In the developed world vitamin B1 deficiency presenting as Wernicke encephalopathy occurs mainly in those who chronically abuse alcohol, particularly in the context of poor nutritional intake.[2]Chandrakumar A, Bhardwaj A, 't Jong GW. Review of thiamine deficiency disorders: Wernicke encephalopathy and Korsakoff psychosis. J Basic Clin Physiol Pharmacol. 2018 Oct 2;30(2):153-162.
https://www.doi.org/10.1515/jbcpp-2018-0075
http://www.ncbi.nlm.nih.gov/pubmed/30281514?tool=bestpractice.com
Autopsy studies estimate the prevalence of Wernicke's encephalopathy to be 0.1% to 1.0% in the US, with similar rates in Europe.[3]Harper C, Fornes P, Duyckaerts C, et al. An international perspective on the prevalence of the Wernicke-Korsakoff syndrome. Metab Brain Dis. 1995 Mar;10(1):17-24.
http://www.ncbi.nlm.nih.gov/pubmed/7596325?tool=bestpractice.com
Vitamin B1 deficiency in infants and children is extremely rare in the developed world as there is access to thiamine‐rich food and adequate intake.[1]Whitfield KC, Bourassa MW, Adamolekun B, et al. Thiamine deficiency disorders: diagnosis, prevalence, and a roadmap for global control programs. Ann N Y Acad Sci. 2018 Oct;1430(1):3-43.
https://www.doi.org/10.1111/nyas.13919
http://www.ncbi.nlm.nih.gov/pubmed/30151974?tool=bestpractice.com
Vitamin B1 deficiency is more prevalent in low- and middle-income countries where diets are low in thiamine, e.g., countries in Asia where there is a high consumption of thiamine-depleted polished rice, African nations where cassava root is a primary source of energy, and some areas of the Americas, and also in regions where conditions lead to food insecurity (e.g., drought, famine, conflict, displacement), especially in individuals with an increased metabolic need (e.g., pregnancy, infancy, critical illness).[1]Whitfield KC, Bourassa MW, Adamolekun B, et al. Thiamine deficiency disorders: diagnosis, prevalence, and a roadmap for global control programs. Ann N Y Acad Sci. 2018 Oct;1430(1):3-43.
https://www.doi.org/10.1111/nyas.13919
http://www.ncbi.nlm.nih.gov/pubmed/30151974?tool=bestpractice.com
[4]Johnson CR, Fischer PR, Thacher TD, et al. Thiamin deficiency in low- and middle-income countries: Disorders, prevalences, previous interventions and current recommendations. Nutr Health. 2019 Jun;25(2):127-151.
https://www.doi.org/10.1177/0260106019830847
http://www.ncbi.nlm.nih.gov/pubmed/30798767?tool=bestpractice.com
Lack of standardisation in data from different laboratories and assay methods and lack of consensus on clinical case definitions complicates assessment of the global prevalence of thiamine deficiency disorders.[1]Whitfield KC, Bourassa MW, Adamolekun B, et al. Thiamine deficiency disorders: diagnosis, prevalence, and a roadmap for global control programs. Ann N Y Acad Sci. 2018 Oct;1430(1):3-43.
https://www.doi.org/10.1111/nyas.13919
http://www.ncbi.nlm.nih.gov/pubmed/30151974?tool=bestpractice.com
[4]Johnson CR, Fischer PR, Thacher TD, et al. Thiamin deficiency in low- and middle-income countries: Disorders, prevalences, previous interventions and current recommendations. Nutr Health. 2019 Jun;25(2):127-151.
https://www.doi.org/10.1177/0260106019830847
http://www.ncbi.nlm.nih.gov/pubmed/30798767?tool=bestpractice.com