Fozi K, Azmi H, Kamariah H, Azwa M S Noor
Kangar Health Clinic, Perlis.
Med J Malaysia. 2006 Dec;61(5):519-25.
A possible outbreak of beriberi occurred at a drug detention and rehabilitation centre, Pusat Serenti Bukit Cabang, Perlis, Malaysia in February 2004. This outbreak was identified following the presentation of a large number of inmates at a health centre with signs and symptoms of ankle oedema and shortness of breath. Further investigations revealed the death of three inmates at the General Hospital with similar clinical presentations during the period from October 2003 till February 2004. A cross sectional comparative study was carried out at the rehabilitation centre to find out the prevalence of thiamine deficiency among the inmates both symptomatic and asymptomatic. A total of 154 inmates were examined (57 symptomatic and 97 asymptomatic cases). It was found that 74% from the sample study (114 cases) had thiamine deficiency (44 symptomatic and 70 asymptomatic). Further statistical analysis showed that ankle oedema is consistent with the diagnosis of thiamine deficiency but lack sensitivity (p < 0.05, sensitivity 24.6%, specificity 95%). This outbreak could have been triggered by poor diet intake of thiamine by the inmates coupled with possible intake of certain thiamine antagonists in their diet.
2004年2月，马来西亚玻璃市武吉加邦戒毒康复中心可能爆发了脚气病。此次疫情是在大量囚犯因脚踝水肿和呼吸急促的症状前往健康中心就诊后被发现的。进一步调查发现，在2003年10月至2004年2月期间，有三名具有相似临床表现的囚犯在总医院死亡。在该康复中心开展了一项横断面比较研究，以查明有症状和无症状囚犯中硫胺素缺乏症的患病率。总共检查了154名囚犯（57例有症状和97例无症状）。结果发现，样本研究中的74%（114例）存在硫胺素缺乏（44例有症状和70例无症状）。进一步的统计分析表明，脚踝水肿与硫胺素缺乏症的诊断相符，但缺乏敏感性（p<0.05，敏感性24.6%，特异性95%）。此次疫情可能是由于囚犯硫胺素饮食摄入不足，以及他们的饮食中可能摄入了某些硫胺素拮抗剂引发的。
