Lecture on Defeciency Diseases

7/25/2019 Lecture on Defeciency Diseases

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Nutrient Defeciency

Diseases

Prof. Asha Kawara


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Nutritional requirements


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Macro v. micro nutrients

Macro-nutrients

Protein (amino acids) Energy (carbohydrates) at (fatty acids)

Micro-nutrients

Water soluble vitamins(assist in energy-re!ease of

carbohydrates and red b!ood ce!! formation) Fat soluble vitamins(de"e!o#ment $ metabo!ism) Minerals


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Macro-nutrients

Energy

Necessary for a!! bodi!y function

Protein Necessary for structura! de"e!o#ment (musc!e

and bone)

at

Necessary for ce!! membrane and s%in ce!!de"e!o#ment


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Micro-nutrients

&"er"iew of ma'or micronutrient deficiencies

ron

odine

itamin A

itanin D

*inc

+!inica! features

,iochemica! assessment

reatment

Micronutrient deficiencies in emergencies


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What is Malnutrition?

Ma!nutrition /!ac% of nutrients 0 #oor nutrition1

wo #rinci#!e constituents2

Protein-energy ma!nutrition

Deficiency in micronutrients


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Types of malnutrition

3e"ere Protein-Energy Ma!nutrition (45 3.D.) Kwashior%or (!ow #rotein) Marasmus (!ow ca!ories)

Mi!d0moderate undernutrition (46 3.D.) 3tunting 7nderweight 8asting


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4 Major Micronutrient Deficiencies

ron

odine

itamin A

*inc

itamin D

Anemia

odine Deficiency

Disorders (DD)

9ero#tha!mia

Mu!ti#!e disorders

:ic%ets


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!ashior"or

#!ollenbelly

$ella%ra

Decrease&

musclemass

#parse

hair

'nfection

(pathy


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!ashior"or )lo! protein* Decrease& muscle mass(fai!ure to gain weight and of

!inear growth) #!ollen belly(edema and !i#id bui!d-u# around the !i"er)

+han%es in s"in pi%ment )pella%ra*,may !ose #igment

where the s%in has #ee!ed away (des;uamated) and the

s%in may dar%en where it has been irritated or traumati


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Marasmus )lo! calories*

avenouslyhun%ry

/ross

!ei%ht

loss 0

no fat


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Marasmus

Deficit in ca!ories> /marasmus1 comes from?ree% origin of word /to waste1

?ross weight !oss

@y#er-a!ert and ra"enous!y hungry +hi!dren ha"e no subcutaneous fator musc!e

e"entua!!y star"e to death (immediate cause oftenis #neumonia)


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(nemia

Most common g!oba! nutrition #rob!em

+ommon causes of anemia

ron deficiency anemia (DA) nfections (ma!aria= hoo%worm= @) &ther "itamin deficiencies @emog!obino#athies

@ea!th im#act

Perinata! $ materna! morta!ity De!ayed chi!d de"e!o#ment :educed wor% ca#acity


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ow dietary inta%es

Diet #oor in iron-rich

foods0anima! foods@igh inta%e of inhibitors (ea)

nfections (ma!aria= he!minthes

infection= schistosomiasis)

,!ood !oss

(nemia- is" Factors


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(nemia- #i%ns 0 #ymptoms

iredness and

fatigue

@eadache and

breath!essness

Pa!!or2 #a!e

con'uncti"ae=#a!ms= tongue= !i#s

and s%in


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(nemia- (ssessment

,!ood can be tested for anaemia using different methods

which !oo% at the co!our of the b!ood= the number of b!ood

ce!!s= or use a chemica! which reacts with the haemog!obin.

@emog!ogin (@emocue) @ematocrit

Defined by 8@& as2 @b BCC. g0d > chi!dren @b BC6. g0d > women @b BC6. g0d - Men


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'n&icators of 'ron #tatus

3o!ub!e transferrin rece#tor (sf:)

erritin (E:)

ron (e) and tota! iron binding ca#acity (,+)

*inc #roto#or#hyrin (*P)

@emog!obin (@b)Price,

ComplexityofTestLab

Field


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(nemia- Treatment

Dietary diversification

oods that are rich in iron inc!ude2 Meat

ortified cerea!s

3#inach

+ashew nuts

enti!s and beans

Fortification

Iron supplements


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odine Deficiency Disorders (DD)

3ignificant cause of #re"entab!e brain damage in chi!dren

@ea!th effects2

ncreased #erinata! morta!ity

Menta! retardation ?rowth retardation

Pre"entab!e by consum#tion of ade;uate!y iodi


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'o&ine Deficiency (ffects

the 1rain

e&uce&e&uce&

intellectualintellectual

performanceperformance

/oiter/oiter

+retinism+retinism

*Goiter manifests only a small portion of


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ow iodine !e"e! in food

#roducts grown on iodine-#oor soi!> erosion= f!oods

> mountainous areas

distance from sea (!ow fish inta%e)

Non-a"ai!abi!ity of iodi


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Measure urinary io&ine e2cretion )3'*

Measure levels of thyroi& hormones in bloo&

Measure &e%ree of %oitre?rade No ?oitre

?rade C Pa!#ab!e ?oitre

?rade 6 isib!e ?oitre

'DD- (ssessment


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#alt 'o&ine Measurement

WYD Iodine CheckerSingle wavelength (585 nm) spectrophotometer

Measures iodine level (ppm) in salt based on theabsorption of the iodine-starch blue compound

Titration

Gold standard

Rapid KitQualitatiely measures iodine content in salt

!i"hly sensitie #ut not specific

Inexpensie

Price,

Complexity

ofTestLab

Field


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5itamin ( Deficiency )5(D*

eading cause of #re"entab!e b!indness among #re-schoo!

chi!dren

A!so affects schoo! age chi!dren and #regnant women

8ea%ens the immune system and increases c!inica!

se"erity and morta!ity ris% from meas!es and diarrhoea

3u##!ementation with "itamin A ca#su!es can reduce chi!dmorta!ity by 65.

8@& (66) estimates that 6C of a!! chi!dren suffer from

AD= most!y in Africa and Asia


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+!inica! deficiency is defined by2

night b!indness

,itotFs s#ots

cornea! Gerosis and0 or u!cerations cornea! scars caused by Gero#htha!mia

5(D- #i%ns 0 #ymptoms


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8@& +!assification of 9ero#htha!mia

2B

1N Night blindness

2B Bitots spots

X3 Corneal xerosis

X4 Cornealulcerations

-KeratomalaciaX5 Corneal scars

- permanentblindness

X3

X5X4


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ow a"ai!abi!ity of "itamin A-

rich foodsac% of breastfeeding@igh rates of infection

(meas!es= diarrhoea)Ma!nutrition

5(D- is" Factors


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5(D - (ssessment

+!inica! assessment for night b!indness

,iochemica! assessment

:etino!

3erum ana!y


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Drie& 1loo& #pots for 1$

uic% and easy fie!d friend!y techni;ue

+o!!ection through "eni#uncture or finger stic%

asting not necessary D,3 shou!d com#!ete!y dry and be #rotected from

humidity

3torage of D,3 at >6o+ on!y for short term= >Ho+ for

!ong term

3hi##ing of D,3 cards on fro


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$oor 6uality D1#


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5(D- Treatment

3u##!ementation

+a#su!es gi"en during immuni


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i%h &ose oral supplements ofvitamin (

:a#id and targeted

@igh!y effecti"e in !owering

morta!ity in infants andchi!dren in third wor!dcommunities

@igh!y effecti"e in reducing

com#!ications in meas!es

:educed #re"a!ence ofma!aria in chi!dren in Pa#uaNew ?uinea


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5itamin D Deficiency7 ic"ets

htt#200www.s#oi!hea#.co.u%0ric%ets.htm


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5itamin D Deficiency7 ic"ets

Rickets is the result of vitamin D deficiency and is

more common in post-medieval and early modern

urban industrial populations.

The avitaminosis may be attributable to

malnutrition, but is also linked with lack of

exposure to sunliht. Disease may be a

contributory factor, and in this case there wereother patholoical chanes which may indicate an

infection or inflammation of the bone.


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8inc Deficiency

*inc essentia! for the function of many en


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8inc Deficiency- #i%ns 0 #ymptoms

@air !oss

3%in!esions

Diarrhea

Poor growth

Acrodermatitis entero#athica

Death


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8inc Deficiency- Treatment

:egu!ar


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Deficiencies of2

itamin + scur"y

Niacin ("itamin ,5)#e!!agra hiamin ("itamin ,C)beriberi

usua!!y associated with situations where#o#u!ations are fu!!y de#endent on !imitedcommodities for their food needs.

Micronutrient &eficiencies inemer%encies
http://en.wikipedia.org/wiki/Diarrheahttp://en.wikipedia.org/wiki/Skin


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5itamin + - (scorbic (ci&

@umans are among the few s#ecies that cannotsynthesi


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#curvy 9 #i%ns 0 #ymptoms

3ma!! b!ood "esse!s fragi!e

?ums reddened and b!eed easi!y

eeth !oose oint #ains

Dry sca!y s%in

!ower wound-hea!ing= increased susce#tibi!ity toinfections= and defects in bone de"e!o#ment in

chi!dren


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Thiamin 9 5itamin 1:

8hat it does in the body

energy #roduction and carbohydrate and fattyacid metabo!ism

"ita! for norma! de"e!o#ment= growth=re#roduction= hea!thy s%in and hair= b!ood

#roduction and immune function

Deficiency due to diets of #o!ished rice


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1eri 1eri- #i%ns 0 #ymptoms

De"e!o# within C6 wee%s

Dry ,eriberi#eri#hera! neuro#athy

Difficu!ty wa!%ing and #ara!ysis of the !egs

:educed %nee 'er% and other tendon ref!eGes= foot andwrist dro#

Progressi"e= se"ere wea%ness and wasting of musc!es 8et ,eribericardio#athy

Edema of !egs= trun% and face +ongesti"e heart fai!ure (cause of death)


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8rist $ foot dro#2

Dry 1eri 1eri

Edema2

Wet 1eri 1eri


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iboflavin Deficiency

Deficiency is rare and often occurs with other

, "itamin deficiencies

3e"era! months for sym#toms to occur ,urning= itching of eyes Angu!ar stomatitis

+hei!osis 3we!!ing and sha!!ow u!cerations of !i#s ?!ossitis


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iboflavin &eficiency

Angu!ar stomatitis ?!ossitis


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Niacin 9 5itamin 1;

Essentia! for hea!thy s%in= tongue= digesti"e tract

tissues= and :,+ formation

Processing of grains remo"es most of their niacin

content so f!our is enriched with the "itamin


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$ella%ra 9 #i%ns 0 #ymptoms

Othree DsF2 diarrhea= dermatitis and dementia :eddish s%in rash on the face= hands and feet

which becomes rough and dar% when eG#osed to

sun!ight (#e!!agrous dermatosis) acute2 red= swo!!en with itching= crac%ing= burning=

and eGudate

chronic2 dry= rough= thic%ened and sca!y withbrown #igmentation

dementia= tremors= irritabi!ity= anGiety= confusionand de#ression


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$ella%ra Dermatitis


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#ummary

Ma'or ris% factors for micronutrient deficiency

diseases inc!ude #oor dietary inta%e= infection=

disease and sanitation

he ma'or MDD are anemia= iodine deficiency=

"itamin A deficiency= and


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Documents

Lecture on Defeciency Diseases