Presentation on theme: "Dr K N Prasad Community Medicine"— Presentation transcript:
1 Dr K N Prasad Community Medicine Nutritional problemsDr K N PrasadCommunity Medicine
2 Xeropthalmia Common cause for blindness in SEA Commonly affected are children below the age of 3 yearsRisk factors are – low SES, Ignorance, faulty feeding practices, Acute diarrhoea, Measles, bottle feedingCommon in rice eating population
3 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
4 Prevention and control Medium term action:Regular and adequate intake of Vitamin A rich foods, Food fortification with Vitamin Aex. Vanaspathi, Margarine oil, dried mild powder, sugar.
5 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
6 Nutritional Anemia A disease syndrome caused by malnutrition Commonly called as Iron deficiencyWHO standard – Hb level estimationAdult male – 13 gm%Adult Female non pregnant- 12gm%Pregnant woman- 11gm%Children < 6 years- 11gm%Children 6-14 years- 12gm%
7 Global problem of Anemia Prevalence is highest in developing countriesChild bearing age group is highest burden other than childrenTwo third of pregnant women and half of non pregnant women are anemic in developing countries4-12% of child bearing women are anemic in developed countries
8 India Many have iron deficiency other than anemia Rural population both Male and female are susceptibleCommon cause is inadequate intake , poor bioavailability and excess loss of ironInfections – Malaria, Hook worm, etc.Short interval between pregnanciesFolic acid deficiency is accounting for % of population
9 Detrimental effect of Anemia Pregnancy- increased risk of Mortality and morbidity ( 40% )Aggravate by infections and susceptible to infectionsDecreased working capacityDecreased economy of the country
10 InterventionsIron & 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 ageEligibility : 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 acidDuration: 2-3 months Hb returns to normalFollow up: estimate Hb after 3 monthsChildren: if anemia supplement 20mg of elemental iron ( 100mg Fe Sulphate)
11 Iron Fortification Fortification to salt is tried Recommended for high risk group in the endemic areaOther measuresChanging dietary habitsControl of parasitic infectionsNutrition education
12 Iodine deficiency disorders (IDD) Equivalent to GoitreMajor nutritional problem in IndiaDeficiency leads to wide range of disorders commencing from Intra uterine life to childhood , adult life with serious health and social implications.
13 Public health problem of IDD Major problem in SEACommon In Himalayan region known as Goitre beltIDD is common everywhere in IndiaNo state is free from IDDmillionPresent- 130 million have IDDClinical manifestations are wide.
14 Control of IDD Iodised salt and Oil Monitoring and surveillance Manpower trainingMass campaign
15 Iodised salt and Oil Iodised salt is widely used in India Recommended concentration isnot less than 30 PPM at production levelNot less than 15 PPM at consumer levelNon iodised salt is completely banned for saleIM injection of Iodised oil 1 ml for high risk group individualsIodised oilProtection for 4 yearsReplace salt with iodised saltToxicity risk is low
16 MonitoringNeonatal hypothyroidism is a sensitive indicator for community IDDLaboratory test for iodine excretion determinationDetermination of iodine in drinking water , soil and foodDetermination of iodine in salt for quality assessment.
17 Mass campaign Public awareness about IDD Use of only iodised salt for regular consumption
18 Asking for help is a strength not weakness Thought for the dayAsking for help is a strength not weakness