Case study of a disease (Nutritional, infectious and life style) along with the

public health data analysis and discussion

Reducing vitamin –A deficiency
Vitamin –A deficiency happens when your body doesn’t get enough vitamin A.
Vitamin A deficiency can cause vision loss and blindness. It can also lead to
complications in the skin, heart, lungs, tissue and immune system. It also affects
people with certain liver disorders and conditions that affect people with certain
liver disorders and conditions that affect how their bodies can absorb vitamins.
Vitamin A deficiency is the leading cause of preventable blindness in children and
increase the risk of disease and death from severe infection. In pregnant woman it
cause night blindness and may increase the maternal mortability (the death of
woman during pregnancy or within 42 days of giving birth).An estimated 250
million preschool children worldwide are vitamin A deficient. An estimated
250000-500000 vitamin A deficient children become blind every year, with half of
these dying within 12 months of losing their sight because their deficiency is
severe.
What is vitamin A
Vitamin A plays a key role in many systems of your body. Vitamin A is essential
for healthy vision, metabolism and cell development. It’s an important factor in
keeping your immune system and reproductive system healthy. Our body can’t
make vitamin A on its own, so you must get it through the food we eat. Vitamin A
is vital for your vision. Eyes need to make specific pigments for your retinas to
work correctly. Lack of vitamin A hinders your eyes ability to make these
pigments which can lead to night blindness. In other words vitamin A is required to
see at night. In eyes also vitamin A is required to produce moisture to keep corneas
properly lubricated. If your corneas get too dry, they become damaged, which can
lead to blindness. Vitamin A also keeps your skin and lining of lungs, intestine and
urinary tract in tip-top shape. It also helps your immune system protected.
Different forms of vitamin A
There are two forms of vitamin A.
Preformed vitamin A
Preformed vitamin A or retinol is found naturally in animal products, including
beef, poultry, fish, liver and eggs. Some cereals and dairy products are fortified
with vitamin A as well.
Provitamin A carotenoids
Carotenoids are from plant sources and are the pigments in vegetables and fruits
that give them yellow, orange and red colors. After you eat these fruits and
vegetables your body slowly converts the carotenoids into vitamin A. The most
common type of carotenoid is beta carotene.
Complications associated due to vitamin A deficiency
Vitamin A deficiency can lead to many complications, including-
Eye problem
Vitamin A is a key factor in many functions in your eye. Vision loss and blindness
can occur.
Skin issues
A lack of vitamin A can cause dry, scaly and itchy skin.
Infertility
Vitamin A plays an important role in your reproductive system. Vitamin A
deficiency can lead to trouble conceiving and infertility.
Growth issues
Vitamin A deficiency can cause delayed growth and development in children.
Respiratory tract infections
Vitamin A deficiency can cause problems with the immune system. This can lead
to infections in your chest and throat.
Signs and symptoms of vitamin A deficiency
One of the early signs of vitamin A deficiency is night blindness. If your have
night blindness you have trouble seeing well in the dark, but you can see normally
if enough light is present. A retinol disorder causes night blindness. As the vitamin
A deficiency worsens, the whites of your eyes and your corneas can become dry
and you aren’t able to produce tears (Xerophthalmia). Foamy spots called Bitot
spot may appear in the whites of the eye. Open sores on your corneas (Corneal
ulcers) may appear, clouding of your corneas (keratomalacia) which can lead to
blindness.

Causes of vitamin A deficiency

Vitamin A deficiency occurs when you don’t get enough vitamin A in your diet.
While rare in developed countries, vitamin A deficiency happens frequently in
developing countries of the world.
It also occur because of liver disorders. Liver store most of body’s vitamin A and
liver disorders can interfere with vitamin storage.
Disease and conditions that impair your intestine’s ability to absorb fat can also
cause vitamin A deficiency. These conditions can reduce body’s ability to absorb
vitamins such as vitamin A. These conditions include- chronic diarrhea, cystic
fibrosis, pancreatic disorders, bile duct blockage, Zn/ Fe deficiency, alcohol use
disorders.
Diagnosis of vitamin A deficiency
Usually healthcare provider will treat your vitamin A deficiency with high doses of
a vitamin A supplement for several days. After several days of high dose, low
doses of vitamin A are suggested to intake until vision and skin issues start to
resolve. Vitamin A supplements can cure night blindness. However vision loss due
to scarring from corneal ulcers can’t be cures.
Infants shouldn’t take high doses of vitamin A because it can be toxic to them.
However children can be treated with vitamin A supplements. Correct dose have
been decided by the healthcare provider. Consuming high levels of vitamin A can
lead to toxicity. Eating vitamin rich food can be one of the alternative.
A genetic technology used to cure vitamin A deficiency
Rice can make up the majority of food that children suffering from vitamin A
deficiency eat in some countries. Scientist have therefore developed using GM
technology a type of a rice labelled as Golden rice which provide more dietary
vitamin A. The first golden rice was developed in 1999.Further it have been
improved and second version of golden rice was released in 2006. No negative
health effects of GM food was observed.
Survey
Comprehensive national nutrition survey data on vitamin A deficiency was
obtained from the studies carried out by Ministry of Health and Family welfare,
UNICEF and population council 2019. VAD studies were done in different age
group children. It shows that vitamin A deficiency among pre-school children aged
1-4 years was 18% which is 22% among school age children (5-9 years) and 16%
among adolescents aged 10-19 years. The prevalence of vitamin A deficiency was
higher among early adolescents age 10-14 years (18%) compared to late
adolescents aged 15-19 years (13%).

Among Indian states, Jharkhand has severe vitamin A deficiency across all the age
group (≥ 20 %) followed by Mizorem, Chattisgarh, Telangna, Haryana and Bihar.
According to the WHO guidelines of prevalence (≥ 20 %) (WHO, 2007), vitamin
A deficiency was identified as a severe public health problems in 12 states among
pre-school children and in four states among adolescent. Among North- East hill
states, 5-9 years children from Tripura and Manipur have severe VAD with
moderate level in other states.
Discussion
The world Health Organization indicates that poverty has a strong association with
nutrition deficiency. Because poor households are less access to nutrient rich food
which is often expensive. It is necessary to access the reason for high prevalence of
high micro nutrient deficiencies.
Prevention
The best way to prevent vitamin A deficiency is to eat a healthy diet that includes
food that can contain vitamin A. Vitamin A can be found naturally in-
Green vegetables
Orange and yellow vegetables
Orange and yellow fruits
Dairy products
Liver, beef and chicken
Certain types of fish, such as salmon
Eggs
Cereals
Rice potatoes, wheat and soya bean