Burnet research in Lao PDR is helping to address the serious problem of beriberi, a rapid onset and acute disease caused by thiamine (Vitamin B1) deficiency that can be fatal for infants, but which is easily preventable.
Beriberi is typically seen in breastfed infants aged one to five months whose mother is thiamine deficient. The child can suffer cardiac complications and die within a few days if not treated.
According to Professor Mike Toole from Burnet’s Centre for International Health (CIH), beriberi occurs in regions of Lao PDR where the staple diet is polished white rice.
“Typically, new mothers in these remote rural areas eat lots of sticky, white rice, and not much else for the first 40 days, because there are lots of food taboos after childbirth,” Professor Toole said.
“The problem has got worse, we think, because people have switched from hand-pounding rice, which leaves a bit of the husk, to using electrical mills which gets rid of all the thiamine.
“The child will go into heart failure; it’s called ‘wet’ beriberi. The mother may have symptoms of numbness or burning in her extremities, but for the baby it’s fatal.
“Beriberi is very easy to treat, but the baby needs to get to hospital very quickly. You just give an injection of thiamine and the baby recovers well.”
Professor Toole said Burnet and Save the Children Fund have been advocating for thiamine supplements to be made available in regions where beriberi is prevalent.
In 2014, Save The Children commissioned Burnet to carry out a technical review of the evidence for the prevention of infantile beriberi to stimulate discussion and to advocate for prevention strategies in Lao PDR.
Professor Toole recently presented research conducted by CIH’s Celeste Marsh to the National Nutrition Centre in Vientiane, where the National Nutrition Committee and Centre for Maternal and Child Health both pledged to incorporate beriberi prevention into their new national strategic plans.
“We’ve been promoting these thiamine supplements and we distribute them in areas where Burnet works and where Save the Children works and they don’t see beriberi anymore,” Professor Toole said.
“These supplements need to be available in every province in the country, rather than waiting for these very sick babies to come into hospital.
“The Wellcome Trust did studies along the Thai-Burma border and found that more babies were dying from beriberi than from malaria.
“They started giving out thiamine in the refugee camps and the problem went away, so it’s very easy, easier than malaria to prevent.
“It’s pretty solid evidence.”