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BMC Public Health

, 14:852

Global health

Abstract

BackgroundEven though the WHO currently recommends zinc for diarrhea management, no consensus has been reached with respect to routine distribution of zinc for preventive reasons. We reviewed the health impact of preventive zinc interventions, and evaluated the relative cost effectiveness of currently feasible interventions.

MethodsUsing the latest relative risk estimates reported in the literature, we parameterized a health impact model, and calculated the expected benefits of zinc supplementation in a representative low-income country. We then computed the cost and cost-effectiveness for three delivery mechanisms: the direct distribution of zinc supplements, the distribution of micronutrient biscuits including zinc, and the distribution of zinc through water filtration systems.

ResultsCombining all health outcomes and impact estimates, we find that systematic zinc supplementation among children of ages one to five would avert 1.423 DALYs per 100 households and year in least developed countries. The estimated cost per DALY is US$ 606 for pill supplementation, US$ 1211 for micronutrient biscuits, and US$ 879 per DALY saved for water filtration systems.

ConclusionsPreventive zinc supplementation to children of ages 1–5 appears to be a highly cost-effective intervention in typical developing country settings. More research will be needed to determine the most effective mechanism to deliver zinc to this target population.

KeywordsZinc supplementation Cost-effectiveness Diarrhea ALRI AbbreviationsWHOWorld Health Organization

DALYDisability adjusted life year

ALRIAcute lower respiratory illness

DHSDemographic and Health Surveys

RRRelative risk.

Electronic supplementary materialThe online version of this article doi:10.1186-1471-2458-14-852 contains supplementary material, which is available to authorized users.

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Author: Günther Fink - Jesse Heitner

Source: https://link.springer.com/







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