Vit. A def report edited.pptx

7/29/2019 Vit. A def report edited.pptx

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Vitamin A deficiency, according to WHO is tissue concentration of Vitamin

A low enough to have adverse health consequences even if there is no

evidence of clinical Xerophthalmia.

Vitamin A deficiency can occur at any age but it is most common amongchildren under 6 years of age. Over 100 million preschool-age children are

thought to be affected.

Lack of vitamin A in children causes severe visual impairment and

blindness, and significantly increases the risk of severe illness, and even

death, from such common childhood infections as diarrheal disease.


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Vitamin A Deficiency

leading cause of preventable blindness in

children

increases the risk of disease and death from

severe infections

In pregnant women VAD causes night

blindness and may increase the risk of

maternal mortality.


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For children

causes severe visual impairment and blindness

significantly increases the risk of severe illness, andeven death, from such common childhood infections

as diarrhoeal disease and measles.

For pregnant women in high-risk areas, vitamin Adeficiency occurs especially during the lasttrimester when demand by both the unborn child

and the mother is highest. demonstrated by the high prevalence of night

blindness during this period.


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common in many developing countries

typically begins during infancy, when infants

do not receive adequate supplies of colostrum

or breast milk

Chronic diarrhea

leads to excessive loss of vitamin A in young

children, and vitamin A deficiency increases the

risk of diarrhea


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ETIOLOGY OF VITAMIN

A DEFICIENCY


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o PRIMARY VITAMIN A DEFICIENCY

- prolonged dietary deprivation- endemic in Southeast Asia

o SECONDARY VITAMIN A DEFICIENCY

- decreased bioavailability of provitamin A

- interference with absorption, storage or

transport

- common in prolonged protein-energy

undernutrition


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VITAMIN A DEFICIENCY CLINICAL

MANIFESTATIONS


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1. NYCTALOPIA

- Difficulty to adjust to dim light

- Insufficient adaptation to darkness

- Inhibits Rhodopsin production


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2. XEROPHTHALMIA

- Dry eyes- Conjunctiva becomes dry and thick and wrinkled

- Loss of goblet cells in the conjunctiva which is

responsible for mucus secretion

- Eyes fail to produce tears

- Dead epithelial and microbial cells accumulate on

the conjunctiva and form debris


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most common symptom of vitamin A deficiency in

young children and pregnant women

Corneal ulceration and necrosis


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3.) BITOTS SPOT

- Foamy, cheesy accretions of desquamated

keratin and saprophytic bacilli overlying an area of

conjunctival xerosis

-Build up of keratinized epithelial debris and

secretions found in the conjunctiva

- Usually associated with night blindness


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- In advanced deficiency, cornea becomes hazy and

develop erosions

- Liquefactive corneal necrosis

4.) KERATOMALACIA

-Softening of the cornea

- Leads to corneal scarring

that blinds at least a quarter

of a million each year


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5.) FOLLICULAR

HYPERKERATOSIS

-Rough

keratinized skin

-Resembles

goosebumps


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6.) Increased the severity and mortality risk

of infections (particularly diarrhea and

measles) malaria, and respiratory disease


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TREATMENTS FORVITAMIN A

DEFICIENCY


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TIMING VITAMIN A DOSE

Immediately on diagnosis

< 6 mos. of age 50,000 IU

6-12 mos. of age 100,000 IU

>12 mos. of age 200,000 IU

Next day Same age-specific dose

Atleast 2 weeks later Same age-specific dose

TREATMENT FOR XEROPHTHALMIA

For all age groups except for women of reproductive age


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For women of reproductive age:

Night Blindness/ Bitots Spot: ---- 10,000 IU

daily for atleast 2 weeks or weekly doses of

25,000 IU


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VITAMIN A TOXICITY


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ACUTE VITAMIN A TOXICITY

Accidental ingestion by children (>300,000)

Eating of polar bear or seal liver by arctic explorers

Headaches, drowsiness, irritability, nausea and vomiting,

skin peeling

CHRONIC VITAMIN A TOXICITY

Mega therapy/ massive daily doses (150,000-350,000 IU)

Coarse hair, cracked lips, dry, rough skin, alopecia of theeyebrows, frail bone

In children, hepatomegaly, splenomegaly and pseudotumor

cerebri


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PREVENTION

i i h l i S h d l


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Individual Oral dose Timing

Children 6-11 mos.old 55 mg. Retinylpalmitate (100,00 IU) Once every 4-6 mos.

Children > 12 mos.

old

100 mg.

(200,000 IU)

Once every 4-6 mos.

Infants 0-6 mos. old 1375 mg.

(25,000 IU)

1-3 times over the

first 6 mos. of life

Women ofchildbearing age

110 mg.(200,000 IU)

Within 1-2 months atmost of giving birth

Pregnant and

Lactating women

275 mg. (5,000-

10,000 IU)

Daily

Vitamin A Prophylaxis Schedule


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RDA of Vitamin A for different age group:

1 year or younger 375 mcg

1-3 years old 400 mcg



All males older than 10 years old 1000 mcg

All females older than 10 years old 800 mcg

Vit. A def report edited.pptx

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