IJCM_48A: Nutritional Challenges in Tribal Infants: The Tragic Link to Beriberi and Mortality
Authors: Abhishek R 
Published: April 2024

Background:
Infant mortality is a critical public health indicator that reflects the well-being of a population. In India, infant mortality remains a poignant challenge, reflecting the nation’s diverse healthcare landscape. Despite commendable strides in recent years, infants continue to face a higher risk of mortality, influenced by a complex interplay of factors such as maternal health, socioeconomic disparities, and limited access to quality healthcare. Currently in India NNMR-24.9, IMR-35.2 (NFHS 5), As the SVYM tribal RCH program was implemented in 3 districts (Mysore, Chamarajanagar & Kodagu Districts), recorded infant mortality in this area IMR- 62.93 (during Jan to Dec 2022), higher than the national average, most of infant deaths falls under are postneonatal deaths. This abstract will spotlight the impact of infant mortality in specific contexts, such as within tribal populations, considering unique socio-cultural aspects that influence health outcomes.

Objectives:
Identify factors responsible for infant deaths among tribal communities under intervention areas of SVYM

Methodology:
Identify factors responsible for infant deaths among tribal communities under intervention areas of SVYM

Results:
73% of women who experienced infant deaths were aged <25 years, 8% were illiterate and 96% depended on daily wages. 99 % of Pregnant mothers received ANC check-ups. 95 % were institutional deliveries and 5 % were home delivery. Out of 75 infant deaths, 51% were male, and 49% were female, 51(68%) were low birth weight, 22(29%) infant deaths in Hdkote & 56(75%) were in Jenu kuruba, 2(3%) in Betta kuruba & Paniya. Age of infants during death, 46(61%) infant deaths (29 days to 6 months) and 4 deaths (6 to 12 months) were postneonatal, 12(16%) were early neonatal deaths,13 (17%) were Late neonatal death. 68% of infant deaths were at Home, 32% in hospitals. 29% of babies were admitted to NICU due to various reasons like 10(48%) LBW, 4(19%) preterm & Neonatal jaundice,1(3%) breathing difficulties, and 2(10%) not drinking milk and 88% started breastfeeding within 1 hour. As per verbal autopsy before the death Infants had the following symptoms, 55.47% breathing difficulty, 28.40 % fever, and excess crying, 24.30% cold, 18.9% vomiting, 14.90% cough, and change in voice 9.5%. Based on the FGD and personal interviews found that most of the tribes depend on the government rations in these high-risk regions, which results in Poor dietary diversity, food preparation, cooking practices, and traditional post-partum food restrictions. uncertainties surrounding the identification and assessment of thiamine deficiency, due to the broad non-specific clinical manifestations, that overlap with other conditions resulting in frequent misdiagnosis and missed treatment opportunities, and secondly the lack of readily available and agreed upon biomarker analysis.

Conclusion:
The prevalence of beriberi in tribal populations presents a pressing health concern that demands attention and targeted interventions. Remains an important public health problem where highly polished rice is the major staple food and other primary dietary sources of thiamine are in short supply. The impact of nutritional deficiency on infant mortality within these communities underscores the need for comprehensive strategies addressing both prevention and treatment. Education on nutrition, promotion of diverse and nutrient-rich diets, and accessibility to fortified foods or supplements can play pivotal roles in mitigating the risk of beriberi.