Trends and mortality effects of vitamin A deficiency in children in 138 low-income and middle-income countries between 1991 and 2013: a pooled analysis of population-based surveys
Stevens GA, Bennett JE, Hennocq Q, Lu Y, De-Regil LM, Rogers L, et al.
Published in Lancet Glob Health, Vol. 3 (9), pp. e528-36
Methodology
Pooled analysis of 134 population-representative surveys from 83 countries with measured serum retinol, modelled with a Bayesian hierarchical model to estimate deficiency (serum retinol below 0.70 micromol/L) in children aged 6-59 months across 138 low- and middle-income countries, 1991-2013, and the deaths attributable to it.
Key Findings
Deficiency fell from 39% in 1991 to 29% in 2013. In 2013 it was highest in sub-Saharan Africa (48%) and south Asia (44%), and had dropped to 6% in east and southeast Asia and Oceania. About 94,500 diarrhoea deaths and 11,200 measles deaths in 2013 were attributable to deficiency, 1.7% of all deaths under 5 in these countries.
Conclusions
Vitamin A deficiency remains common in south Asia and sub-Saharan Africa, where more than 95% of attributable deaths occur; elsewhere the death burden has almost disappeared.
Limitations
Modelled estimates with wide credible intervals where survey data are sparse; serum retinol is lowered by infection; mortality effects were derived from supplementation trials rather than measured directly.
Related Health Concerns
Study Details
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