Vitamin A Deficiency: Diagnosis, Management, and Nutritional Therapy
Abstract
Background: Vitamin A is an essential fat-soluble micronutrient critical for vision, immune function, epithelial integrity, and cellular differentiation. Deficiency remains a major global health issue, particularly in resource-limited settings, where it contributes significantly to childhood morbidity and mortality.
Aim: To review the diagnosis, management, and nutritional strategies for vitamin A deficiency (VAD), emphasizing its etiology, epidemiology, pathophysiology, and clinical implications.
Methods: This narrative review synthesizes evidence from global health guidelines, epidemiological studies, and clinical research on VAD. It explores biological mechanisms, risk factors, diagnostic approaches, and therapeutic interventions, including supplementation protocols and preventive strategies.
Results: VAD predominantly affects children under five and pregnant or lactating women in developing countries, with prevalence rates reaching 30% in children and up to 76% in lactating mothers. Clinical manifestations range from night blindness to xerophthalmia and keratomalacia, often accompanied by increased infection risk. Serum retinol <20 µg/dL is a key diagnostic marker, though interpretation requires clinical context. WHO-recommended supplementation regimens significantly reduce morbidity and mortality, while food fortification and biofortification offer sustainable prevention. In high-income countries, VAD occurs mainly in malabsorptive states, liver disease, bariatric surgery, and prematurity.
Conclusion: Timely diagnosis and supplementation are essential to prevent irreversible blindness and systemic complications. Integrated strategies combining supplementation, fortification, and education remain critical for global VAD control.
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