Should we prioritise children 6-23 months of age for vitamin A supplementation? Case study of West and Central Africa.
BMJ Nutr Prev Health
; 7(1): 88-94, 2024.
Article
em En
| MEDLINE
| ID: mdl-38966108
ABSTRACT
Background:
Vitamin A (VA) supplementation has been associated with reductions of all-cause child mortality. Child mortality amenable to VA, particularly related to infectious diseases, may be age dependent; hence, the beneficial effect of VA supplementation may differ between younger and older children. We aimed to estimate the all-cause child mortality disaggregated by younger and older than 2 years of age and estimate the contribution of VA supplementation in preventing child death in West and Central Africa.Methods:
Using the most recent (post-2010) cross-sectional Demographic and Health Surveys and Multiple Indicator Cluster Surveys, we analysed child-level data (n=187 651) from 20 West and Central African countries. Age-specific (all-cause) mortality rates were estimated using survival analyses. Age-specific VA supplementation coverage was linked with the age-specific all-cause child mortality to estimate the contribution of the supplementation in averting child death.Results:
The cost per averted child death was also estimated using an average cost of US$1.2/child and VA supplementation coverage which ranged from 14% in Cote d'Ivoire to 81% in the Gambia. About 75% of the under-5 mortality occurred in the first 2 years of life. The share of excess (all-cause) mortality averted by VA supplementation was significantly higher in the first 2 years of life. A mean reduction of 7.1 deaths/1000 live births was estimated for children 6-23 months, compared to a reduction of 2.5 deaths/1000 live births for older children (24-59 months). The mean cost/averted child death for the 20 countries was 2.8 times lower for the 6-23 than the 24-59 months age group.Conclusion:
Prioritising VA supplementation for children in the first 2 years of life could be more cost-effective than when implemented among 6-59 months of age.
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MEDLINE
Idioma:
En
Ano de publicação:
2024
Tipo de documento:
Article