E50.0-9
DESCRIPTION
A condition predominantly affecting the skin, mucous membranes and the eyes.
It is most common in children of 1–5 years of age.
If associated with measles and diarrhoea there is an increased risk of illness and death.
If not identified and treated early, it can cause blindness.
Clinical features include:
- night blindness or inability to see in the dark
- white foamy patches on the eye (Bitot’s spot) or conjunctival and corneal dryness
- keratomalacia or wrinkling and cloudiness of cornea
- corneal ulceration or the cornea becomes soft and bulges
GENERAL MEASURES
Increase dietary intake of vitamin A rich food including: fortified maize meal and/or bread; carrots, sweet potato, mangoes and pawpaw, broccoli, sprouts; dark green leafy vegetables e.g. morogo/imifino and spinach; apricots, melon, pumpkin, and liver, eggs, full cream milk and fish.
MEDICINE TREATMENT
Prophylaxis
- Vitamin A (retinol), oral, every 6 months up to the age of 5 years.
| Age range |
Dose Units |
Capsule 100 000 IU |
Capsule 200 000 IU |
| Infants 6–11 months | 100 000 | 1 capsule | - |
| Children 12 months–5 years | 200 000 | 2 capsules | 1 capsule |
Children with the following conditions should be given an additional dose:
- Severe Acute Malnutrition
- persistent diarrhoea
- measles
- Vitamin A (retinol), oral.
| Age range |
Dose Units |
Capsule 100 000 IU |
Capsule 200 000 IU |
| Infant < 6 months | 50 000 | ½ capsule | - |
| Infants 6–11 months | 100 000 | 1 capsule | - |
| Children 12 months–5 years | 200 000 | 2 capsules | 1 capsule |
Administration of a vitamin A capsule
- Cut the narrow end of the capsule with scissors.
- Open the child’s mouth by gently squeezing the cheeks.
- Squeeze the drops from the capsule directly into the back of the child’s mouth. If a child spits up most of the vitamin A liquid immediately, give one more dose.
- Do NOT give the capsule to the mother or the caretaker to take home
Treatment
If any clinical eye signs of vitamin A deficiency are present (see clinical features above), give a pre-referral dose:
- Vitamin A (retinol), oral, as a pre-referral dose.
| Age range |
Dose Units (IU) |
Capsule 100 000 IU |
Capsule 200 000 IU |
| Infant < 6 months | 50 000 | ½ capsule | - |
| Infants 6–11 months | 100 000 | 1 capsule | - |
| Children 12 months–5 years | 200 000 | 2 capsules | 1 capsule |
Note:
- Children (6 months to 5 years of age) who received a routine prophylactic dose within the previous month should not receive any additional doses of vitamin A.
- If a child is scheduled to receive a routine prophylactic dose of vitamin A and has received a treatment dose within the past month, postpone the routine dose for approximately one month.
- Wait at least one month between doses.
- Children receiving routine multivitamin syrup can still receive vitamin A supplements.
REFERRAL
All cases with clinical signs.