Outbreak of oral ulcers (glossitis) among the students of three central schools under Tsirang district Bhutan, 2018
Published in BMC Oral Health, 2021
This study investigated an outbreak of oral ulcers, predominantly glossitis, that occurred in September 2018 across three central schools in Tsirang district, Bhutan. A total of 204 students were clinically assessed, with the majority presenting symptoms such as burning sensation, tongue pain, impaired taste, and intolerance to spicy foods.
The outbreak investigation combined clinical examinations, nutritional surveys, and laboratory analyses. Results indicated inadequate dietary intake of vitamin B complex (particularly riboflavin and folate) and iron. Laboratory findings confirmed below-normal levels of certain micronutrients, while cytology tests identified fungal elements in some cases.
The study concluded that nutritional deficiencies in school-provided meals contributed significantly to the outbreak. It recommended strengthening the school feeding program to ensure a balanced diet, with fortified foods and adequate micronutrient supply to prevent future outbreaks.
This was the first documented outbreak of glossitis in Bhutan, providing critical evidence for policymakers to improve student nutrition and school health programs.
Recommended citation: Gyeltshen, T., Dorji, L., Dorj, L. et al. Outbreak of oral ulcers (glossitis) among the students of three central schools under Tsirang district Bhutan, 2018. BMC Oral Health 21, 444 (2021). https://doi.org/10.1186/s12903-021-01808-5
Download Paper | Download Slides