Risk-Benefit and Cost-Effectiveness of Universal Iron Interventions for Public Health Control of Anemia in Young Children in 78 Countries: A Microsimulation Study

Almost 300 million children worldwide are anemic. Universal distribution of iron interventions (iron supplements or iron-containing multiple micronutrient powders, MNPs) to young children (e.g. <2 years of age) is a key World Health Organization recommendation to prevent anemia in low-income countries. However, concerns of iron-induced infection risk and limited effectiveness for anemia and broader child health outcomes have raised questions about whether iron interventions produce a net health benefit and are cost-effective. This has constrained implementation. Net effects likely differ in each country according to the epidemiology of anemia and infection, and local health care costs. Quality of implementation likely also affects net benefit. This means analyses must be country-specific. To help guide policymakers, we estimated country-specific net benefit-risk and cost-effectiveness of universal intervention with MNPs or iron supplements to young children. We developed a bespoke microsimulation model to estimate country-specific net Disability Adjusted Life Years (DALYs) attributable to anemia and infection in children from age 0-18 months who received MNPs, iron supplements or control from age 6-12 months. The model utilised publically available data on anemia, malaria, diarrhoea and respiratory infection epidemiology, and modified their risks according to effect sizes from the pivotal systematic reviews of randomised trials used to inform current guidelines. We next es...
Source: Blood - Category: Hematology Authors: Tags: 903. Outcomes Research-Non-Malignant Hematology: Poster I Source Type: research