Vitamin A deficiency causes child blindness

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Vitamin A deficiency causes child blindness

A child of 7 years Old named Arif is now totally blind. Now he begs with her mother. Where as he could a healthy, strong and clever citizen not being the burden of society. Arif or his father is not aware of the reason of his blindness.  The term Vitamin A is the generic descriptor for a group of chemical compounds known as retinoid exhibiting qualitatively the biological activity of retinal. They include retinal, its ester (retinyl palmitate) and retinoic acid. Vitamin A is a fat-soluble substance found in ester form m animal and dairy products and it is hydrolyzed in the intestinal cells to form retinal. Carotene the naturally occurring progenitor of vitamin A in the certain vegetables and fruits, is split in cells of the small intestine to retinaldehyde, most of which is readily converted to retinal. Vitamin A is an essential nutrient needed in small amounts for normal cellular function, and is especially required for the visual system, growth and development, maintenance of epithelial cellular integrity, immune function and reproduction Vitamin A deficiency occurs when body stores are depleted to the extent that normal physiological function is unpaired even though it this stage overt clinical deficiency, such as eye signs, may not be evident. Depletion of stored vitamin A is usually seen as the consequence of an inadequate dietary intake of the vitamin itself over a period of time, although losses may be increased in association with infection. The level of depletion at which physiological functions begin to be impaired is not entirely clear. What is known, however, is that the vitamin is extensively recycled between the plasma, liver and other tissues? It appears that the rate of utilization by specific tissues can show some adaptation to diminishing availability. This adaptation and recycling may serve to maintain relatively constant levels in the blood until body stores become depleted below a critical point, exceeding the capacity of homeostatic mechanism to the point where adaptation can no longer compensate. Severe vitamin A deficiency has long been recognized as a potentially lethal, but preventable nutritional disease. However, the extent to which a large proportion of the population might be affected by less severe forms of deficiency and the implications of this for survival and health have only been realized recently. Vitamin-A deficiency is a major cause of preventable blindness in children in Bangladesh. It also impairs growth, lowers resistance to infections and increases the risk of dying. In pregnant and postpartum women, Vitamin—A deficiency can have Serious consequences for the health and survival of women and for the Vitamin-A status of their children.
Since 1973, the government has implemented a national programme for the control of Vitamin-A deficiency among children. This has had financial and technical Support from UNICEF and financial support from CIDA, using a community- based supplementation approach with active participation of those communities.
Bangladesh has distributed Vitamin-A capsules to children aged 12-59 months
twice a year since the start of the national programme. Until the mid-1990s, the distribution system relied on door-to-door distribution Vitamin-A capsu1e by health workers. From 1995, the distribution of vitamin A capsules was linked with the National Immunization Day (NID) for polio at over 120,000 fixed sites in the country. This change in strategy resulted in an increase in coverage from around 45 per cent to over 80 per cent, a remarkable achievement. These impressive results led the government to implement National Vitamin-A Weeks, to distribute the other biannual Vitamin—A dose in years when only one NID was conducted.
From 2003, a new strategy was developed, which became biannual in 2003 and this strategy discontinued after 2005. The Government of Bangladesh recognized that distributing multiple nutrition and health interventions would be more cost-effective than Vitamin-A supplements alone, and implemented a package of health and nutrition services for children through a national Vitamin- A Campaign.
In the first campaign in October 2003, Vitamin-A supplements were distributed to children aged 12-59 months, albendazole to children aged 24-59 months. Children in primary and secondary schools tested salt for iodine. In this connect ion, the following Vitamin- A Plus campaigns included vitamin A supplementation and albendazole treatment and also included other health and nutrition interventions such as measles vaccination and dissemination of health and nutrition messages.
The high coverage of Vitamin-A Supplementation to children has resulted in a reduction in the prevalence of vitamin A deficiency. Since 1997, the prevalence of night blindness Sean early indicator of vitamin A deficiency has been maintained below the 1 percent threshold that indicates a public health problem. However, it must be emphasized that vitamin A deficiency is being controlled by the Vitamin-A supplementation programme rather than being eliminated, because infants and young children still consume diets that are lacking in Vitamin-A. For this reason, the vitamin A supplementation programme must continue until production and consumption of Vitamin-A rich foods are increased.

In 1990, the World Summit for Children adopted a declaration, which as a global objective called for the virtual elimination of vitamin A deficiency and its consequences by the year 2000. In 1992, at the International Congress of Nutrition, this goal was restated. There has been a quantum increase in terms of the awareness of the problem and the adopt ion of actions which will in time ensure its elimination. So far we attempted to review the present situation in relation to vitamin A deficiency in Bangladesh. It has included information on the existing intervention strategies and specific needs and key options for action to improve the situation. Over the past few decades a good number of studies including national surveys have been carried out to investigate the prevalence of vitamin A deficiency among different population groups in Bangladesh, and demonstrated a significant public health problem. The magnitude of the problem is considerable, especially among preschool children, adolescents and women of reproductive age. Although the prevalence of ‘night blindness in preschool children has decreased over the past two decades, this biochemical assessment of vitamin A status based upon the measurement of serum retinol levels reveal that there is a high Prevalence of sub clinical vitamin A deficiency. Among school-age children and adolescents, the prevalence of night blindness and Bitot’s spot has decreased slightly over the same period of time; however, it is still a significant problem. Furthermore, recent reports indicate that night blindness among rural mothers is as high as 1.2%. Only a limited number of studies, with a small sample size, provide information on serum retinol levels in school-age children, adolescents and pregnant women. Furthermore, the dietary intake of each population group was found to be less donating dietary problems as a significant risk factor for vitamin A deficiency. Several strategies have been developed with the objective of controlling vitamin A deficiency in Bangladesh. The biannual distribution of high-dose vitamin A capsules to children less than 60 months of age was found to be effective in reducing deficiency. However, this programme is only beneficial for preschool children. Other programmes like home gardening and nutrition education including social marketing have been have been in operation for a long time; however, each of the programmes has its limitation. Although some progress has been made in improving the situation, the magnitude of the problem makes it clear that there is a need for more sustainable long-term approaches to alleviate the problem of vitamin A deficiency will require integrated approaches and the action is needed at every level and also within many sectors.


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