Original Article
European Journal of Clinical Nutrition (2009) 63, 591–597; doi:10.1038/ejcn.2008.9; published online 13 February 2008
Global and regional child mortality and burden of disease attributable to zinc deficiency
Contributors: CLFW wrote the initial draft of the manuscript. REB conceptualized and assisted with the analyses. ME calculated the disease burden attributable to zinc deficiency. All authors contributed to the final manuscript.
C L Fischer Walker1, M Ezzati2 and R E Black1
- 1Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
- 2Department of Population and International Health, Harvard School of Public Health, Boston, MA, USA
Correspondence: Dr CL Fischer Walker, Department of International Health, Johns Hopkins Bloomberg School of Public Health, 615 N Wolfe St. Rm E5543, Baltimore, MD 21205, USA. E-mail: cfischer@jhsph.edu
Received 21 August 2007; Revised 8 January 2008; Accepted 8 January 2008; Published online 13 February 2008.
Abstract
Background/Objectives:
Zinc is an essential micronutrient and deficiency can lead to an increased risk for infectious diseases and growth retardation among children under 5 years of age. We aimed to estimate disease-specific and all-cause mortality attributable to zinc deficiency.
Subject/Methods:
We estimated the prevalence of zinc deficiency in Latin America, Africa and Asia, where based on zinc availability in the diet and childhood stunting rates, zinc deficiency is widespread. The relative risks of death among zinc-deficient children for diarrhea, malaria and pneumonia were estimated from randomized controlled trials. We used the comparative risk assessment methods to calculate deaths and burden of disease (measured in disability-adjusted life years, DALYs) from each of these three diseases attributable to zinc deficiency in these regions.
Results:
Zinc deficiency was responsible for 453 207 deaths (4.4% of childhood deaths), and 1.2% of the burden of disease (3.8% among children between 6 months and 5 years) in these three regions in 2004. Of these deaths, 260 502 were in Africa, 182 546 in Asia and 10 159 in Latin America. Zinc deficiency accounted for 14.4% of diarrhea deaths, 10.4% of malaria deaths and 6.7% of pneumonia deaths among children between 6 months and 5 years of age.
Conclusions:
Zinc deficiency contributes to substantial morbidity and mortality, especially from diarrhea. Zinc supplementation provided as an adjunct treatment for diarrhea may be the best way to target children most at risk of deficiency.
Keywords:
zinc, burden of disease, diarrhea, pneumonia, malaria
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