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Recent case reports have, however, highlighted the persistence of thiamine deficiency as a cause of infant mortality in South and Southeast Asia. Low infant thiamine status and incidence of beriberi is attributable to maternal thiamine deficiency and insufficient breast milk thiamine. Poor dietary diversity, food preparation and cooking practices and traditional post\u2010partum food restrictions likely play a role in these high\u2010risk regions. Given the contribution of thiamine deficiency to infant mortality and emerging evidence of long\u2010lasting neurodevelopmental deficits of severe and even subclinical deficiency in early life, public health strategies to prevent thiamine deficiency are urgently needed. However, efforts are hampered by uncertainties surrounding the identification and assessment of thiamine deficiency, due to the broad non\u2010specific clinical manifestations, commonly referred to as thiamine deficiency disorders (TDD), 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 and cut\u2010off thresholds. This review will discuss the key challenges and limitations in the current understanding of TDD and explore how ongoing initiatives plan to fill persistent knowledge gaps, namely in the development of a standardised case definition to help more accurately diagnose and treat TDD in low\u2010resource settings. Given more attention and ensuring greater recognition of TDD will support the design and implementation of treatment and prevention programmes, and ensure beriberi can truly be considered \u2018the forgotten disease of Asia\u2019.<\/jats:p>","DOI":"10.1111\/nbu.12481","type":"journal-article","created":{"date-parts":[[2021,1,15]],"date-time":"2021-01-15T06:49:12Z","timestamp":1610693352000},"page":"12-25","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":30,"title":["Infantile thiamine deficiency in South and Southeast Asia: An age\u2010old problem needing new solutions"],"prefix":"10.1111","volume":"46","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9543-6461","authenticated-orcid":false,"given":"T. J.","family":"Smith","sequence":"first","affiliation":[{"name":"Institute for Global Nutrition University of California Davis Davis CA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S. 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