Neten Dorji | Trashigang
With 103 students of Tshenkharla Central School in Trashiyangtse suffering from tongue inflammation since January 27, it was concluded that there is an outbreak of glossitis in the school.
Along with the 103 glossitis cases, 22 students were found with features of chilblain, 13 students had aphthous ulcer (four isolated and nine mixed with glossitis), seven with angular cheilitis (three isolated four mixed with glossitis) and two students were found to have clinical pallor and were asymptomatic.
Three students were reported to have tingling sensation, pins and needle sensation and hypersensitivity in lower extremities.
However, 22 students recovered.
A team, comprising of three doctors, dzongkhag health officer (DHO) and deputy chief dzongkhag education officer, visited the school and conducted an investigation on food nutrition and sanitation in the school.
They screened 423 students using standard tool examination for oral lesions and peripheral neuropathy as per the national protocol.
The report stated they were investigating for nutritional deficiency and other medical conditions.
“The menu planning, food and preparation and serving were found to be satisfactory as per the third national mess management protocol draft.”
It was reported that of the 423 students in the school, 362 students reported to be non-vegetarians and 61 students are strictly vegetarian.
Officiating principal, Karchung, said they hardly get a variety of vegetables from local vegetable groups.
The school is linked with farmers for supply of vegetables. “As vitamin B complex comes from the meat, we have been providing the meat twice a week and egg three times.”
He said the school administration informed all parents not to worry about their children, as the case is not severe. “Except for three students, others can eat well.”
Meanwhile, students were supplemented with vitamin B complex, vitamin C and folic acid for a period of two weeks as per the treatment protocol in the national protocol for management of oral lesions and peripheral neuropathy.
Dzongkhag health officer, Tshewang Sither, said they can not say diseases occurred due to lack of nutrition. “We have to examine and investigate the patient thoroughly.”
He said health education was provided to all students to take healthy balanced meal, the importance of micronutrients and oral hygiene.
The team recommended the education sector to find ways to improve the variety of vegetables provided to students and providing seasonal fruits.
“The school management has to allow students to wear hand gloves, warm footwear, use heaters and provide warm water during peak season,” the report recommended. “The school to come up with innovative ideas to combat cold for instance a knitting club with members who will knit gloves and hats of various sizes for use in the winter.”
Chief programme officer of school health and nutrition division, Karma Wangchuk said the division has sent a clear directive to manage the case. “It is difficult to find the cause but we are in the process of conducting thorough research.”