@article{ca594c361a774069b7c3d0126023d5be,
title = "Estimating lives saved by achieving dietary micronutrient adequacy, with a focus on vitamin A intervention programs in Cameroon",
abstract = "Background: We previously compared the potential effects of different intervention strategies for achieving dietary vitamin A (VA) adequacy. The Lives Saved Tool (LiST) permits estimates of lives saved through VA interventions but currently only considers periodic VA supplements (VASs). Objective:We aimed to adapt the LiST method for estimating the mortality impact of VASs to estimate the impact of other VA interventions (e.g., food fortification) on child mortality and to estimate the number of lives saved by VA interventions in 3 macroregions in Cameroon. Methods: We used national dietary intake data to predict the effects of VA intervention programs on the adequacy of VA intake. LiST parameters of population affected fraction and intervention coverage were replaced with estimates of prevalence of inadequate intake and effective coverage (proportion achieving adequate VA intake).We used a model of liver VA stores to derive an estimate of themortality reduction from achieving dietary VA adequacy; this estimate and a conservative assumption of equivalent mortality reduction for VAS and VA intake were applied to projections for Cameroon. Results: There were 2217-3048 total estimated VA-preventable deaths in year 1, with 58% occurring in the North macroregion. The relation between effective coverage and lives saved differed by year andmacroregion due to differences in total deaths, diarrhea burden, and prevalence of lowVA intake. Estimates of lives saved by VASs (the intervention common to both methods) were similar with the use of the adapted method (in 2012: North, 743-1021; South, 280-385; Yaound{\'e} and Douala, 146-202) and the {"}usual{"} LiST method (North: 697; South: 381; Yaound{\'e} and Douala: 147). Conclusions: Linking effective coverage estimates with an adapted LiST method permits estimation of the effects of combinations of VA programs (beyond VASs only) on childmortality to aid program planning andmanagement. Rigorous program monitoring and evaluation are necessary to confirm predicted impacts.",
keywords = "Child, Dietary intake, Modeling, Mortality, Vitamin A",
author = "Reina Engle-Stone and Amanda Perkins and Adrienne Clermont and Neff Walker and Haskell, {Marjorie J.} and Vosti, {Stephen A.} and Brown, {Kenneth H.}",
note = "Funding Information: Published in a supplement to The Journal of Nutrition. This article is part of a project to update the nutrition modeling components of the Lives Saved Tool (LiST), which is supported by a grant from the Children{\textregistered}s Investment Fund Foundation (CIFF). LiST is developed and maintained by the Institute for International Programs at Johns Hopkins Bloomberg School of Public Health, with support from the Bill & Melinda Gates Foundation. The Supplement Coordinator for the supplement publication is Adrienne Clermont. Supplement Coordinator disclosures: Adrienne Clermont is a member of the project team at Johns Hopkins Bloomberg School of Public Health that is implementing the CIFF-funded project that this supplement is a part of. As a result, part of her salary is paid through the grant from CIFF. The article contents are the responsibility of the authors and do not necessarily represent the official views of institutions or sponsors involved. Publication costs for this supplement were defrayed in part by the payment of page charges. This publication must therefore be hereby marked {"}advertisement{"} in accordance with 18 USC section 1734 solely to indicate this fact. The opinions expressed in this publication are those of the authors and are not attributable to the sponsors or the publisher, Editor, or Editorial Board of The Journal of Nutrition. This analysis was supported by the Bill & Melinda Gates Foundation. Support for the collection and analysis of the data on which this analysis is based was provided by the Michael and Susan Dell Foundation and Sight and Life. Author disclosures: RE-S, AP, AC, NW, MJH, SAV, and KHB, no conflicts of interest. Supplemental Tables 1–3 are available from the {\textquoteleft}{\textquoteleft}Online Supporting Material{\textquoteright}{\textquoteright} link in the online posting of the article and from the same link in the online table of contents at http://jn.nutrition.org. Address correspondence to RE-S (e-mail: renglestone@ucdavis.edu). Abbreviations used: CHD, Child Health Day; DHS, Demographic and Health Survey; EAR, Estimated Average Requirement; LiST, Lives Saved Tool; MINIMOD, Micronutrient Intervention Modeling Project; RAE, retinol activity equivalent; VA, vitamin A; VAD, vitamin A deficiency; VAS, vitamin A supplement.",
year = "2017",
month = nov,
day = "1",
doi = "10.3945/jn.116.242271",
language = "English (US)",
volume = "147",
pages = "2194S--2203S",
journal = "Journal of Nutrition",
issn = "0022-3166",
publisher = "American Society for Nutrition",
number = "11",
}