Nutritional problems
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Nutritional problems. Dr K N Prasad Community Medicine. Xeropthalmia. Common cause for blindness in SEA Commonly affected are children below the age of 3 years Risk factors are – low SES, Ignorance, faulty feeding practices, Acute diarrhoea, Measles, bottle feeding

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Nutritional problems

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Nutritional problems

Dr K N Prasad

Community Medicine


Xeropthalmia

  • Common cause for blindness in SEA

  • Commonly affected are children below the age of 3 years

  • Risk factors are – low SES, Ignorance, faulty feeding practices, Acute diarrhoea, Measles, bottle feeding

  • Common in rice eating population


Prevention and control

  • Short term action:

  • Large dose of Vitamin A orally on periodic basis to vulnerable group.

  • Two lakhs IU Retinol Palmitate in oil for children less than 6 years of age once in 6 months.

  • Children less than 1 year will get one Lakh IU of RP


Prevention and control

  • Medium term action:

  • Regular and adequate intake of Vitamin A rich foods, Food fortification with Vitamin A

  • ex. Vanaspathi, Margarine oil, dried mild powder, sugar.


Prevention and control

  • Long term action:

  • Education opportunities:

  • General population, pregnant and lactating mothers about consumption of dark GLV, Promotion of breast feeding, improvement in environment health, immunisation against measles, improved health services for MCH


Nutritional Anemia

  • A disease syndrome caused by malnutrition

  • Commonly called as Iron deficiency

  • WHO standard – Hb level estimation

  • Adult male – 13 gm%

  • Adult Female non pregnant- 12gm%

  • Pregnant woman- 11gm%

  • Children < 6 years- 11gm%

  • Children 6-14 years- 12gm%


Global problem of Anemia

  • Prevalence is highest in developing countries

  • Child bearing age group is highest burden other than children

  • Two third of pregnant women and half of non pregnant women are anemic in developing countries

  • 4-12% of child bearing women are anemic in developed countries


India

  • Many have iron deficiency other than anemia

  • Rural population both Male and female are susceptible

  • Common cause is inadequate intake , poor bioavailability and excess loss of iron

  • Infections – Malaria, Hook worm, etc.

  • Short interval between pregnancies

  • Folic acid deficiency is accounting for 50-70% of population


Detrimental effect of Anemia

  • Pregnancy- increased risk of Mortality and morbidity ( 40% )

  • Aggravate by infections and susceptible to infections

  • Decreased working capacity

  • Decreased economy of the country


Interventions

  • Iron & Folic acid supply: under National Program for Nutritional anemia daily supplementation of IFA to prevent mild and moderate anemia.

  • Beneficiaries : Pregnant & Lactating mothers , children below 12 year sof age

  • Eligibility : Hb< 12gm% , refer to Hospital if Hb<10gm%

  • Dose: Each Tab contains 80 mg of elemental iron ( 200mg Fe sulphate ) and 0.5mg of Folic acid

  • Duration: 2-3 months Hb returns to normal

  • Follow up: estimate Hb after 3 months

  • Children: if anemia supplement 20mg of elemental iron ( 100mg Fe Sulphate)


Iron Fortification

  • Fortification to salt is tried

  • Recommended for high risk group in the endemic area

  • Other measures

    • Changing dietary habits

    • Control of parasitic infections

    • Nutrition education


Iodine deficiency disorders (IDD)

  • Equivalent to Goitre

  • Major nutritional problem in India

  • Deficiency leads to wide range of disorders commencing from Intra uterine life to childhood , adult life with serious health and social implications.


Public health problem of IDD

  • Major problem in SEA

  • Common In Himalayan region known as Goitre belt

  • IDD is common everywhere in India

  • No state is free from IDD

  • 1960- 9 million

  • Present- 130 million have IDD

  • Clinical manifestations are wide.


Control of IDD

  • Iodised salt and Oil

  • Monitoring and surveillance

  • Manpower training

  • Mass campaign


Iodised salt and Oil

  • Iodised salt is widely used in India

  • Recommended concentration is

  • not less than 30 PPM at production level

  • Not less than 15 PPM at consumer level

  • Non iodised salt is completely banned for sale

  • IM injection of Iodised oil 1 ml for high risk group individuals

  • Iodised oil

  • Protection for 4 years

  • Replace salt with iodised salt

  • Toxicity risk is low


Monitoring

  • Neonatal hypothyroidism is a sensitive indicator for community IDD

  • Laboratory test for iodine excretion determination

  • Determination of iodine in drinking water , soil and food

  • Determination of iodine in salt for quality assessment.


Mass campaign

  • Public awareness about IDD

  • Use of only iodised salt for regular consumption


Thought for the day

Asking for help is a strength not weakness


Thank you


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