Burden of micronutrient deficiencies by socio-economic strata in children aged 6 months to 5 years in the Philippines

Abstract

BackgroundMicronutrient deficiencies (MNDs) are a chronic lack of vitamins and minerals and constitute a huge public health problem. MNDs have severe health consequences and are particularly harmful during early childhood due to their impact on the physical and cognitive development. We estimate the costs of illness due to iron deficiency (IDA), vitamin A deficiency (VAD) and zinc deficiency (ZnD) in 2 age groups (6–23 and 24–59 months) of Filipino children by socio-economic strata in 2008.MethodsWe build a health economic model simulating the consequences of MNDs in childhood over the entire lifetime. The model is based on a health survey and a nutrition survey carried out in 2008. The sample populations are first structured into 10 socio-economic strata (SES) and 2 age groups. Health consequences of MNDs are modelled based on information extracted from literature. Direct medical costs, production losses and intangible costs are computed and long term costs are discounted to present value.ResultsTotal lifetime costs of IDA, VAD and ZnD amounted to direct medical costs of 30 million dollars, production losses of 618 million dollars and intangible costs of 122,138 disability adjusted life years (DALYs). These costs can be interpreted as the lifetime costs of a 1-year cohort affected by MNDs between the age of 6–59 months. Direct medical costs are dominated by costs due to ZnD (89% of total), production losses by losses in future lifetime (90% of total) and intangible costs by premature death (47% of total DALY losses) and losses in future lifetime (43%). Costs of MNDs differ considerably between SES as costs in the poorest third of the households are 5 times higher than in the wealthiest third.ConclusionsMNDs lead to substantial costs in 6-59-month-old children in the Philippines. Costs are highly concentrated in the lower SES and in children 6–23 months old. These results may have important implications for the design, evaluation and choice of the most effective and cost-effective policies aimed at the reduction of MNDs.

Dietary diversity and nutritional adequacy of under-fives in a fishing community in the central region of Ghana

“…Micronutrient malnutrition is one form of malnutrition which poses great risk to children and is referred to as hidden hunger. It is caused by chronic lack of vitamins and minerals as a consequence of nutrient inadequacy [2,3]. According to the World Health Organization (WHO), one in every two pre-school aged children suffer from hidden hunger [4].…”

Food Fortification for Addressing Iron Deficiency in Filipino Children: Benefits and Cost-Effectiveness

“…First, this may be captured in terms of the ‘cost of illness', focusing on the health-care costs and productivity losses for the affected individual. Second, the impact of a disease may be expressed in terms of ‘burden of the disease', which identifies the impact on the affected individual in terms of years lived with disability (disability-adjusted life years; DALYs) and years of life lost [48]. The costs of illness and burden of disease are often used as indicators to reflect the impact of a disease and thus categorize the importance of addressing each disease for policy makers.…”

Insects as sources of iron and zinc in human nutrition

“…Because Fe and Zn play important roles in numerous biochemical pathways, deficiency of these micronutrients has negative effects on many physiological systems including the gastrointestinal tract, the central nervous system, and the immune, skeletal and reproductive systems. These health effects in the long run result in a high economic burden for individuals and countries (6) . The WHO estimates that compared with the year 2000, the number of individuals who died from Fe-deficiency anaemia (IDA) in the year 2015 increased from 61 000 to 78 000 and thus, as a result, the crude death rate due to IDA increased from 1·0 % to 1·1 % (7) .…”