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; Yaoundé and Douala, 146-202) and the "usual" LiST method (North: 697; South: 381; Yaoundé 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.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 2194S-2203S |
| Journal | Journal of Nutrition |
| Volume | 147 |
| Issue number | 11 |
| DOIs | |
| State | Published - Nov 1 2017 |
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Keywords
- Child
- Dietary intake
- Modeling
- Mortality
- Vitamin A
ASJC Scopus subject areas
- Medicine (miscellaneous)
- Nutrition and Dietetics
Cite this
Estimating lives saved by achieving dietary micronutrient adequacy, with a focus on vitamin A intervention programs in Cameroon. / Engle-Stone, Reina; Perkins, Amanda; Clermont, Adrienne; Walker, Neff; Haskell, Marjorie J.; Vosti, Stephen A.; Brown, Kenneth H.
In: Journal of Nutrition, Vol. 147, No. 11, 01.11.2017, p. 2194S-2203S.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Estimating lives saved by achieving dietary micronutrient adequacy, with a focus on vitamin A intervention programs in Cameroon
AU - Engle-Stone, Reina
AU - Perkins, Amanda
AU - Clermont, Adrienne
AU - Walker, Neff
AU - Haskell, Marjorie J.
AU - Vosti, Stephen A.
AU - Brown, Kenneth H.
PY - 2017/11/1
Y1 - 2017/11/1
N2 - 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; Yaoundé and Douala, 146-202) and the "usual" LiST method (North: 697; South: 381; Yaoundé 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.
AB - 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; Yaoundé and Douala, 146-202) and the "usual" LiST method (North: 697; South: 381; Yaoundé 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.
KW - Child
KW - Dietary intake
KW - Modeling
KW - Mortality
KW - Vitamin A
UR - http://www.scopus.com/inward/record.url?scp=85032749083&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85032749083&partnerID=8YFLogxK
U2 - 10.3945/jn.116.242271
DO - 10.3945/jn.116.242271
M3 - Article
C2 - 28904117
AN - SCOPUS:85032749083
VL - 147
SP - 2194S-2203S
JO - Journal of Nutrition
JF - Journal of Nutrition
SN - 0022-3166
IS - 11
ER -