Including Bitot's spots and corneal ulceration and night blindness



Affects the skin, gastrointestinal tract, and nervous system and is sometimes called the 3Ds: dermatitis, diarrhoea, and dementia



Loss of tendon reflexes; drooping of arms and feet; wet or cardiac beriberi resulting in heart failure

Vitamin C


Painful joints, swollen and bleeding gums, and slow healing or reopening of old wounds

micronutrient deficiencies because one does not often see the signs and symptoms as visibly as those for PEM. Nonetheless, these deficiencies can be fatal. In addition to deficiency diseases of vitamin A, iron, and iodine, conditions widely described as diseases of public health importance, epidemics of scurvy, beriberi, and pellagra, have been frequently reported among refugee populations, primarily because of limited access to a diverse diet and overreliance on one or two commodities (i.e., maize or polished rice). The importance of micronutrient deficiencies among the refugee population has only been documented since the late 1980s, and more attention is being paid to the usefulness of inclusion of micronutrient-rich foods and/or supplements in the management of refugee nutrition (Table 2).

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