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Over a third of child deaths and 11 per cent of global disease burden due to maternal and child undernutrition
 More than one third of child deaths and 11 per cent of the total disease burden worldwide are due to maternal and child undernutrition. These and other shocking statistics are the conclusions of Professor Robert Black, Johns Hopkins School of Public Health, Baltimore, MD, USA, and Professor Zulfiqar Bhutta, Department of Paediatrics and Child Health, Aga Khan University, Karachi, Pakistan, and colleagues, authors of this first paper in The Lancet Undernutrition Series.
The authors say: “Maternal and child undernutrition is highly prevalent in low-income and middle-income countries, resulting in substantial increases in mortality and overall disease burden”. Undernutrition encompasses stunting, wasting, and deficiencies of essential vitamins and minerals as one form of the condition known as malnutrition, with obesity or over-consumption of specific nutrients as another form.
They estimate that stunting, severe wasting, and intrauterine growth restriction together were responsible for 2.2. million deaths (2005) and 21 per cent of disability-adjusted life years (DALYs) for children under five-years. Deficiencies of vitamin A and zinc have by far the highest disease burden in the micronutrients studied, and were estimated to be responsible for 0.6 million and 0.4 millions deaths, respectively, in 2005, and together cause 9 per cent of global childhood DALYs. Iodine and Iron deficiencies have small disease burdens, partly because of intervention programmes – but sustained effort is needed to further reduce their burden. The paper also examines the effect of suboptimum breastfeeding, which is estimated to be responsible for 1.4 million child deaths and 44 million DALYs in children under five years.
By doing an analysis that accounted for co-exposure of these nutrition-related factors, the authors found that they were together responsible for 35 per cent of child deaths globally and 11 per cent of the total global disease burden. The authors conclude: “The high mortality and disease burden resulting from these nutrition-related factors make a compelling case for the urgent implementation of interventions, to reduce their occurrence or ameliorate their consequences.”
Further, the authors identify key areas where further research is required – including developing methods to assess nutritional status and its determinants; the prevalence of micronutrient deficiencies (eg, vitamin A, iron, zinc) in populations; consequences of nutritional deficiencies for mortality from HIV/AIDS, malaria, tuberculosis and other infectious diseases; consequences of nutritional deficiencies on immune systems, brain development and cognitive ability; overlap of micronutrients and their joint effects on mortality and disease; and finally development of international fetal and newborn growth standards.”
Professor Robert Black
Johns Hopkins Bloomberg School of Public Health
Baltimore, MD, USA
Tel: 1 410 955 3934
Email: rblack@jhsph.edu
Professor Zulfiqar Bhutta
Department of Paediatrics and Child Health
Aga Khan University, Karachi, Pakistan
Tel: +92 21 4864782 /+92 300 8236813
Email: zulfiqar.bhutta@aku.edu
For further information, please contact:
Department of Public Affairs
Aga Khan University
Stadium Road, P.O. Box 3500, Karachi-74000.
Fax: 493 4294, 493 2095
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