1 / 27

Global Health Challenges Social Analysis 76: Lecture 20

Global Health Challenges Social Analysis 76: Lecture 20. Attributable Disease Burden of 20 Risk Factors. Iron Deficiency Anaemia Vitamin A Deficiency Zinc Deficiency Review of Diseases, Injuries and Risk Factors. Perinatal mortality: OR’s for each 1 g/dL Hb increase. Summary OR: 0.72.

zerlina-mcgowan
Download Presentation

Global Health Challenges Social Analysis 76: Lecture 20

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. Global Health ChallengesSocial Analysis 76: Lecture 20 Harvard University Initiative for Global Health

  2. Attributable Disease Burden of 20 Risk Factors Harvard University Initiative for Global Health

  3. Iron Deficiency Anaemia Vitamin A Deficiency Zinc Deficiency Review of Diseases, Injuries and Risk Factors Harvard University Initiative for Global Health

  4. Perinatal mortality: OR’s for each 1 g/dL Hb increase Summary OR: 0.72 From Stoltzfus et al, 2005 Harvard University Initiative for Global Health

  5. Harvard University Initiative for Global Health

  6. Prevalence of anaemia among children 0 – 4 years old by CRA region Prevalence (%) 5 - 16 16 - 28 28 - 39 39 - 51 51 - 63 From Stoltzfus et al, 2005 Harvard University Initiative for Global Health

  7. Harvard University Initiative for Global Health

  8. Harvard University Initiative for Global Health

  9. Effect of Iron/Folic Acid (IFA) Supplementation on Adverse Events in Children 1-48 Months Old • Nepal (19,299 child-years IFA, 9,799 placebo) – no effect on deaths1 • Zanzibar (16,950 child-years IFA, 8,574 placebo) – 12% increase in all hospitalizations/deaths, 16% in malaria, 33% in pneumonia2 1Tielsch et al, submitted 2Sazawal et al, submitted Harvard University Initiative for Global Health

  10. Effect of Iron/Folic Acid Supplementation on Adverse Events (Hospitalization and Death) in Children in Zanzibar (following 16,950 child-years in supplemented and 8,574 in placebo groups) From Sazawal et al, submitted Harvard University Initiative for Global Health

  11. Iron Deficiency Anaemia Vitamin A Deficiency Zinc Deficiency Review of Diseases, Injuries and Risk Factors Harvard University Initiative for Global Health

  12. Effects of Vitamin A on Infectious Disease Morbidity • Possible effect on diarrhea severity, but not all morbidity • No effect on pneumonia morbidity • Effect on measles complications Harvard University Initiative for Global Health

  13. Prevalence of vitamin A deficiency among children 0-4 years old by CRA regions Prevalence (%) 0 - 1 0 1 0 - 1 9 1 9 - 2 9 2 9 - 3 8 3 8 - 4 8 From West et al., 2002 Harvard University Initiative for Global Health

  14. Major Trials of Vitamin A to Prevent Mortality Over 165,000 children participated in these 8 trials Harvard University Initiative for Global Health

  15. Vitamin A Implementation • Widespread implementation of Vitamin A supplementation often linked to immunization programs. • Is coverage sustainable outside of immunization campaigns? Harvard University Initiative for Global Health

  16. Iron Deficiency Anaemia Vitamin A Deficiency Zinc Deficiency Review of Diseases, Injuries and Risk Factors Harvard University Initiative for Global Health

  17. Harvard University Initiative for Global Health

  18. Global Zinc Deficiency 0 – 14.9 % Deficient 15 – 24.9 % Deficient > 25 % Deficient From Brown et al, 2004 Harvard University Initiative for Global Health

  19. Preventive Effect of Zinc Supplementation on Diarrheal Prevalence in Continuous Supplementation Trials Harvard University Initiative for Global Health

  20. India(S) Peru Vietnam Jamaica India(B) Pooled 0 0.5 1 1.5 2 2.5 3 Relative Risk and 95% CI Preventive Effect of Zinc Supplementation on Pneumonia Incidence in Continuous Supplementation Trials Harvard University Initiative for Global Health

  21. Effect of Zinc Supplementation on Malaria in Children 1Bates et al, Brit J Nutr, 1993 2Shankar et al, Am J Trop Med Hyg, 2000 Harvard University Initiative for Global Health

  22. Trial in Bangladesh Evaluating the Preventive Effect of Weekly Zinc Supplementation • 1-23 mo. old children, weekly zinc (70 mg) • 6% less diarrhea, 17% less pneumonia, 49% less severe pneumonia and 42% less otitis media, • 85% less mortality From Brooks et al, Lancet 2005 Harvard University Initiative for Global Health

  23. Efficacy Trials of Zinc Supplementation on Child Mortality • Zanzibar and Nepal • Children 1-35 mo. old (>60,000 child-years) • Randomized, controlled trials • Daily 10 mg zinc (5 mg if <12 mo old) • All children receive vitamin A • Trial to be completed in Zanzibar in September 2005 and Nepal in January 2006 Harvard University Initiative for Global Health

  24. Iron Deficiency Anaemia Vitamin A Deficiency Zinc Deficiency Review of Diseases, Injuries and Risk Factors Harvard University Initiative for Global Health

  25. Leading Causes of the Global Burden of Disease 2002 DALYs % • Perinatal conditions 6.5 • Lower respiratory infections 6.1 • HIV/AIDS 5.7 • Depression 4.5 • Diarrhoeal diseases 4.2 • Ischaemic heart disease 3.9 • Cerebrovascular disease 3.3 • Malaria 3.1 • Road traffic accidents 2.6 • Tuberculosis 2.3 Source: World Health Report, 2004 Harvard University Initiative for Global Health

  26. Attributable Disease Burden of 20 Risk Factors Harvard University Initiative for Global Health

  27. What is Missing? What diseases, injuries or risk factors are missing from these lists? Harvard University Initiative for Global Health

More Related