Micronutrient deficiencies


Micronutrient deficiencies are also an important nutritional problem in Lao PDR. Although up to the present there have been no detail precided data but most of those deficiencies are as below.

Iodine deficiency

Iodine deficiency disorders are a major nutrition problem in the Lao PDR. Their spectrum ranges from mere cosmetic annoyance to a conspicuous grade-lV goitre, and even severe mental retardation. Results from a subjective goitre survey (unpublished) between October 1988 and February 1990 in nine provinces (N= 20,447) indicated a 10% goitre prevalence in the plains region and a 30% prevalence for the mountainous area.

Vitamin A deficiency

Although up to the present there have been no vitamin A studies in the Lao PDR utilizing objective methodologies (serum retinol, relative dose response, impression cytology, dark adaptation) to determine the extent of the problem, there are some indications of vitamin A deficiency. The 1968-1969 Lao Health Survey in the Mekong Valley, for example, indicated that 7.62% of the people (N= 2,988) exhibited some signs of vitamin A deficiency (Bitot's spot, keratomalacia, night blindness). The present evaluation team also found several blind children at Mahosot Hospital. From interviews with their parents and attending physicians, it appears that vitamin A deficiency is most likely the cause of their affliction. Children who are undergoing weaning are most vulnerable, since vegetables are not included in the diet of children under two years of age.

Vitamin B1 (thiamine) and B2, (riboflavin) deficiencies

The magnitude of problems related to thiamine and riboflavin deficiency is unclear. More systematic and scientific evidence is needed. The Lao Health Survey in the Mekong Valley found widespread signs of B2 deficiency (46.8%). The consultant team also discovered 10 students (28.6%) with active angular stomatitis or scars in one classroom (grade 3) in the Ban Huachieng primary school. Chaitanee District, Vientiane Prefecture.

Over the past two years Vientiane hospitals have reported that several patients have died of unexplained causes. Others with the same symptoms, however, quickly recovered after receiving vitamin B1 treatment. Some villagers in Ban Huachieng are also familiar with the sudden unexplained nocturnal death syndrome (SUNDS) which strikes young, physically active males. They even use the same term as in north-east Thailand - lai tai - which literally means "sleep death." While the aetiology of SUNDS remains unclear, some experts believe that vitamin B1 deficiency may be one of the factors involved.

Nutritional anaemia or iron deficiency

The nature and extent of nutritional anaemia has yet to be determined. In the 1968-1969 Mekong Valley study, 35% of women between 19 and 49 years of age (N= 1,177, most of whom were pregnant or lactating) possessed a haematocrit level of 34% or below. Doctors in the maternal and child health clinic at Mahosot Hospital confirmed this rate and the importance of iron deficiency anaemia among pregnant and lactating women.