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Sep 19, 2007Article Details
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Main Article Content
Estimating the burden of disease attributable to vitamin A deficiency in South Africa in 2000
Abstract
Objectives. To estimate the burden of disease attributable to
vitamin A deficiency in children aged 0 - 4 years and pregnant
women aged 15 - 49 years in South Africa in 2000.
Design. The framework adopted for the most recent World
Health Organization comparative risk assessment (CRA)
methodology was followed. Population-attributable fractions
were calculated from South African Vitamin A Consultative
Group (SAVACG) survey data on the prevalence of vitamin A
deficiency in children and the relative risks of associated health
problems, applied to revised burden of disease estimates for
South Africa in the year 2000. Small community studies were
used to derive the prevalence in pregnant women. Monte Carlo
simulation-modelling techniques were used for the uncertainty
analysis.
Setting. South Africa.
Subjects. Children under 5 years and pregnant women 15 - 49
years.
Outcome measures. Direct sequelae of vitamin A deficiency,
including disability-adjusted life years (DALYs), as well as
mortality associated with measles, diarrhoeal diseases and
other infections, and mortality and DALYs associated with
malaria in children and all-cause maternal mortality.
Results. One-third of children aged 0 - 4 years and 1 - 6% of
pregnant women were vitamin A-deficient. Of deaths among
young children aged 0 - 4 years in 2000, about 28% of those
resulting from diarrhoeal diseases, 23% of those from measles,
and 21% of those from malaria were attributed to vitamin A
deficiency, accounting for some 3 000 deaths. Overall, about 110
467 (95% uncertainty interval 86 388 - 136 009) healthy years of
life lost, or between 0.5% and 0.8% of all DALYs in South Africa
in 2000 were attributable to vitamin A deficiency.
Conclusions. The vitamin A supplementation programme
for children and the recent food fortification programme
introduced in South Africa in 2003 should prevent future
morbidity and mortality related to vitamin A deficiency.
Monitoring the effectiveness of these interventions is strongly
recommended.
South African Medical Journal Vol. 97 (8) Part 2 2007: pp. 748-753
