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Publication type: Article in scientific journal
Type of review: Peer review (publication)
Title: Burden of micronutrient deficiencies by socio-economic strata in children aged 6 months to 5 years in the Philippines
Authors: Wieser, Simon
Plessow, Rafael
Eichler, Klaus
Malek, Olivia
Capanzana, Mario V.
Agdeppa, Imelda
Brügger, Urs
DOI: 10.21256/zhaw-3953
Published in: BMC Public Health
Volume(Issue): 2013
Issue: 13
Page(s): 1167
Pages to: 1181
Issue Date: 2013
Publisher / Ed. Institution: BioMed Central
ISSN: 1471-2458
Language: English
Subjects: Age factor; Child; Cost of illness; Health care cost; Human; Infant; Iron; Micronutrient; Philippines; Prevalence; Quality-adjusted life year; Socioeconomic factor; Vitamin A deficiency; Zinc; Nutrition; Health economics; Micronutrient deficiency; Preschool
Subject (DDC): 616: Internal medicine and diseases
618.92: Pediatrics
Abstract: Background: Micronutrient 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. Methods: We 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. Results: Total 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. Conclusions: MNDs 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.
Fulltext version: Published version
License (according to publishing contract): CC BY 2.0: Attribution 2.0 Generic
Departement: School of Management and Law
Organisational Unit: Winterthur Institute of Health Economics (WIG)
Published as part of the ZHAW project: Burden of micronutrient deficiencies and cost-effectiveness of interventions with fortified foods
Appears in collections:Publikationen School of Management and Law

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