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MAMA History

MAMA History. Dr. Priscilla Benner MD MAMA Director. The construction begins. The main building at the Nutritional Center. Building the dining room. One of the first mission teams. Dr. Benner talking with the people in the community about the Nutrition Center. Making new contacts.

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MAMA History

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  1. MAMA History Dr. Priscilla Benner MD MAMA Director

  2. The construction begins

  3. The main building at the Nutritional Center

  4. Building the dining room

  5. One of the first mission teams

  6. Dr. Benner talking with the people in the community about the Nutrition Center.

  7. Making new contacts

  8. The moms are working in the garden at the Nutrition Center.

  9. The harvest is ready.

  10. Importance of Vitamin A Dr. Benner

  11. Focus on Vitamin A • Vitamin A distribution and food fortification has become a standard part of Child Survival efforts around the world. • Vitamin A saves children's lives, eyes and faces.

  12. Vitamin A Functions • Vision (night, day, colour) • Epithelial cell integrity against infections • Immune response • Haemopoiesis • Skeletal growth • Fertility (male and female) • Embryogenesis

  13. Severe Vitamin A deficiency is a wide spread problem in Nigeria, especially in the Northwest, and is one of the reasons that children suffer so many infections.

  14. Why do children become vitamin A deficient? • Mothers of poor children often have Vitamin A Deficiency and produce deficient breast milk. • Children’s diets provide too little vitamin A. • Children spend a large part of their childhood being sick.ProvitaminA carotenoids in vegetables and fruits are less readily bio-available than previously thought. • Early weaning is often onto foods low in vitamin A. • Growth velocity, and therefore vitamin A requirement, is higher during pre-school age than at any other time postnatally. Humphrey, Katz et al, 2002

  15. is distributed every 4-6 months to infants, children, and new mothers according to established protocols Vitamin A distribution… is part of child survival programs all over the world prevents infections and improves growth

  16. Revised Recommendations 2002 IVACG

  17. In acute emergencies such as measles, pneumonia, TB, malaria, meningitis, severe diarrhea, severe malnutrition, or when signs impeding loss of vision from nutritional blindness, or risk of mouth infection leading to noma are detected, -use the Vitamin A Emergency Triple Dose Treatment This will replenish acutely depleted Vitamin A sores and can be life SAVING! Also, use all other appropriate treatments for the conditions. SEEK CONSULTATION!

  18. Emergency Triple Dose Treatment: • For noma, malaria, measles, pneumonia or any life-threatening infection in malnourished children • Give the age appropriate Vitamin A mega dose: • One dose today • One dose tomorrow • One dose in 2 weeks

  19. Vitamin A Single (Extra) Dose Treatment for Malnourished Children with Moderate Infections • In addition to other appropriate treatments, when a malnourished child presents with a serious, but not acutely life-threatening condition such as: • Ear infection • Diarrhea • Tonsillitis • Respiratory infection • Parasites • Worsening malnutrition • Give one extra dose of Vitamin A but do not repeat more often than once per month in the absence of severe infection. • See Chart.

  20. Nutritional Blindness Bitot Spots • Very Dangerous! • Permanent blindness may occur if Vitamin A is not given immediately – following the protocol.

  21. Nutritional Blindness Keratomalacia: Hazy Dry Cornea Poor Quality • Now the cornea is becoming soft – very critical danger! • Megadose vitamin A according to the International Norms but be given now!

  22. Nutritional Blindness Gelatinous cornea • Bulging, about ready to rupture. • If that happens, the eye will be permanently blind. • There is still a chance that this eye can be saved by 3 doses of Vitamin A.

  23. Nutritional Blindness • Same eye, healed by timely Vitamin A capsules. Scar remains, but vision is good. This eye was saved by 3 Vitamin A capsules!

  24. Nutritional Blindness: Bitot Spots Xerophthalmia Dry Eye Hazy dry cornea poor quality — Keratomalacia Same eye, healed by timely Vitamin A capsules. Scar remains, but vision is good. Gelatinous cornea, bulging, about ready to rupture. If that happens, the eye will be permanently blind.

  25. Essential Micronutrients • Besides Vitamin A, there are many other essential micronutrients (vitamins and minerals) that are found to be lacking in children who get noma, nutritional blindness, and other deadly infections (“Hidden Hunger”). • Improving nutrition by better diet in pregnancy, exclusive breast feeding early in life, and food fortification with COMPLETE ESSENTIAL MICRONUTRIENTS will prevent many deaths from childhood infections.

  26. INTESTINAL PARASITES

  27. Intestinal parasites- The Scope of the Problem • Most common infection worldwide • Prevalence rates in resource poor communities can be over 90%. • In 2008, 3.5 billion people (mostly children) were estimated to be infested with intestinal parasites. From: Tropical Medicine Institute of Sao Paulo Brazil. • Estimated over 300 million suffer severe impairments because of high worm burdens.

  28. Intestinal parasites cause illness and death from: • Anemia • Malnutrition • Impairment of physical growth-both stunting and wasting • Poor intellectual development • Infections

  29. Where do intestinal parasites come from? • They enter the body through food and water that has been contaminated by human or fecal waste, or through skin if the person steps (or sits) in mud that contains human or animal feces. • Many people infested with intestinal parasites are not clinically ill but can still spread the disease by not using latrines or toilets.

  30. Children with swollen bellies usually have: • Severe malnutrition • A large burden of intestinal parasites

  31. Parasites compete with children for food! Children with heavy worm burdens may be forced to share ¼ or more of their daily nutrients with their parasites.

  32. Deworming promotes child survival. • Therefore, national level mass deworming campaigns been implemented in many developing countries. • One tablet of deworming medicine, usually Albendazole, is given every 6 months according to standardized protocols to everyone in the community. • This is effective in controlling the worm burden and usually well accepted by communities. • Deworming can be integrated into Child Health Day Events along with immunizations, vitamin A distribution, bed net distribution and growth monitoring.

  33. Albendazole targets the three major intestinal parasites: • Ascarislumbricoides-Round worm • Trichuris-Whipworm • Anclostomaduodenale (Africa)or Necantoramericanus (Western Hemisphere)-Hookworm

  34. Other medicines that may be used: • MEBENDAZOLE 500mg tablets can also be used as single dose treatments of intestinal parasites • LEVAMISOLE 80mg can be used for school age children • PYRANTEL 10mg/kg • If Shistosomiasis is a problem in the region, PRAZIQUANTEL is used. Instructions may be added to this seminar if there is need for this medication in the target population.

  35. Each parasite produces a different set of problems: • Ascaris is the large roundworm with a voracious appetite for calories and vitamins. • Hookworm is the parasite that attaches itself to the intestinal lining and dines on the blood of its victim. • Whipworm is the one which attaches to the rectum, causing prolapse and bleeding.

  36. Ascaris Notice the size of the parasite in centimeters.

  37. Ascaris at surgery

  38. The entire community should be dewormed.

  39. Correct Practices of Albendazole Administration

  40. Children over age 1 and all adults can be dewormed. • Follow the recommendation of the Ministry of Health regarding pregnant women. • Albendazole is safe in lactation but the woman can save her pill to take after the first 3 months of pregnancy. • Note: Follow norms of MOH in country for children age 12-24 months and pregnant women.

  41. Always include the children not enrolled in school in the deworming.

  42. 1. Wash your hands with soap and water if you touch the child’s mouth.

  43. 2. Ask all mothers to help you by washing their hands first, then you give the pill to the mother, who places it in her child’s mouth after reassuring the child.

  44. 3. Never put pill in the mouth of a crying child.

  45. 4. Do not coerce, threaten, or unnecessarily frighten the child. Treat him or her gently and with patience.

  46. A child that is regularly treated for worms: • is more active in school. • grows and learns better. • is more resistant to other infections.

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