Thiamine deficiency remains an important health care issue in many world populations. Causes of thiamine deficiency include inadequate diets, consumption of foods containing thiaminases or antithiamine compounds, and prolonged cooking of foods. In addition, clinical disorders such as chronic alcoholism, HIV-AIDS (1), and gastrointestinal disorders are associated with a high incidence of thiamine deficiency. Populations at particularly high risk include victims of political trade embargos (2) and displaced persons in refugee camps. In this latter regard, an important study by McGready et al (3) in this issue of the Journal describes a high incidence of postpartum thiamine deficiency (assessed by using the erythrocyte transketolase activation assay) in a group of Karen women from a refugee camp on the Thailand-Burma border. Up to 58 of these women were thiamine deficient at 3 mo postpartum despite the distribution in their rations of what appeared to be adequate dietary thiamine supplements. Thiamine supplementation was limited during pregnancy to women with peripheral neuropathy and other clinical signs of beriberi. This nutritional policy was started when it was recognized that infantile beriberi is a major cause of infant mortality in this population.
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