Discuss the causes, clinical features and prevention of vitamin A deficiency.
How to lay out the answer. Follow the frame, then write it in your own words.
1 · Open in two lines. Vitamin A deficiency is a public health problem among preschool children. It causes xerophthalmia and lowers immunity, raising deaths from measles and diarrhoea.
2 · Causes.
Low intake of retinol and beta-carotene; low fat in the diet.
Infections: measles, diarrhoea, worms.
PEM (low retinol-binding protein); early weaning.
3 · Draw the eye. [Diagram: an eye with a Bitot's spot on the conjunctiva and a hazy cornea, labelled]
4 · WHO classification. XN, X1A, X1B, X2, X3A, X3B, XS and XF, one line each.
5 · Effects beyond the eye. Follicular hyperkeratosis, poor growth, low immunity and higher child deaths.
6 · Prevention.
Short-term: 9 doses from 9 months to 5 years.
Medium-term: fortified oil and milk.
Long-term: green leafy vegetables, yellow fruits, kitchen gardens, measles vaccine.
7 · In the community. Six-monthly vitamin A rounds at anganwadis, records on the child's card, and kitchen gardens with drumstick and papaya.
8 · Close in one line. Vitamin A blindness is fully preventable with a dose every six months and a plate of greens.
Scoring tip: Write the eight WHO stages in order with their codes; examiners look for X1B and X3.
