Aree Valyasevi

Iron deficiency and educational achievement in Thailand

This double-blind clinical trial was conducted in Thailand to assess the impact of iron treatment on the IQ and educational attainment of 1358 9-11-y-old children. The children were classified into one of three groups: iron replete, iron depleted, and iron-deficient anemic. The Raven Progressive Matrices was used to measure IQ. A Thai language and a math test were administered to assess school attainment. A 50-mg/d tablet of ferrous sulphate was given for 2 wk and a 100 mg/d tablet, for 14 wk. An anthelminthic drug was given on the day of the blood test before treatment and 3 mo after the intervention started. There is evidence of a positive association between iron status and IQ and a language school achievement test but there is no support for the internal validity of the hypothesis that this association is causal.

Energy requirements of pregnancy in rural Thailand.

The energy cost of pregnancy was measured in rural Thai women between 10 wk gestation and term. The energy cost of pregnancy, which includes the increase in basal metabolic rate (BMR), the energy equivalent of maternal fat laid down, and the assumed energy equivalent of fetal fat and fetal and maternal protein, was 202 MJ (1 MJ = 239 kcal). BMR increased by 100 MJ overall and maternal fat gain averaged about 1.3 kg, equivalent to 60 MJ. The energy cost was more than covered by an overall increase in food intake of 238 MJ with little evidence of any complementary reduction in total energy expenditure by reduced physical activity.

Effects of an iron supplementation trial on the Fe status of Thai schoolchildren

A double-blind clinical trial was conducted among 9- to 11-year-old children in sixteen schools in the Chon Buri province of Thailand to assess the effects of an iron supplement combined with an anthelminthic agent (i.e. albendazole). In addition to the albendazole, Fe or placebo tablets were distributed to 2268 children enrolled in grades three to five without knowledge of the Fe status of the children. Criteria for case inclusion were: (a) absence of A E Barts or haemoglobin (Hb) H disease, (b) absence of abnormal Hb EE, and (c) age, 108-144 months. The results showed a significant improvement in the Fe status of the children after 16 weeks of treatment. The increments were: Hb from 124 to 128 g/l, serum ferritin from 34.54 to 104.72 micrograms/l, transferrin saturation from 24.09 to 35.05%; free erythrocyte protoporphyrin decreased from 444.7 to 281.4 micrograms/l erythrocytes. These changes were significantly greater than in the control group that received only the anthelminthic agent. However, the administration of albendazole only also resulted in significant changes in the same Fe indicators.

Therapeutic Interventions in Diarrhea

Consideration of the formidable array of recent scientific information on the epidemiology, etiology, pathogenesis, and physiologic mechanisms of diarrhea, along with the myriad interrelationships with nutrition, leads, fortunately, to a coherent and relatively concise series of recommendations for the clinical management of these interacting conditions. This summary indicates the practical therapeutic guidelines aimed at the practitioner and community health worker to be derived from the extensive literature. Implementation of these measures will substantially reduce not only the immediate deleterious effects of diarrhea, dehydration, and in some cases death, but also the longer-term, more prevalent, and insidious adverse effects on nutrition.

Bilateral Ptosis as a Sign of Thiamine Deficiency in Childhood Response to Corrective Therapy is Rapid

ment, called &dquo;wet type.&dquo; Juvenile beriberi is seen in older children who have consumed almost nothing except rice. Characteristic symptoms of juvenile beriberi appear mainly in the brain and peripheral nerves. Nasal voice, hoarseness, difficulty of hearing, ptosis, strabismus, and nystagmus are expressions of cerebral nerve involvement. Calf pain, gait difficulty, and abnormal deep tendon reflexes are seen as signs of peripheral neuritis. Dilatation and edema of the heart are said to be relatively rare in juvenile beriberi5; however, Pongpanich et al.11 recently reported cardiac beriberi in three children. Older children suf-

Studies of Bladder Stone Disease in Thailand

Studies of urinary mucoproteins were carried out in newborn and infants of hyper-(village) and hypo-endemic (city) areas in North-east Thailand. The findings are as follows: (1) Village newborn excret

Public Health Program to Promote Nutrition in Rural Areas — Thailand Experience

Thailand is located in Southeast Asia region having common borders with Burma, Laos, Cambodia and Malaysia. The census in 1975 revealed a total population of 43.3 million with 85 percent of the people living in rural areas. The cultural and economic foundation of the nation is rice farming.