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  • Title: Vitamin A.
    Author: Pinnock C.
    Journal: Nurs J India; 1991 Nov; 82(11):307-8. PubMed ID: 1809940.
    Abstract:
    20-40 million children in the world have mild vitamin A deficiency and another 3 million have severe vitamin A deficiency leading to high rates of xerophthalmia and blindness. Vitamin A influences growth, survival, and resistance to infection. Vitamin A deficiency reduces the T-cells' ability to fight infection and decreases mucous production resulting in more bacteria being able to attach themselves to respiratory mucosa. Thus it increases the body's susceptibility to respiratory infection. For example, health workers in rural Indonesia who followed children for 18 months and learned that those with mild vitamin A deficiency are twice the risk of respiratory infection than those who do not have such a deficiency. This risk is higher regardless of the children's overall nutritional status. A study in urban India shows the same results. A study in Ethiopia finds children with xerophthalmia not only at increased risk of respiratory infection but also of diarrhea. Other studies demonstrate that respiratory disease, diarrhea, and measles precipitate vitamin A deficiency. For example, corneal ulceration follows an episode of measles in 79% of all corneal ulceration cases in Tanzania. In Indonesia, children with measles are 11 times more likely to have xerophthalmia. Children with mild vitamin A deficiency in Indonesia face death 4 time more often than those with no such deficiency. Vitamin A supplementation decreases mortality 72% in 60-71 month old children and 15% in 12-23 month old children, yet increases it 23% in 36-47 month old children. In Ethiopia, an infection is more predictive of severe, symptomatic vitamin A deficiency than is preexisting malnutrition. Still vitamin A deficiency increases the likelihood of respiratory infection and diarrhea. Thus vitamin A deficient children enter a downward spiral. The longterm solution to vitamin A deficiency is community development and increased consumption of dark green edible plants and red and orange fruits.
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