Burden of disease attributable to vitamin A deficiency in Iranian population aged less than five years: findings from the global burden of disease study 2010

Morteza Mansourian,Alireza Khajavi,Hamid Asayesh,Roya Kelishadi,Sara Nejatinamini,Asal Ataie- Jafari,Shohreh Naderimagham,Omid Safari,Maryam Bahreynian,Ali Asghar Ahmadishokouh,Farshad Sharifi,Mostafa Qorbani,Fahad Saqib

doi:10.1186/s40200-017-0313-7

Abstract

BackgroundVitamin A deficiency (VAD) is considered as one of the most serious public health concerns in developing countriesand the leading cause of mortality in under-five-year-old children.A large number of young children and pregnant women especially in low-income, non-industrialized communities are more susceptible to VAD. This study aims to report the burden of disease (BOD) attributable to VAD in Iranian population aged less than 5 years by using data of the Global Burden of Disease (GBD) study 2010.MethodsThe GBD 2010 study calculated the proportion of deaths, years of life lost (YLLs), and years lived with disability (YLDs) and disability-adjusted life years (DALYs) attributable to VAD by using the comparative risk assessment (CRA). VAD defined as low serum retinol concentrations (plasma retinol concentration < 0.70 umole/L) among children aged less than five. The VAD outcomes consisted of mortality due to diarrhea, measles, malaria, neglected infectious diseases, morbidity due to malaria (children < 5 years), low birth weight and other perinatal conditions. Uncertainty in the estimates is presented as 95% uncertainty interval (UI).ResultsIn 1990, there were 371 (95% UI: 166,665) DALYs due to VAD per 100,000 under five-year-old Iranian children in both sexes. The DALYs rate had a downward trend throughout the following years and reached to 76 (95% UI: 33–139)in 2010.The DALYs in children aged under 5 years was 378 (95% UI: 153–747) years for boys and 363 (95% UI: 148–692) years for girls in 1990 which fell to 79 (95% UI: 32–149) and 73 (95% UI: 29–138) in boys and girls in 2010, respectively. The rates of YLDs attributable to VAD changed in both sexes from 87(95% UI: 34–162) in 1990 to 46 (95% UI: 17–69) in 2010. The highest rate of YLDs attributed to VAD was observed in children aged 1–4. On the other hand, the YLLs were mostly in the 0–1-year-oldchildren in all years except 2010.ConclusionIt was found that DALYs attributable to VAD in 1990, followed by a considerable reduction rate after a period of two decades, in 2010. Additional studies on the burden of diseases particularly at sub-national level with more accurate data are recommended.

Highlights

Vitamin A deficiency (VAD) is considered as one of the most serious public health concerns in developing countriesand the leading cause of mortality in under-five-year-old children.A large number of young children and pregnant women especially in low-income, non-industrialized communities are more susceptible to VAD
A large number of young children and pregnant women especially inlow-income and non-industrialized communities are more susceptible toVAD. It results in night blindness, xerophthalmia, infection, iron deficiency anemia, and increased mortalityrate [2].According to the World Health Report (2011), the global prevalence of VAD in 0–4- year- old children was close to 21%, and the frequency of nightblindness was estimated to be 5% among pregnant women with the greatest prevalence in Asian and African countries [6,7,8].It is estimated that approximately 190 million preschool children and19 million pregnant women are affected by VAD, worldwide [6]
This study aims to report the burden of disease (BOD) attributable to VAD in Iranian population aged less than 5 years by using data of the Global Burden of Disease (GBD) study from 1990 to 2010 [15].this study aims to compare the results with the similar findings and discuss about the limitations of the GBD project for estimating burden of VAD

Summary

Introduction

Vitamin A deficiency (VAD) is considered as one of the most serious public health concerns in developing countriesand the leading cause of mortality in under-five-year-old children.A large number of young children and pregnant women especially in low-income, non-industrialized communities are more susceptible to VAD. A large number of young children and pregnant women especially inlow-income and non-industrialized communities are more susceptible toVAD It results in night blindness, xerophthalmia, infection, iron deficiency anemia, and increased mortalityrate [2].According to the World Health Report (2011), the global prevalence of VAD in 0–4- year- old children was close to 21%, and the frequency of nightblindness was estimated to be 5% among pregnant women with the greatest prevalence in Asian and African countries [6,7,8].It is estimated that approximately 190 million preschool children and million pregnant women are affected by VAD, worldwide [6]. Any improvement in vitamin A status might promote resistance to its health consequences and reduced mortality rate up to 23% [9]

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