title: Postpartum thiamine deficiency in a Karen displaced population.
abstract: BACKGROUND
  Before its recognition, infantile beriberi was the leading cause of infant death in camps for displaced persons of the Karen ethnic minority on Thailand's western border.
  
  
  OBJECTIVE
  This study aimed to document thiamine status in the peripartum period to examine the current supplementation program and the correlation between the clinical manifestations of thiamine deficiency and a biochemical measure of thiamine status.
  
  
  METHODS
  Women were enrolled prospectively at 30 wk of gestation and were followed up weekly until delivery and at 3 mo postpartum. Thiamine supplementation during pregnancy was based on patient symptoms.
  
  
  RESULTS
  At 3 mo postpartum, thiamine deficiency reflected by an erythrocyte transketolase activity (ETKA) > or = 1.20% was found in 57.7% (15/26) of mothers, 26.9% (7/26) of whom had severe deficiency (ETKA > 1.25%). No significant associations between ETKA and putative maternal symptoms or use of thiamine supplements were found.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Shoklo Malaria Research Unit, Mae Sot, Thailand.
authors.forename: R
authors.initials: R
authors.lastname: McGready
authors.forename: J A
authors.initials: JA
authors.lastname: Simpson
authors.forename: T
authors.initials: T
authors.lastname: Cho
authors.forename: L
authors.initials: L
authors.lastname: Dubowitz
authors.forename: S
authors.initials: S
authors.lastname: Changbumrung
authors.forename: V
authors.initials: V
authors.lastname: Böhm
authors.forename: R G
authors.initials: RG
authors.lastname: Munger
authors.forename: H E
authors.initials: HE
authors.lastname: Sauberlich
authors.forename: N J
authors.initials: NJ
authors.lastname: White
authors.forename: F
authors.initials: F
authors.lastname: Nosten
mesh_terms: D000293:Adolescent; D000328:Adult; D015331:Cohort Studies; D019587:Dietary Supplements; D004912:Erythrocytes / Q000201:enzymology; D005260:Female; D006801:Humans; D006867:Hydrolases / Q000008:administration & dosage / Q000009:adverse effects; D007231:Infant, Newborn; D007774:Lactation / Q000097:blood*; D008895:Milk, Human / Q000737:chemistry; D049590:Postpartum Period; D011247:Pregnancy / Q000097:blood*; D011256:Pregnancy Outcome; D011295:Prenatal Care; D011446:Prospective Studies; D012036:Refugees; D013785:Thailand / Q000453:epidemiology; D013831:Thiamine / Q000008:administration & dosage*; D013832:Thiamine Deficiency / Q000097:blood / Q000188:drug therapy / Q000453:epidemiology*; D014174:Transketolase / Q000097:blood
chemical_list: D014174:Transketolase; D006867:Hydrolases; C022731:thiaminase II; D013831:Thiamine