Menu ENN Search

Thiamine Deficiency and its Prevention and Control in Major Emergencies

Review in progress

WHO are finalising a report on Thiamine Deficiency and its Prevention and Control in Major Emergencies This is a comprehensive review which is unique in that its focus is on thiamine deficiency in an emergency context. Furthermore, the document tackles subject areas which until now have not been properly addressed in the literature, e.g. guidelines on how to assess whether there is a public health problem, and prevention strategies geared specifically to emergency situations.

"populations affected by emergencies and dependent on food aid where milled rice is the major cereal distributed and those dependent on starchy staple foods such as cassava and tubers with few possibilities of diversifying their diets, usually have a low intake of thiamine even if their calorie intake may be sufficient."

 

The review documents recent outbreaks of the deficiency disease amongst emergency affected populations e.g. Cambodian refugees in Thailand and Bhutanese refugees in Nepal and then examines risk factors associated with these outbreaks for example:

The review then moves on to describe the symptoms and various syndromes of thiamine deficiency in adults and infants. The document also identifies risk factors for sub-clinical deficiency and symptoms, i.e. anorexia.

There is a section on biochemical methods of detecting thiamine deficiency:

There is also a table which suggests guidelines for differentiating levels of risk for thiamine deficiency in a population. The table defines mild, moderate and severe public health problems in terms of percentages of a population with clinical or biochemical signs of deficiency, e.g. percentage of the population with urinary thiamine levels below a certain amount. Such guidelines have been absent from the literature and are long overdue.

The review also sets out the thiamine content of certain foods and discusses the factors influencing content and utilisation of thiamine in food, i.e. interaction with other micronutrients. There is also a section on recommendations to reduce losses of thiamine during food preparation, some of which are summarised below.

The paper holds that nutrition education messages based on the above could contribute enormously to keeping losses of thiamine at a minimum. There is a very useful section on anti-thiamine factors which are present in food, or are produced as a result of microbial or other action, e.g. polyphenols which may be found in coffee and tea. This section concludes with recommendations for decreasing the influence of anti-thiamine factors, e.g. heating products containing thiaminase before consumption.

The final part of the review deals with strategies to prevent thiamine deficiency in large populations affected by emergencies. This section raises awareness about thiamine deficiency risks in populations heavily dependant on milled rice and starchy staple foods

A list of the main ways to increase intake of thiamine in emergency affected populations is given

Further information contact Zita Weise Prinzo, WHO, Avenue Appia 1211 Geneva 27, Switzerland. E-mail: weiseprinzoz@who.ch

More like this

FEX: Diagnosing Beriberi in Emergency Situations

by Prof Mike Golden, Aberdeen University. This piece will be most useful to medical professionals - doctors and nurses. However, the article may also be useful for non...

FEX: Persistent Micronutrient Problems among Refugees in Nepal

by Janack Upadhyay This article describes nutritional aspect of emergency food aid in Bhutanese refugee camps in Nepal; the author was regional Food & Nutrition...

FEX: Outbreak of micronutrient deficiency disease: did we respond appropriately?

By Dianne Stevens, Patricia Araru and Buwa Dragudi, Save the Children (UK) Dianne Stevens is a nutritionist with a Masters in Public Health and Tropical Medicine. She has been...

FEX: Acceptability and use of cereal-based foods in refugee camps: case studies from Nepal, Ethiopoa and Tanzania

By Catherine Mears with Helen Young Outbreaks of scurvy, pellagra and beri beri among refugees in the 1980s caused a public outcry, as many of these more unusual deficiency...

FEX: The use and acceptability of micronutrient enriched foods

A study by Oxfam, UNHCR and Micronutrient Initiative. Emergency general rations supplied by the international aid community have frequently failed to supply adequate amounts...

FEX: Thiamine content of F-75 for complicated severe acute malnutrition: time for a change?

Summary of research1 Location: Global What we know: Complicated cases of severe acute malnutrition (SAM) are usually severely ill with comorbidities. What this article adds:...

FEX: Micronutrient research in progress

Examination for scurvy in Tanzania An article in the last issue of Field Exchange presented a review of the approaches that agencies and others use for identifying...

en-net: Integrity of minerals and vitamins in grilled/fried CSB + and ++

Dear all, Some recipes found on the field are involving fried or grilled CSB + or CSB ++. The idea is great, but I was wondering if these treatments would not alter the...

FEX: Diet and renal function in malnutrition

Summary of presentation1 Supplementary suckling (SS) has revolutionised management of young, malnourished infants Water balance in young, malnourished infants Water is an...

FEX: Appropriate Vitamin C Fortification Levels for CSB?

Report summary : The Institute of Medicine In 1995 the Senate Appropriations Committee Report directed USAID to initiate a pilot programme to increase the vitamin C content of...

FEX: Low rate of low birthweight in refugee camps in Nepal

A small-for-gestational-age term baby born at Janakpur Zonal Hospital, southern Nepal Summary of research1 Researchers have conducted a study aimed at verifying a low rate in...

FEX: Micronutrients - The Basics

Taken from draft guideline material prepared by Fiona Watson, Institute of Child health, London. Micronutrients are essential for life and are distinct from macronutrients...

FEX: Bioavailability of iron, zinc and provitamin A carotenoids in biofortified staple crops

Summary of study1 Location: Global What we know: Biofortification of staple foods is one potential way of increasing micronutrient intake in resource limited populations....

FEX: Mainstreaming nutrition in a school-based feeding programme in northeast Nigeria

By Greg Sclama View this article as a pdf Lisez cet article en français ici Gregory Sclama is an Assistant Professor of International Development and Economics at the...

FEX: Excess dietary iodine in long-term African refugees

Summary of published research1 In Africa, great progress has been made towards the elimination of iodine deficiency, largely due to the increased household availability of...

FEX: Scurvy outbreak in Afghanistan: an investigation by Action Contre la Faim (ACF) and WHO

By Philipe Leborgne, Caroline Wilkinson, Sylvie Montembaut, and Mija Tesse Ververs Dr Philippe Leborgne has been Head of the ACF Medical Department since 1994. Before this he...

FEX: Multi–micronutrient supplements for pregnant women from developing countries

Summary of a workshop report* UNICEF/WHO and the United Nations Universities (UNU) recently convened a meeting to decide upon the composition of a multi-micronutrient...

FEX: Nutrition and brain development in early life

Summary of review1 Location: Global What we know: It is likely that nutrition deficiency during pregnancy and early childhood affects individual cognition, behaviour, long...

FEX: Innovation and success in prevention of konzo

By Dr Howard Bradbury1 This article was prepared by Dr Howard Bradbury, who is an Emeritus Fellow at the Australian National University. Since the mid-nineties he has been...

FEX: Biofortification: Helping meet nutrition needs worldwide

News By Dr Erick Boy, Nutrition Head, HarvestPlus Dr Erick Boy is a public health practitioner and has a doctoral degree in nutrition from University of California, Davis. He...

Close

Reference this page

Thiamine Deficiency and its Prevention and Control in Major Emergencies. Field Exchange 3, January 1998. p7. www.ennonline.net/fex/3/thiamine