Beri-beri: the major cause of infant mortality in Karen refugees
Beri-beri: the major cause of infant mortality in Karen refugees
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DOI：
10.1016/s0035-9203(03)90134-9
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发表时间：
2003-03-01
影响因子：
2.2
通讯作者：
Nosten, F
中科院分区：
文献类型：
--
作者：
Luxemburger, C;White, NJ;Nosten, F
在1987年至1990年对泰国西北部边境的一个难民人口进行的一项妊娠期疟疾预防的前瞻性评价中，尽管获得良好的保健服务，但记录了极高的婴儿死亡率（18%）。婴儿脚气病被认为是主要的死亡原因，占所有婴儿死亡率的40%。此后，婴儿严重维生素B缺乏症得到及时诊断和治疗。在1993年至1996年的第二项队列研究中，对这一影响进行了前瞻性评估。婴儿脚气病的病死率从几乎100%下降到7%。婴儿总死亡率从每1 000活产183人下降到78人。新生儿后期死亡率下降了79%（95%CI 65 - 87%），而新生儿死亡率保持不变。急性呼吸道感染导致的死亡率没有变化（分别为15/1000和11/1000），而脚气病导致的死亡率从73/1000下降到5/1000（P <0.0001）。在认识到这一点之前，大约7%的婴儿死于婴儿脚气病。这种致命但可预防的综合症可能比迄今认识到的更为常见，特别是在这个人口众多的地区的难民人口中。
During a prospective evaluation of malaria prophylaxis in pregnancy in a refugee population on the north-western border of Thailand from 1987 to 1990, an extremely high infant mortality rate (18%) was documented despite good access to health care. Infantile beri-beri was recognized as the main cause of death accounting for 40% of all infant mortality. Thereafter, severe vitamin B, deficiency in infants was diagnosed and treated promptly. The impact of this was assessed prospectively from 1993 to 1996 in a second cohort study. The case fatality of infantile beri-beri fell from almost 100% to 7%. The overall infant mortality rates declined from 183 to 78 per 1000 live births. Post-neonatal deaths fell by 79% (95% CI 65-87%) while neonatal mortality remained unchanged. Mortality resulting from acute respiratory infections did not change (15 and 11 per 1000, respectively), whereas mortality attributable to beri-beri decreased from 73 to 5 per 1000 (P < 0.0001). Before its recognition approximately 7% of all infants in this population died from infantile beri-beri. This lethal but preventable syndrome may be more common than hitherto recognized, particularly in refugee populations, in this populous region.