Thiamin deficiency and uncomplicated falciparum malaria in Laos

Abstract

Summaryobjective Thiamin deficiency complicates severe Plasmodium falciparum malaria in Thailand and may contribute to acidosis. We therefore estimated the frequency of biochemical thiamin deficiency in patients presenting with uncomplicated falciparum malaria in southern Laos.methods Red cell transketolase activation coefficients (a) were measured in 310 patients presenting with uncomplicated falciparum malaria and 42 days after starting treatment.results Twelve per cent of patients had biochemical evidence of severe deficiency (a values >1.31) at presentation, declining to 3% 42 days later.conclusion Thiamin deficiency was common in Lao patients admitted with uncomplicated P. falciparum infection and was reduced following treatment of malaria and multivitamin supplementation. The role of this preventable and treatable disorder in malaria and other acute infections, and the incidence of beriberi in rural Laos, needs further investigation.

Chemical and genetic validation of thiamine utilization as an antimalarial drug target

“…Therefore, although oxythiamine is unlikely to be developed as an antimalarial in its own right, we propose that it can serve as a starting point from which to design antimalarials targeting this pathway. Another factor to consider in developing antimalarials that target the parasite's thiamine-utilization pathway is the reported association between P. falciparum malaria and thiamine deficiency 27,28 . The reason for this association is unclear, but may be related to the increase in the basal metabolic rate (and hence thiamine utilization) because of the febrile nature of the illness 28 .…”

“…Another factor to consider in developing antimalarials that target the parasite's thiamine-utilization pathway is the reported association between P. falciparum malaria and thiamine deficiency 27,28 . The reason for this association is unclear, but may be related to the increase in the basal metabolic rate (and hence thiamine utilization) because of the febrile nature of the illness 28 . The reduced thiamine concentrations in these individuals would be predicted to enhance the antiplasmodial activity of inhibitors that act competitively with thiamine (such as oxythiamine), but such inhibitors may also exacerbate the host's thiamine deficiency.…”

A Large Outbreak of Thiamine Deficiency Among Illegal Gold Miners in French Guiana

“…5 Malaria is often associated with beriberi because it increases glucose demand and requirement for lactate elimination, both of which are affected by the lack of thiamine. 14 Finally, the consumption of thiamine antagonists, such as sugar and coffee, was also reported, which possibly contributed to the patients' thiamine deficiency. Citreoveridinproducing P. citreonigrum was not found, but its causative role in beriberi has not been proven in humans.…”

Prise en charge du paludisme pédiatrique: rôle des interventions nutritionnelles

“…Le paludisme accroît le métabolisme du glucose, accélérant ainsi une carence en thiamine par l'intermédiaire de l'accroissement de son utilisation [138] . Une carence prolongée en thiamine entraîne un béribéri, affection caractérisée par un accroissement de l'accumulation d'acide lactique ou par une acidose lactique.…”