Micronutrient deficiencies - Vitamin A deficiency is no longer a public health problem in India as it has been virtually eliminated. More than 90% of households now consume iodized salt, reducing iodine deficiency disorders. Prevalence of iron deficiency anemia has been reduced from 78% to 48% from 1998 to 2006.

1. Micronutrient deficiencies
dr Shambhavi

2. Micronutrient deficiencies
• Vitamin A deficiency is no longer a public
health, virtually eliminated
• More than 90% of household consume iodized
salt and IDD is on the way to elimination
• Prevalence of Iron Deficiency Anemia has
been reduced from 78% in 1998 to 48% in
2006

3. Vitamin A deficiency

8. prevention

11. ANEMIA
• Decrease in hemoglobin level for age and sex
Causes:
• 1.ongoing blood loss: hemorrhage due to
trauma,menorrhagia,per rectal bleed(upper
and lower GI bleed),worm infestation
• 2.Decreased production of RBC,HB: iron,folic
acid,vit b12 deficiency,poor bone marrow
function,leukemia
• 3.destruction of RBC: transfusion
reaction,malaria, sickle cell disease

12. • Classification according to CBIMCI:
• No anemia
• Anemia
• Severe anemia
ASSESSMENT:
• look for palmer pallor

13. Malnutrition

14. • 1. no anemia :
no palmer pallor
Treatment: home treatment
Assess nutritional status, if has feeding
problems, councel the mother about proper
feeding and feeding requirements for the
patients age,sex.

15. 2.Anemia: some palmer pallor
Treatment: opd basis
• Give iron supplimentation
• Oral antimalarial if high risk of malaria
• Deworming (if >1 yr child )with mebendazole
if not taken antihelminth in past 6 months
• Councelling for high risks and danger signs
• Follow up in 14 days

16. • 3. severe anemia:
treatment
• Sever palmer pallor
• Refer urgently to hospital
• At hospital:
• find out the cause
• Treat the cause
• Blood transfusion if necessary

17. Fever
Definition
• Increase in body temperature above the set
point.
• Rectal temperature above 38C or 100.4F
• note: axillary temperture is 0.5C /1F lower than
rectal temperature

18. Causes
Infectious causes:
1.CNS: meningitis ,encephalitis, tb, brain abscess
2.respiratory: ARI( upper and lower),lung
abscess,empyema,tb
3.CVS: infective endocarditis,rheumatic fever
4.Skin: abscess,fever with rashes, any pus
collection

19. GI system: appendicitis,gastroenteritis,hepatitis,
pancreatitis, cholecystitis
• Genitourinary : UTI, pyelonephritis, pyocele
• Others: kalazar,malaria,measles,viral infections,HIV,
dengue
Non infectious causes:
Leukemia,malignancy
Hyperthermia, heat stroke
Gout
Vaccine associated due to tissue reaction
Drugs

20. Approach to a child with fever
• CBIMCI guideline

21. assessment
• By history or feels hot or by temperature
above 37.5C
Then ask: brief history about fever:
• How long ? Pattern? h/o measles in past three
months?
• Look and feel for: neck stiffness,bulging
fontanelle, runny nose
• Signs of measles( generalised rash,
cough,coryza)

22. • h/o measles in past three months?
• If yes:
• Look for mouth ulcers, are they deep and
extensive
• Look for pus draining from eye
• lOok for clouding of cornea

23. Classify fever
if high risk for malaria

24. If low risk for malaria

25. If measles now or within last 3 months

26. • Thank you
• 