Micronutrient deficiencies

Definition of Micronutrient Deficiencies

This is the deficiencies of minerals such as iron, iodine, zinc, calcium, phosphorus, magnesium, copper, potassium, sodium, chloride, fluoride etc); folic acid and vitamins.

Aetiology of Micronutrient Deficiencies

1. Inadequate dietary intake
2. Increased requirements
3. Increased loss (e.g. worm infestation)

Epidemiology

Global; high prevalence in under-developed countries, especially sub-Saharan Africa

Clinical features of Micronutrient Deficiencies

1. Iron: anaemia
2. Iodine: goitre
3. Zinc, copper: manifestations of enzyme and
4. insulin deficiencies
5. Calcium: rickets, osteomalacia Phosphorus and fluoride: teeth and bone abnormalities
6. Vitamins:
   1. A: keratomalacia, corneal xerosis, night blindness
   2. B (thiamine): beri-beri
   3. B (riboflavin): scrotal and vulval. dermatoses, angular stomatitis, scars, magenta tongue, cheilosis
   4. B (niacin): scarlet and dry tongue, pellagra 6
   5. Ascorbic acid: scurvy, petechiae and
      musculo-skeletal haemorrhages
   6. D: rickets, epiphyseal enlargement, muscle wasting, bossing of skull bone, ‘thoracic rosary’, persistently open
      anterior fontanelle, genu valgum or varum

Investigations

• Blood, urine and stool tests.
• Other investigations as appropriate

Treatment objectives

• Correct nutrient deficiencies
• Ensure adequate intake
• Prevent complications

Treatment for Micronutrient Deficiencies

• Administration of specific nutrients (as concentrates in foods)
• Food supplementation
• Treat underlying diseases

Prevention

• Nutritional counselling
• Optimal breastfeeding and appropriate weaning practices
• Adequate intake of locally available, nutritious foods.
• Personal/food/water hygiene
  Prophylactic therapies for malaria