Suboptimal Thiamin Status Is Common Among Women Of Reproductive Age And Children ≤ 5 y In Cambodia: Findings From The National Micronutrient Survey
Bibliographic record
Abstract
Thiamin deficiency is thought to be an issue in Cambodia because case reports of beriberi are not uncommon, and several studies across Southeast Asia have reported low thiamin concentrations among women of reproductive age (WRA), children <5 y, and breastfed infants. However, due to a lack of population‐representative data, the magnitude of this public health issue is currently unknown. The objective of this study was to assess biochemical thiamin status using erythrocyte thiamin diphosphate (eTDP) concentrations among a nationally representative sample of WRA (15–49 y) and children ≤ 5 y, and to classify thiamin status using various cut‐offs from the literature. Non‐fasting venous blood samples were collected as part of a National Micronutrient Survey linked to the 2014 Cambodian Demographic and Health Survey, and eTDP was measured among 719 women and 761 children using HPLC‐FLD. The median (SD) age of women was 30 (6) y, and children (46% girls) were 42 (17) mo. Women had lower mean (95% CI) eTDP of 150 nmol/L (146–153) compared to children, 174 nmol/L (171–179; P < 0.001). Thiamin status was assessed using 10 different cut‐offs from the literature, none of which were developed in relation to clinical presentation of beriberi. Thiamin status varied dramatically depending on the cut‐off employed (70 nmol/L and 180 nmol/L): from 2% to 78% among women, and <1% to 58% among children. Deficiency was most prevalent among infants aged 6–12 mo ( n =50); even using the most conservative cut‐offs (from the Institute of Medicine), 4% were deficient (<70 nmol/L) and 14% had marginal status (70–90 nmol/L). More research is required to develop more useful, clinically meaningful thiamin status cut‐offs to define thiamin status and to attain global consensus on their use. Immediate action is required, however, to develop interventions to increase thiamin intake, and thus improve thiamin status, among women and children in Cambodia and throughout Southeast Asia.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".