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By ULYCLINIC

Introduction

A condition predominantly affecting the skin, mucous membranes and the eyes. It is most common in children of 1–5 years of age. If associated with measles and diarrhoea there is an increased risk of illness and death. If not identified and treated early, it can cause blindness.

Risk Factors

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Signs and symptoms

• Night blindness or inability to see in the dark
• White foamy patches on the eye (Bitot’s spot) or conjunctival and corneal dryness
• keratomalacia or wrinkling and cloudiness of cornea
• Corneal ulceration or the cornea becomes soft and bulges

Diagnostic criteria

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Investigations

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Managemet

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  • Non-pharmacological

    Dietary supplementation with vitamin-A rich food include:

    • fortified maize meal and/or bread, fortified margarine
    • carrots, sweet potato, mangoes and pawpaw, broccoli, sprouts
    • dark green leafy vegetables e.g. matembele, mnafu and spinach
    • apricots, melon, pumpkin
    • liver, eggs, full cream milk and fish

  • Pharmacological

    For Prophylaxis

    Vitamin A (retinol), oral, every 6 months up to the age of 5 years.

    Age range - Infants 6 –11 months

    Dose units - 100,000
    Capsule 100,000u - 1 capsule
    Capsule 200,000 u - ___

    Age range - Children 12 months–5 years

    Dose units - 200,000
    Capsule 100,000u - 2 capsule
    Capsule 200,000 u - 1 capsule

    For Treatment

    Children 0–5 years of age, with:

    • Severe under nutrition/malnutrition
    • Persistent diarrheoa
    • Any of the clinical signs of vitamin A deficiency
    • Measles

    A: Vitamin-A (retinol), oral, every 6 months up to the age of 5 years.

    Age range - Infant < 6 months

    Dose Unit(IU) - 50,000
    Capsule 100,000IU - ½ capsule
    Capsule 200,000IU - _______

    Age range - Infants 6 –11 months

    Dose Unit(IU) - 100,000
    Capsule 100,000IU - 1 capsule
    Capsule 200,000IU - _______

    Age range - Children 12 months–5 years

    Dose Unit(IU) - 200,000
    Capsule 100,000IU - 2 capsule
    Capsule 200,000IU - 1 capsule

    Administration of a vitamin A capsule

    • Cut the narrow end of the capsule with scissors.
    • Open the child’s mouth by gently squeezing the cheeks.
    • Squeeze the drops from the capsule directly into the back of the child’s mouth. If a child spits up most of the vitamin A liquid immediately, give one more dose.

    Children > 5 years of age and adults with:

    • Any clinical signs of vitamin A deficiency
    • Measles

    Note: Do NOT give the capsule to the mother or the caretaker to take home.

    • Children who received a prophylactic dose within the previous month should not receive the treatment dose of vitamin A.
    • If a child is scheduled to receive a routine prophylactic dose of vitamin A and has received a treatment dose within the past month, postpone the routine dose for approximately one month.
    • Wait at least one month between doses.
    • Children receiving routine multivitamin syrup can still receive vitamin A supplements.

Prevention

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Updated on,

20 Novemba 2020 11:09:10

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References

    1. STG
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