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Nutrients
Volume 13
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10.3390/nu13010244
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Article

Reducing the Burden of Anemia and Neural Tube Defects in Low- and Middle-Income Countries: An Analysis to Identify Countries with an Immediate Potential to Benefit from Large-Scale Mandatory Fortification of Wheat Flour and Rice

by
Vijaya Kancherla
1,
Manpreet Chadha
2,*,
Laura Rowe
3,
Andrew Thompson
2,
Sakshi Jain
2,
Dylan Walters
2 and
Homero Martinez
2
1
Center for Spina Bifida Prevention, Department of Epidemiology, Emory University Rollins School of Public Health, Atlanta, GA 30322, USA
2
Nutrition International, Ottawa, ON K2P 2K3, Canada
3
Food Fortification Initiative, Atlanta, GA 30322, USA
*
Author to whom correspondence should be addressed.
Nutrients 2021, 13(1), 244; https://doi.org/10.3390/nu13010244
Submission received: 8 December 2020 / Revised: 12 January 2021 / Accepted: 13 January 2021 / Published: 16 January 2021
(This article belongs to the Special Issue Health Benefits of Iron and Folic Acid Supplementation)
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Abstract

Using a predetermined set of criteria, including burden of anemia and neural tube defects (NTDs) and an enabling environment for large-scale fortification, this paper identifies 18 low- and middle-income countries with the highest and most immediate potential for large-scale wheat flour and/or rice fortification in terms of health impact and economic benefit. Adequately fortified staples, delivered at estimated coverage rates in these countries, have the potential to avert 72.1 million cases of anemia among non-pregnant women of reproductive age; 51,636 live births associated with folic acid-preventable NTDs (i.e., spina bifida, anencephaly); and 46,378 child deaths associated with NTDs annually. This equates to a 34% reduction in the number of cases of anemia and 38% reduction in the number of NTDs in the 18 countries identified. An estimated 5.4 million disability-adjusted life years (DALYs) could be averted annually, and an economic value of 31.8 billion United States dollars (USD) generated from 1 year of fortification at scale in women and children beneficiaries. This paper presents a missed opportunity and warrants an urgent call to action for the countries identified to potentially avert a significant number of preventable birth defects, anemia, and under-five child mortality and move closer to achieving health equity by 2030 for the Sustainable Development Goals.
Keywords: DALYs; fortified foods; developing countries; neural tube defects; anemia; child mortality; infant mortality; women’s health; Sustainable Development Goals; health policy DALYs; fortified foods; developing countries; neural tube defects; anemia; child mortality; infant mortality; women’s health; Sustainable Development Goals; health policy

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MDPI and ACS Style

Kancherla, V.; Chadha, M.; Rowe, L.; Thompson, A.; Jain, S.; Walters, D.; Martinez, H. Reducing the Burden of Anemia and Neural Tube Defects in Low- and Middle-Income Countries: An Analysis to Identify Countries with an Immediate Potential to Benefit from Large-Scale Mandatory Fortification of Wheat Flour and Rice. Nutrients 2021, 13, 244. https://doi.org/10.3390/nu13010244

AMA Style

Kancherla V, Chadha M, Rowe L, Thompson A, Jain S, Walters D, Martinez H. Reducing the Burden of Anemia and Neural Tube Defects in Low- and Middle-Income Countries: An Analysis to Identify Countries with an Immediate Potential to Benefit from Large-Scale Mandatory Fortification of Wheat Flour and Rice. Nutrients. 2021; 13(1):244. https://doi.org/10.3390/nu13010244

Chicago/Turabian Style

Kancherla, Vijaya, Manpreet Chadha, Laura Rowe, Andrew Thompson, Sakshi Jain, Dylan Walters, and Homero Martinez. 2021. "Reducing the Burden of Anemia and Neural Tube Defects in Low- and Middle-Income Countries: An Analysis to Identify Countries with an Immediate Potential to Benefit from Large-Scale Mandatory Fortification of Wheat Flour and Rice" Nutrients 13, no. 1: 244. https://doi.org/10.3390/nu13010244

APA Style

Kancherla, V., Chadha, M., Rowe, L., Thompson, A., Jain, S., Walters, D., & Martinez, H. (2021). Reducing the Burden of Anemia and Neural Tube Defects in Low- and Middle-Income Countries: An Analysis to Identify Countries with an Immediate Potential to Benefit from Large-Scale Mandatory Fortification of Wheat Flour and Rice. Nutrients, 13(1), 244. https://doi.org/10.3390/nu13010244

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