Vitamin A is a retinol ester that can be either ingested or synthesized within the body from plant carotene. It is important in maintaining the integrity of skin and membranes, immunity, and night vision. Deficiency of vitamin A results in increased rate of infection, as well as increased mortality.

In Kenya about 75% of children aged below 5 years have vitamin A deficiency. Worldwide, vitamin A supplementation has been shown to result in 23–34% reduction of all childhood mortality (6–59 months), 50% reduction in measles mortality, and 33% reduction in diarrhoeal disease mortality. Vitamin A deficiency is a major cause of illness and blindness among poor communities worldwide.

Eye Manifestations of Vitamin A Deficiency

  • Early signs include reversible dry cornea and night blindness.
  • Later signs include irreversible damage of cornea – rupture and scarring, Bitot’s spots (white areas on lateral parts of the sclera) and blindness also develops as a consequence of vitamin A deficiency.

Prevention of Vitamin A Deficiency

  • Encourage families to consume vitamin A rich foods, which include:
    • Animal products, for example liver, milk and kidneys.
    • Plant products, for example dark green leafy vegetables, yellow fruits and vegetables (carrots, pumpkin, pawpaw).
  • Give vitamin A supplementation together with immunization.
  • Give vitamin A supplementation routinely in the presence of the following conditions:
  • Malnutrition
  • Diarrhoea
  • Malaria
  • Tuberculosis
  • Pneumonia
  • Worm infestation
  • Fever
  • Measles
  • For children aged below 5 years, it is important to ensure that they have not received vitamin A in the last 1 month.

Treatment for Xerophthalmia

  • Affected children are given vitamin A on day 1 and 2 and a third dose 1–4 weeks after second dose.
  • Children suffering from measles should be treated as if they have xerophthalmia.