Brown Kenneth H, Hess Sonja Y, Vosti Stephen A, Baker Shawn K
Department of Nutrition, Program in International and Community Nutrition, University of California, One Shields Avenue, Davis, CA 95616, USA.
Food Nutr Bull. 2013 Jun;34(2):199-214. doi: 10.1177/156482651303400209.
Zinc supplementation of young children in lower-income countries reduces morbidity from diarrhea and pneumonia and all-cause mortality, but the most cost-effective approach for distributing zinc supplements is unknown.
To examine the potential impact of four possible strategies for delivering zinc supplements on disease prevention and deaths averted among children 6 to 59 months of age in sub-Saharan Africa.
We analyzed different zinc supplementation strategies to assess their likely impact on morbidity and mortality of preschool children in sub-Saharan Africa and to estimate their possible costs.
Preventive zinc supplementation reduces diarrhea incidence by 27% among children 12 to 59 months of age, pneumonia incidence by 21% among children 6 to 59 months of age, and all-cause mortality by 18% among children 12 to 59 months of age. The likely average total program costs of zinc supplementation programs were estimated from the outlays of existing service delivery platforms, such as child health days, community-based nutrition programs, and clinic-based treatment of diarrhea, assuming different levels of coverage and target age ranges of children.
We found that the average total costs per life saved ranged from approximately US$462 to US$3,111, and the most cost-effective interventions were weekly or intermittent preventive zinc supplementation, because of the possibility of high coverage and fewer supplements required. Empirical data from zinc supplementation programs will be needed to confirm these estimates.
在低收入国家，给幼儿补充锌可降低腹泻和肺炎的发病率以及全因死亡率，但分发锌补充剂最具成本效益的方法尚不清楚。
研究四种可能的锌补充剂递送策略对撒哈拉以南非洲6至59个月大儿童疾病预防和避免死亡的潜在影响。
我们分析了不同的锌补充策略，以评估它们对撒哈拉以南非洲学龄前儿童发病率和死亡率的可能影响，并估计其可能成本。
预防性补充锌可使12至59个月大儿童的腹泻发病率降低27%，使6至59个月大儿童的肺炎发病率降低21%，使12至59个月大儿童的全因死亡率降低18%。假设儿童的覆盖水平和目标年龄范围不同，根据儿童健康日、社区营养项目和基于诊所的腹泻治疗等现有服务提供平台的支出，估计了锌补充项目可能的平均总成本。
我们发现，每挽救一条生命的平均总成本约为462美元至3111美元，最具成本效益的干预措施是每周或间歇性预防性补充锌，因为其有可能实现高覆盖率且所需补充剂较少。需要锌补充项目的实证数据来证实这些估计。
