Medical Journal of Malaysia

MJM, Vol 70 Supplement 1 September 2015

Factors associated with beri-beri outbreak among inmates in LG detention camp, Negeri Sembilan, Malaysia, 2014

Noor Aizam Mohd Said, Hazlina Y, Mohd Paid Y, Bina Rai S

Malaysia EIP, Ministry of Health Malaysia


Introduction: A beri-beri outbreak occurred in the LG Detention Camp, Negeri Sembilan in March 2014. The purpose of this study was to determine the factors influencing thiamine deficiency among the inmates, identify risk factors and prevent future outbreak.

Methods:  A case was defined as inmates with at least one of the following symptoms: leg swelling, difficulty breathing, fatigue, poor appetite, vomiting, abdominal discomfort or paraesthesia. Face to face interviews were conducted using a standard questionnaire, followed by physical examination. We observed the process of food preparation and serving and reviewed menu to calculate the total calorie and thiamine content. The associated risk factors were determined by a case-control study.

Results: Of 1001 inmates, 19 (1.9%) cases identified. All were male and the median age was 29 years. The median duration of stay in the camp was 157 days. All cases had bilateral leg oedema with symptoms of paraesthesia (52.6%), fatigue (36.8%), difficulty breathing (36.8%), poor appetite (21.1%), and abdominal pain (33.3%). The only risk factor with beri-beri was alcohol intake (p=0.04). The mean calorie intake 1661kcal. The calorie and thiamine content in food was insufficient for the age group. Age, nationality, duration of stay in the camp, and body mass index were not significantly factors for beri-beri.

Conclusion: This beri-beri outbreak is likely due to diet low in Thiamine. The only associated risk factor is alcohol intake. Thiamine supplementation was given to cases and rest given Vitamin B Complex. Diet modification according to Recommended Nutrient Intake, Malaysia was initiated. No more cases detected on our regular monthly follow-up.

Keywords:  inmates, Beri-beri, thiamine deficiency