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      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

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          Abstract

          Background

          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. 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.

          Methods

          The 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).

          Results

          In 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.

          Conclusion

          It 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.

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          Most cited references34

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          GBD 2010: design, definitions, and metrics.

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            Healthy life expectancy for 187 countries, 1990–2010: a systematic analysis for the Global Burden Disease Study 2010

            The Lancet, 380(9859), 2144-2162
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              Extent of vitamin A deficiency among preschool children and women of reproductive age.

              Knowledge of the extent of vitamin A (VA) deficiency (D) is critical for identifying high-risk populations and mobilizing resources for prevention. Yet, all estimates are necessarily imperfect, often based on assumptions in the absence of data. In 1995, the World Health Organization estimated 254 million children to be VA-deficient and 2.8 million to have xerophthalmia. Subsequently, estimates were changed to 75-140 million and 3.3 million, respectively. Although both sets are consistent with a problem of enormous magnitude, the discrepancies also created uncertainty. The present analysis indicates there are approximately 127 million and 4.4 million preschool children with VAD (serum retinol 6 million women develop night blindness (XN) during pregnancy annually. Roughly 45% of VA-deficient and xerophthalmic children and pregnant women with low-to-deficient VA status live in South and Southeast Asia. These regions harbor >60% of all cases of maternal XN, three fourths of whom seem to live in India. Africa accounts for 25-35% of the global cases of child and maternal VAD; about 10% of all deficient persons live in the eastern Mediterranean region, 5-15% live in the Western Pacific and approximately 5% live in the Region of the Americas. VA prophylaxis seems to be preventing the number of deficient preschool children from increasing while probably reducing rates of blindness and mortality. Greater effort is needed to assess and prevent VAD and its disorders, particularly among pregnant and lactating women.
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                Author and article information

                Contributors
                mqorbani1379@yahoo.com
                Kelishadi@med.mui.ac.ir
                Journal
                J Diabetes Metab Disord
                J Diabetes Metab Disord
                Journal of Diabetes and Metabolic Disorders
                BioMed Central (London )
                2251-6581
                9 August 2017
                9 August 2017
                2017
                : 16
                : 32
                Affiliations
                [1 ]ISNI 0000 0001 1498 685X, GRID grid.411036.1, Child Growth and Development Research Center, Research Institute for Primordial Prevention of Non-communicable Disease, , Isfahan University of Medical Sciences, ; Hezarjerib Ave, Isfahan, Iran
                [2 ]ISNI 0000 0001 0166 0922, GRID grid.411705.6, Non-Communicable Diseases Research Center, , Alborz University of Medical Sciences, ; Baghestan Boulevard, Karaj, 31485/56 Iran
                [3 ]ISNI 0000 0001 0166 0922, GRID grid.411705.6, Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, , Tehran University of Medical Sciences, ; Tehran, Iran
                [4 ]ISNI 0000 0001 0166 0922, GRID grid.411705.6, Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Research Institute, , Tehran University of Medical Sciences, ; Tehran, Iran
                [5 ]ISNI 0000 0001 0706 2472, GRID grid.411463.5, Department of Nutrition, Science and Research Branch, , Islamic Azad University, ; Tehran, Iran
                [6 ]ISNI 0000 0001 0166 0922, GRID grid.411705.6, Elderly Health Research Center, Endocrinology and Metabolism Population Sciences Institute, , Tehran University of Medical Sciences, ; Tehran, Iran
                [7 ]GRID grid.411746.1, Health Management and Economics Research Center and Department of Health Education and Promotion, , Iran University of Medical Sciences, ; Tehran, Iran
                [8 ]ISNI 0000 0001 1781 3962, GRID grid.412266.5, Department of Applied Linguistics, , Tarbiat Modares University, ; Tehran, Iran
                [9 ]ISNI 0000 0004 0384 871X, GRID grid.444830.f, Department of Medical Emergencies, , Qom University of Medical Sciences, ; Qom, Iran
                Article
                313
                10.1186/s40200-017-0313-7
                5550944
                0fccfdc7-d701-45f6-91e3-2303f060c033
                © The Author(s). 2017

                Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

                History
                : 25 December 2016
                : 24 July 2017
                Categories
                Research Article
                Custom metadata
                © The Author(s) 2017

                global burden of disease (gbd),vitamin a deficiency,disability-adjusted life years,years lived with disability,iran

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