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. 2022 Apr 29;19(9):5416.
doi: 10.3390/ijerph19095416.

Impact of Fortified Infant Cereals on the Burden of Iron Deficiency Anemia in 6- to 23-Month-Old Indonesian Infants and Young Children: A Health Economic Simulation Model

Alberto Prieto-Patron  1 , Patrick Detzel  1 , Rita Ramayulis  2 , Sudikno  3 , Irene  4 , Yulianti Wibowo  4
Affiliations

Impact of Fortified Infant Cereals on the Burden of Iron Deficiency Anemia in 6- to 23-Month-Old Indonesian Infants and Young Children: A Health Economic Simulation Model

Alberto Prieto-Patron et al. Int J Environ Res Public Health. .

Abstract

Iron deficiency and iron deficiency anemia (IDA) are highly prevalent among Indonesian infants and young children (IYC). Severe IDA hampers mental development in young children and is linked to lower quality of life and lower productivity as adults. The consumption of fortified infant cereals (FIC) increases iron intake during the weaning period, thus reducing the social burden of IDA. In this manuscript, we aimed to assess the impact of FIC on the burden of IDA on IYC in Indonesia. We analyzed data for IYC aged 6-23 months from the fifth wave (2014-2015) of the Indonesia Family Life Survey (IFLS) and the Indonesia Demographic and Health Survey 2017 (IDHS-17). We adapted a health economic simulation model to estimate the impact of FIC that accounted for lifetime health and cost consequences in terms of reduced future income and DALYs. The mean Hb level was 10.5 ± 1.4 g/dL. Consumers of FIC had a reduced burden of disease (43,000 DALYs; USD 171 million) compared with non-consumers. The consumption of fortified infant cereals plays an important role in reducing the burden of IDA, and it might complement the available strategy of nutritional interventions to address this problem in Indonesian IYC.

Keywords: fortified infant cereals; health economics; infants and young children; iron deficiency anemia.

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Conflict of interest statement

Prieto Patron and Yulianti Wibowo are employees of Nestlé. Patrick Detzel and Irene were previous employee of Nestlé when the manuscript was drafted. Nestlé is a company selling Fortified Infant Cereals.

Figures

Figure A1
Figure A1
Explanation on the model time frame to estimate temporary and permanent consequences of IDA in a birth cohort.
Figure 1
Figure 1
Structure of the simulation model.
Figure 2
Figure 2
Modeling of the hemoglobin concentration trajectory according to the duration of consumption of fortified infant cereals.
Figure 3
Figure 3
Percentage of 6 to 23-month infants and young children with anemia across the 10 socio-economic strata (SES).
Figure 4
Figure 4
Effect of the duration of consumption of fortified infant cereals on hemoglobin levels in infants and young children aged 6–23 months.
Figure 5
Figure 5
Consumption of fortified infant cereals according to wealth group.
Figure 6
Figure 6
Probabilistic sensitivity analysis by economic and health burden in DALYs (disability-adjusted life years). The lines represent 95% confidence intervals.
See this image and copyright information in PMC

References

    1. Petry N., Olofin I., Hurrell R.F., Boy E., Wirth J.P., Moursi M., Angel M.D., Rohner F. The Proportion of Anemia Associated with Iron Deficiency in Low, Medium, and High Human Development Index Countries: A Systematic Analysis of National Surveys. Nutrients. 2016;8:693. doi: 10.3390/nu8110693. - DOI - PMC - PubMed
    1. World Health Organization (WHO) The Global Prevalence of Anemia in 2011. World Health Organization; Geneva, Switzerland: 2015.
    1. Cappellini M.D., Musallam K.M., Taher A.T. Iron deficiency anaemia revisited. J. Intern. Med. 2020;287:153–170. doi: 10.1111/joim.13004. - DOI - PubMed
    1. Burke R.M., Leon J.S., Suchdev P.S. Identification, prevention and treatment of iron deficiency during the first 1000 days. Nutrients. 2014;6:4093–4114. doi: 10.3390/nu6104093. - DOI - PMC - PubMed
    1. Sandjaja S., Budiman B., Harahap H., Ernawati F., Soekatri M., Widodo Y., Sumedi E., Rustan E., Sofia G., Syarief S.N., et al. Food consumption and nutritional and biochemical status of 0·5-12-year-old Indonesian children: The SEANUTS study. Br. J. Nutr. 2013;110:S11–S20. doi: 10.1017/S0007114513002109. - DOI - PubMed

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