Thiamin deficiency and uncomplicated falciparum malaria in Laos.
OBJECTIVE
Thiamin deficiency complicates severe Plasmodium falciparum malaria in Thailand and may contribute to acidosis. We therefore estimated the frequency of biochemical thiamin deficiency in patients presenting with uncomplicated falciparum malaria in southern Laos.


METHODS
Red cell transketolase activation coefficients (alpha) were measured in 310 patients presenting with uncomplicated falciparum malaria and 42 days after starting treatment.


RESULTS
Twelve per cent of patients had biochemical evidence of severe deficiency (alpha values >1.31) at presentation, declining to 3% 42 days later.


CONCLUSIONS
Thiamin deficiency was common in Lao patients admitted with uncomplicated P. falciparum infection and was reduced following treatment of malaria and multivitamin supplementation. The role of this preventable and treatable disorder in malaria and other acute infections, and the incidence of beriberi in rural Laos, needs further investigation.
Mayxay
Mayfong
M
Wellcome Trust-Mahosot Hospital-Oxford Tropical Medicine Research Collaboration, Microbiology Laboratory, Mahosot Hospital, Vientiane, Lao PDR.
Taylor
Ann M
AM
Khanthavong
Maniphone
M
Keola
Siamphay
S
Pongvongsa
Tiengkham
T
Phompida
Samlane
S
Phetsouvanh
Rattanaxay
R
White
Nicholas J
NJ
Newton
Paul N
PN
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000962:Antimalarials / Q000627:therapeutic use; D037621:Artemisinins / Q000627:therapeutic use; D000077332:Artesunate; D001602:Beriberi / Q000150:complications / Q000453:epidemiology; D002648:Child; D002675:Child, Preschool; D002738:Chloroquine / Q000627:therapeutic use; D004338:Drug Combinations; D004359:Drug Therapy, Combination; D004789:Enzyme Activation; D004912:Erythrocytes / Q000201:enzymology; D005260:Female; D006801:Humans; D007223:Infant; D007812:Laos / Q000453:epidemiology; D016778:Malaria, Falciparum / Q000150:complications / Q000188:drug therapy / Q000453:epidemiology*; D008297:Male; D008875:Middle Aged; D011739:Pyrimethamine / Q000627:therapeutic use; D012717:Sesquiterpenes / Q000627:therapeutic use; D013413:Sulfadoxine / Q000627:therapeutic use; D013832:Thiamine Deficiency / Q000150:complications / Q000453:epidemiology*; D014174:Transketolase / Q000378:metabolism; D016896:Treatment Outcome
D000962:Antimalarials; D037621:Artemisinins; D004338:Drug Combinations; D012717:Sesquiterpenes; C001205:fanasil, pyrimethamine drug combination; D000077332:Artesunate; D013413:Sulfadoxine; D002738:Chloroquine; D014174:Transketolase; D011739:Pyrimethamine