title: A retrospective investigation of thiamin and energy intakes following an outbreak of beriberi in The Gambia.
abstract: In the early part of the rainy season in 1988, an outbreak of beriberi occurred in free-living adults in a relatively small area in the North Bank region of The Gambia. In 1995 we selected two compounds in a village called Chilla situated within the affected district to retrospectively examine dietary factors potentially contributing to the outbreak. There had previously been cases of beriberi in one compound (BBC) but not in the other (NBC). We measured energy and thiamin intakes for four days on six occasions during the year. We calculated energy and thiamin intakes of people living in the two compounds and foods were collected for thiamin analysis through the year. Thiamin:Energy ratios only met international recommendations in the immediate post‑harvest season when energy and thiamin intakes were highest and then fell through the year. In the rainy season when food was short and labour was heaviest, energy intakes were lower in the NBC but thiamin:energy ratios were lower in BBC. Records of rainfall in 1988 collected near the village indicated that the amount in August was twice the average. We suggest the heavy rainfall may have increased farm workload and reduced income from outside-village work activity. The lower energy intakes in the NBC may have forced adults to rest thus sparing thiamin demands and delaying onset of beriberi. In contrast, the higher energy intake of adults in the BBC may have enabled them to continue working, thus increasing demands for thiamin and inducing the earlier onset of beriberi.
authors.affiliation: Northern Ireland Centre for Food & Health, University of Ulster, Coleraine BT52 1SA, UK. di.thurnham@ulster.ac.uk
authors.forename: David I
authors.initials: DI
authors.lastname: Thurnham
authors.forename: Angela E
authors.initials: AE
authors.lastname: Cathcart
authors.forename: Margaret B E
authors.initials: MB
authors.lastname: Livingstone
mesh_terms: D000293:Adolescent; D000328:Adult; D001602:Beriberi / Q000453:epidemiology*; D004032:Diet; D002149:Energy Intake; D005260:Female; D005714:Gambia / Q000453:epidemiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D009752:Nutritional Status; D012189:Retrospective Studies; D012621:Seasons; D013831:Thiamine / Q000008:administration & dosage*; D055815:Young Adult
chemical_list: D013831:Thiamine