The Bhutan government has launched a mass screening programme after an outbreak of glossitis, an inflammation of the tongue, in all the schools.

The Ministry of Education (MoE) has started the mass screening after some schools reported cases of glossitis, according to the Bhutanese newspaper.

The condition causes the tongue to swell in size, change in color, and develop a different appearance on the surface. Though there are many reasons for such an outbreak, the main cause is said to be nutritional deficiencies.

Bhutan has reported some cases of micronutrient deficiency over the years, the most prominent being the thiamine deficiency, beriberi, which is caused by vitamin B-1 deficiency. These outbreaks were mostly reported from schools and monastic institutes.

After holding discussions with a number of people, including experts in medicine, nutritionist, public health, education officials, and development partners, the ministry developed a protocol for the management of oral lesions and peripheral neuropathy, which is a disorder that occurs when nerves malfunction because they are damaged or destroyed, the newspaper said.

Currently, the rice provided in schools is fortified with Vitamin A, B1, B3, B9, B12, iron, and zinc. Authorities have said that outbreaks of peripheral neuropathy in the past have greatly reduced since the introduction of fortified rice.

However, since the beginning of 2018,  cases of oral lesions from boarding schools across Bhutan were being reported.  Though the investigations were not conclusive, it was found that the symptoms improved with vitamin B-Complex supplementation. 

Chief Program Officer of School Health and Nutrition Division (SHND) of Ministry of Education, Karma Wangchuk, was quoted as saying that the government provides fortified rice and fortified oil in all the government-feeding schools. The recent outbreak of glossitis in some schools might be due to the missing of vitamin B2 and B-Complex, he added. 

The children, who suffered from the ailment, are being given Vitamin B2 supplement.

To check the spread of the condition, all schools and institutions have been asked to screen children for oral lesions twice a year.  The affected students are to be sent to their nearest health facility for individual treatment.