STORAGE & TRANSPORTATION
Vit A is stored in Liver in it’s active form ‘RETINOL PALMITATE”
but it is highly toxic.
Therefore transported in circulation in combination
with a protein “RETINOL BINDING PROTEIN”
produced by liver
Deficiency of protein (PEM) leads to deficiency of Vit-A
Normal vision & dim vision : important component of
Maintain the integrity and normal functioning of the
glandular & epithelial tissue. e.g : intestinal, respiratory,
urinary, skin & eyes.
Support growth: skeletal growth.
Anti – infective: role in immune response.
Anti-cancer vitamin: Protect against some epithelial cancer
e.g. Bronchial cancer.
EPIDEMIOLOGY OF VIT-A DEFICIENCY
AGE: common in children between 1-3yrs.
Related to ‘faulty weaning practices’ & ‘PEM.’
INFECTION: Diarrhoea, Measles & Respiratory tract infections.
EPIDEMIC OF XEROPHTHALMIA: associated with food
donation programme involving “skimmed milk”
SOUTHERN & EASTERN STATES: rice eating state
(Thorny skin / Phrynoderma)
Cone shaped elevated papules due to thickening of
ROSE BENGAL DYE TEST
(Tetra-chloro tetra-iodo fluorescin)
1% of the dye applied on the conjunctiva
Development of PINK COLOUR stain on conjunctiva
Normal requirement: 600mcg of Vit.A (retinol)
= 2000 IU of retinol Palmitate.
Vitamin A : > 12month of age: 2,00,000 (2lakh) I.U
of retinol palmitate orally on two
< 12month of age: 1,00,000 (1lac) I.U of
retinol palmitate orally on two
SHORT TERM ACTION
MEDIUM TERM ACTION
LONG TERM ACTION
SHORT TERM ACTION (quick result but short lived)
By giving large doses of vit.a to the vulnerable groups
at periodic intervals.
ORAL DOSE OF RETINOL
Children < 12m
Children > 12m
Women of child bearing
Within 1 month of
Pregnant & lactating
MEDIUM TERM ACTION
Fortification: addition of some nutrient to an edible
substance to increase its nutritive value.
By fortification of certain foods with Vitamin A.
e.g : Dalda (vanaspati).
Dried skimmed milk.
sugar, salt, tea etc.
LONG TERM MEASURES
Action is slow but long lasting.
Health education: advised to take vitamin A rich diet.
How to prepare a balanced diet.
How to prepare proper weaning diet.
Promote Breast Feeding: Exclusive breast feding upto
6month. Colostrum is rich in vitamin A
Immunization: against infectious diseases particularly
‘The RighT To SighT”
a global initiative, launched by
WHO: 18th February 1999
India: 14th October 2004
Objective: to reduce avoidable blindness
(preventable & treatable) by the year 2020.
e.g: vit-A def, cataract, glaucoma, refractive error etc
Goal: reduce the prevalence of blindness in india to
0.5% by the year 2020 (current is 1%)
VITAMIN-A PROPHYLAXIS PROGRAMME
2,00,000 IU of Vitamin-A (retinol palmitate) for children
between 1-6 yrs.
family is kept under surveillance for 1yr and children for
NOTE: Vitamin-A solution has been incorporated into the
“National Immunization Schedule” given at
9m – 18m – 24m – 30m – 36m (total 5 doses)
VITAMIN- A PROPHYLAXIS
Every child between 9m – 3yrs of age
given 5 doses of vitamin A.
1st dose at 9month 1,00,000 IU or 1ml
along with measles
2nd dose at 16month 2,00,000 IU or 2ml
along with booster of DPT.
3rd dose after 6month 2L IU
4th dose after 6month 2L IU
5th dose after 6month 2L IU