Outbreak of scurvy in Tana River County, Kenya: A case report

Halestrap, Peter; Scheenstra, Sue

doi:10.4102/phcfm.v10i1.1811

Cited by 8 publications

(10 citation statements)

References 5 publications

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“…Additionally, a control group of 200 well women from clinics also showed low vitamin C status (15 ± 6 µmol/L) and 28% hypovitaminosis C. The differences between these studies may be a reflection of seasonal variation and disparities in intake across socioeconomic and regions of the continent, or limitations of the assay methodologies used. Of note, clinical outbreaks of scurvy still occur in Africa such as a recent outbreak in tribesmen in Kenya [52]. Vitamin C deficiency in India has been relatively well characterized with a large population-based study (Table 2).…”

Section: Low and Middle Income Countriesmentioning

confidence: 99%

Global Vitamin C Status and Prevalence of Deficiency: A Cause for Concern?

2020

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Vitamin C is an essential nutrient that must be obtained through the diet in adequate amounts to prevent hypovitaminosis C, deficiency and its consequences—including the potentially fatal deficiency disease scurvy. Global vitamin C status and prevalence of deficiency has not previously been reported, despite vitamin C’s pleiotropic roles in both non-communicable and communicable disease. This review highlights the global literature on vitamin C status and the prevalence of hypovitaminosis C and deficiency. Related dietary intake is reported if assessed in the studies. Overall, the review illustrates the shortage of high quality epidemiological studies of vitamin C status in many countries, particularly low- and middle-income countries. The available evidence indicates that vitamin C hypovitaminosis and deficiency is common in low- and middle-income countries and not uncommon in high income settings. Further epidemiological studies are required to confirm these findings, to fully assess the extent of global vitamin C insufficiency, and to understand associations with a range of disease processes. Our findings suggest a need for interventions to prevent deficiency in a range of at risk groups and regions of the world.

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Section: Low and Middle Income Countriesmentioning

confidence: 99%

Global Vitamin C Status and Prevalence of Deficiency: A Cause for Concern?

2020

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“…However, vitamin C deficiency may even be common in fertile areas of Africa, such as Uganda [ 34 ]. There have been a number of outbreaks of clinical scurvy in recent years, including in tribesmen in Kenya and during the Afghanistan winter [ 35 , 36 ], and cases of clinical scurvy continue to be diagnosed related to poor intake even in high-income countries [ 12 , 37 ].…”

Section: Dietary Factors Determining Vitamin C Statusmentioning

confidence: 99%

Factors Affecting Vitamin C Status and Prevalence of Deficiency: A Global Health Perspective

2020

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A recent review of global vitamin C status has indicated a high prevalence of deficiency, particularly in low- and middle-income countries, as well as in specific subgroups within high-income countries. Here, we provide a narrative review of potential factors influencing vitamin C status globally. The in vivo status of vitamin C is primarily affected by dietary intake and supplement use, with those who supplement having a higher mean status and a lower prevalence of deficiency. Dietary intake can be influenced by cultural aspects such as traditional cooking practices and staple foods, with many staple foods, such as grains, contributing negligible vitamin C to the diet. Environmental factors can also affect vitamin C intake and status; these include geographic region, season, and climate, as well as pollution, the latter partly due to enhanced oxidative stress. Demographic factors such as sex, age, and race are known to affect vitamin C status, as do socioeconomic factors such as deprivation, education and social class, and institutionalization. Various health aspects can affect vitamin C status; these include body weight, pregnancy and lactation, genetic variants, smoking, and disease states, including severe infections as well as various noncommunicable diseases such as cardiovascular disease and cancer. Some of these factors have changed over time; therefore, we also explore if vitamin C status has shown temporal changes. Overall, there are numerous factors that can affect vitamin C status to different extents in various regions of the world. Many of these factors are not taken into consideration during the setting of global dietary intake recommendations for vitamin C.

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“…21 Because of the rarity and unfamiliarity of scurvy among clinicians and public health workers, there can be a delay in diagnosis and treatment. [22][23][24] For example, in 2002 an epidemic of scurvy in rural Afghanistan was initially misdiagnosed as an outbreak of Crimean-Congo hemorrhagic fever. Aid workers were evacuated, and intervention was delayed until a WHO investigation determined the cause to be scurvy.…”

Section: Introductionmentioning

confidence: 99%

An Epidemic of Scurvy, Identified Based on Lower Extremity Swelling, in a Southern Ethiopian Prison

Amogne

Nimani²,

Shemsedin³

et al. 2021

The American Journal of Tropical Medicine and Hygiene

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In October 2016, we received reports of five deaths among prisoners with leg swelling of unknown etiology in southwestern Ethiopia. A descriptive cross-sectional study was conducted to investigate the outbreak. A suspected case was defined as a prisoner with leg swelling of unknown etiology noted between May 15, 2016 and November 29, 2016. A total of 118 suspected cases were identified with unilateral or bilateral leg swelling without an identifiable cause from a total of 2,790 prisoners. Eight of the suspected cases were thoroughly examined, and seven of these suspected cases had clinical findings consistent with scurvy. Three of the clinical cases had undetectable vitamin C levels in the serum. The attack rate for the prison was 4.2% (118/2,790), and 11 deaths were identified, making the case fatality rate 9.3% (11/118). Clinical cases of scurvy had symptoms of fatigue, myalgia, arthralgia, and signs of follicular hyperkeratosis, petechiae, peripheral edema, and oral lesions. All clinical cases had severe anemia with hemoglobin <6.0 g/dL. The diet provided by the prison excluded fruits and vegetables. Scurvy was determined to be the cause of the outbreak, and vitamin C supplementation was promptly initiated. All symptomatic prisoners improved, and no further cases were identified in a 4-week follow-up period of active surveillance.

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Outbreak of scurvy in Tana River County, Kenya: A case report

Cited by 8 publications

References 5 publications

Global Vitamin C Status and Prevalence of Deficiency: A Cause for Concern?

Global Vitamin C Status and Prevalence of Deficiency: A Cause for Concern?

Factors Affecting Vitamin C Status and Prevalence of Deficiency: A Global Health Perspective

An Epidemic of Scurvy, Identified Based on Lower Extremity Swelling, in a Southern Ethiopian Prison

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