequent clinical reports of infantile beriberi. However the extent of this public health issue is currently unknown due to a lack of population-representative data. Therefore we assessed the thiamine status (measured as erythrocyte thiamine diphosphate concentrations; eThDP) among a representative sample of Cambodian women of childbearing age (15–49 y) and their young children (6–69 mo).</p>
</sec>
<sec id="sec002">
<title>Methodology/Principle findings</title>
<p>Samples for this cross-sectional analysis were collected as part of a national micronutrient survey linked to the Cambodian Demographic and Health Survey (CDHS) 2014. One-sixth of households taking part in the CDHS were randomly selected and re-visited for additional blood sampling for eThDP analysis (719 women and 761 children). Thiamine status was assessed using different cut-offs from literature.</p>
<p>Women were mean (SD) 30 (6) y, and children (46% girls) were 41 (17) mo. Women had lower mean (95% CI) eThDP of 150 nmol/L (146–153) compared to children, 174 nmol/L (171–179;
<italic>P</italic>
< 0.001). Using the most conservative cut-off of eThDP < 120 nmol/L, 27% of mothers and 15% of children were thiamine deficient, however prevalence rates of deficiency were as high as 78% for mothers and 58% for children using a cut-off of < 180 nmol/L. Thiamine deficiency was especially prevalent among infants aged 6–12 mo: 38% were deficient using the most conservative cut-off (< 120 nmol/L).</p>
</sec>
<sec id="sec003">
<title>Conclusions/Significance</title>
<p>There is a lack of consensus on thiamine status cut-offs; more research is required to set clinically meaningful cut-offs. Despite this, there is strong evidence of suboptimal thiamine status among Cambodian mothers and their children, with infants <12 mo at the highest risk. Based on eThDP from this nationally-representative sample, immediate action is required to address thiamine deficiency in Cambodia, and likely throughout Southeast Asia.</p>
</sec>
</div>
</front>
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<name sortKey="Cho, T" uniqKey="Cho T">T Cho</name>
</author>
<author>
<name sortKey="Dubowitz, L" uniqKey="Dubowitz L">L Dubowitz</name>
</author>
<author>
<name sortKey="Changbumrung, S" uniqKey="Changbumrung S">S Changbumrung</name>
</author>
<author>
<name sortKey="Bohm, V" uniqKey="Bohm V">V Böhm</name>
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<name sortKey="Doung Ngern, P" uniqKey="Doung Ngern P">P Doung-ngern</name>
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<author>
<name sortKey="Kesornsukhon, S" uniqKey="Kesornsukhon S">S Kesornsukhon</name>
</author>
<author>
<name sortKey="Kanlayanaphotporn, J" uniqKey="Kanlayanaphotporn J">J Kanlayanaphotporn</name>
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<author>
<name sortKey="Wanadurongwan, S" uniqKey="Wanadurongwan S">S Wanadurongwan</name>
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<author>
<name sortKey="Songchitsomboon, S" uniqKey="Songchitsomboon S">S Songchitsomboon</name>
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<author>
<name sortKey="Anderson, Cam" uniqKey="Anderson C">CAM Anderson</name>
</author>
<author>
<name sortKey="Donovan, Sm" uniqKey="Donovan S">SM Donovan</name>
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<author>
<name sortKey="Murphy, Sp" uniqKey="Murphy S">SP Murphy</name>
</author>
<author>
<name sortKey="Yaktine, Al" uniqKey="Yaktine A">AL Yaktine</name>
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<name sortKey="Said, Hm" uniqKey="Said H">HM Said</name>
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</analytic>
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<analytic>
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<name sortKey="Manzetti, S" uniqKey="Manzetti S">S Manzetti</name>
</author>
<author>
<name sortKey="Zhang, J" uniqKey="Zhang J">J Zhang</name>
</author>
<author>
<name sortKey="Van Der Spoel, D" uniqKey="Van Der Spoel D">D van der Spoel</name>
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<author>
<name sortKey="Kerns, Jc" uniqKey="Kerns J">JC Kerns</name>
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<name sortKey="Chawla" uniqKey="Chawla">Chawla</name>
</author>
<author>
<name sortKey="Lakhmir, S" uniqKey="Lakhmir S">S Lakhmir</name>
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<author>
<name sortKey="Fonzetti, P" uniqKey="Fonzetti P">P Fonzetti</name>
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<name sortKey="Cirio, Rt" uniqKey="Cirio R">RT Cirio</name>
</author>
<author>
<name sortKey="Elder, J" uniqKey="Elder J">J Elder</name>
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<author>
<name sortKey="Guindy, M" uniqKey="Guindy M">M Guindy</name>
</author>
<author>
<name sortKey="Nakar, O" uniqKey="Nakar O">O Nakar</name>
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<name sortKey="Lotan, D" uniqKey="Lotan D">D Lotan</name>
</author>
<author>
<name sortKey="Fattal Valevski, A" uniqKey="Fattal Valevski A">A Fattal-Valevski</name>
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<author>
<name sortKey="Friedmann, N" uniqKey="Friedmann N">N Friedmann</name>
</author>
<author>
<name sortKey="Fattal Valevski, A" uniqKey="Fattal Valevski A">A Fattal-Valevski</name>
</author>
</analytic>
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<analytic>
<author>
<name sortKey="Kuizon, Md" uniqKey="Kuizon M">MD Kuizon</name>
</author>
<author>
<name sortKey="Perlas, La" uniqKey="Perlas L">LA Perlas</name>
</author>
<author>
<name sortKey="Madriaga, Jr" uniqKey="Madriaga J">JR Madriaga</name>
</author>
<author>
<name sortKey="Cheong, Rl" uniqKey="Cheong R">RL Cheong</name>
</author>
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<name sortKey="Desnacido, Ja" uniqKey="Desnacido J">JA Desnacido</name>
</author>
<author>
<name sortKey="Marcos, Jm" uniqKey="Marcos J">JM Marcos</name>
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<author>
<name sortKey="Gangolf, M" uniqKey="Gangolf M">M Gangolf</name>
</author>
<author>
<name sortKey="Czerniecki, J" uniqKey="Czerniecki J">J Czerniecki</name>
</author>
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<name sortKey="Detry, O" uniqKey="Detry O">O Detry</name>
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</author>
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<name sortKey="Jouan, C" uniqKey="Jouan C">C Jouan</name>
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</analytic>
</biblStruct>
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<name sortKey="Thurnham, Di" uniqKey="Thurnham D">DI Thurnham</name>
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<author>
<name sortKey="Cathcart, Ae" uniqKey="Cathcart A">AE Cathcart</name>
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<analytic>
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<name sortKey="Elmadfa, I" uniqKey="Elmadfa I">I Elmadfa</name>
</author>
<author>
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<li>Australie</li>
<li>Cambodge</li>
<li>Canada</li>
<li>Danemark</li>
<li>France</li>
<li>Singapour</li>
<li>États-Unis</li>
</country>
<region>
<li>Hovedstaden</li>
<li>Languedoc-Roussillon</li>
<li>Maryland</li>
<li>Occitanie (région administrative)</li>
</region>
<settlement>
<li>Copenhague</li>
<li>Montpellier</li>
</settlement>
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<country name="Canada">
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<name sortKey="Whitfield, Kyly C" sort="Whitfield, Kyly C" uniqKey="Whitfield K" first="Kyly C." last="Whitfield">Kyly C. Whitfield</name>
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<name sortKey="Karakochuk, Crystal D" sort="Karakochuk, Crystal D" uniqKey="Karakochuk C" first="Crystal D." last="Karakochuk">Crystal D. Karakochuk</name>
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<name sortKey="Smith, Geoffry" sort="Smith, Geoffry" uniqKey="Smith G" first="Geoffry" last="Smith">Geoffry Smith</name>
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<name sortKey="Smith, Geoffry" sort="Smith, Geoffry" uniqKey="Smith G" first="Geoffry" last="Smith">Geoffry Smith</name>
</country>
<country name="Cambodge">
<noRegion>
<name sortKey="Chamnan, Chhoun" sort="Chamnan, Chhoun" uniqKey="Chamnan C" first="Chhoun" last="Chamnan">Chhoun Chamnan</name>
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<name sortKey="Kuong, Khov" sort="Kuong, Khov" uniqKey="Kuong K" first="Khov" last="Kuong">Khov Kuong</name>
<name sortKey="Sophonneary, Prak" sort="Sophonneary, Prak" uniqKey="Sophonneary P" first="Prak" last="Sophonneary">Prak Sophonneary</name>
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<country name="Danemark">
<region name="Hovedstaden">
<name sortKey="Kuong, Khov" sort="Kuong, Khov" uniqKey="Kuong K" first="Khov" last="Kuong">Khov Kuong</name>
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<name sortKey="Dijkhuizen, Marjoleine Amma" sort="Dijkhuizen, Marjoleine Amma" uniqKey="Dijkhuizen M" first="Marjoleine Amma" last="Dijkhuizen">Marjoleine Amma Dijkhuizen</name>
</country>
<country name="États-Unis">
<region name="Maryland">
<name sortKey="Hong, Rathavuth" sort="Hong, Rathavuth" uniqKey="Hong R" first="Rathavuth" last="Hong">Rathavuth Hong</name>
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<country name="France">
<region name="Occitanie (région administrative)">
<name sortKey="Berger, Jacques" sort="Berger, Jacques" uniqKey="Berger J" first="Jacques" last="Berger">Jacques Berger</name>
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<name sortKey="Wieringa, Frank Tammo" sort="Wieringa, Frank Tammo" uniqKey="Wieringa F" first="Frank Tammo" last="Wieringa">Frank Tammo Wieringa</name>
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</record>

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