17.2 Vitamin Deficiency Vitamin A Deficiency • Major cause of blindness. • Mostly affects small children but can affect adults and younger women. • Caused from a lack of food containing Vitamin A. • Vitamin A is found in leafy green vegetables, eggs, many kinds of meat, mango, papaya, pumpkin, breast milk, and many fruits Prevention • To prevent disease, encourage a healthy diet and distribute Vitamin A capsules to children • One dose of 200,000 IU will provide enough Vitamin A for a child for 4-6 months. Prevention • Before giving a preventative dose, check if one has been given in the last 4 months. • Do not give high doses to pregnant women or to women who could be pregnant. • Page 162 for Vitamin A dosing. Signs and Symptoms • Night blindness (‘chicken blindness’) • Bitot’s spots: grey and white spots on conjunctiva • Dry cornea Treatment • Give a treatment dose to: – Patients with confirmed S/S of Vitamin A deficiency – All cases of moderate and severe malnutrition Treatment – Children with measles – Children with severe respiratory infections and severe diarrhea requiring IPD treatment. Vitamin B1 Deficiency (Beriberi) • Caused from a lack of Vitamin B1 in the diet. • It is often seen in pregnant or breastfeeding women and small children. Prevention • Eat a variety of foods to prevent Beriberi. • For example: yellow beans, meat, fruits, and vegetables. Signs and Symptoms • Dry Beriberi: – Mild: numbness, burning sensation or tingling in lower legs and hands. – Severe: weakness (patient cannot walk alone), reduced tendon reflexes Treatment • Mild Dry Beriberi – give 100 mg PO OD x 7 days then 10 mg OD x 6 weeks Signs and Symptoms • Wet Beriberi – Oedema to legs, trunk, and face – Hepatomegaly – Difficulty Breathing – A rapid pulse that can lead to heart failure Treatment • For Wet Beriberi and severe Dry Beriberi: – Admit to IPD – Give Vitamin B1 IM 100mg TID the 1st day – Give Vitamin B1 PO 100 mg OD x 7 days – Then give 10 mg PO OD x 6 weeks. • The patient may be lacking other vitamins including Vitamin B1, ask about their diet • Consider giving B-complex or a multivitamin. • Do not chew betel-nut when taking vitamin B supplements: betel-nut destroys vitamin B1. • Take vitamin B1 tablets 1 hour before meals.