Evidence map›Paper›PMID 29447176›Full record

ArticlePloS one2018

Cost-effectiveness of prenatal food and micronutrient interventions on under-five mortality and stunting: Analysis of data from the MINIMat randomized trial, Bangladesh.

Pernilla Svefors, Katarina Ekholm Selling, Rubina Shaheen, Ashraful Islam Khan, Lars-Åke Persson, Lars Lindholm

Open access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in PloS one, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers, 4 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
16citing papers in PubMed, 4 pooled it
2.0field-weighted citation impact, top 16% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

16 citing papers in PubMed, 4 syntheses or guidelines pooled it, 48 citations in OpenAlex.

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  4. Multiple-micronutrient supplementation for women during pregnancy.The Cochrane database of systematic reviews · 2019
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors at 3 institutions in 3 countries.

Pernilla SveforsInternational Maternal and Child Health, Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden.ORCID 0000-0003-2612-2973
Katarina Ekholm SellingInternational Maternal and Child Health, Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden.
Rubina ShaheenInternational Maternal and Child Health, Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden.
Ashraful Islam KhanInternational Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh.
Lars-Åke PerssonInternational Maternal and Child Health, Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden.
Lars LindholmDepartment of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden.
Uppsala University · SEInternational Centre for Diarrhoeal Disease Research · BDUmeå University · SE

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionNutrition interventions may have favourable as well as unfavourable effects. The Maternal and Infant Nutrition Interventions in Matlab (MINIMat), with early prenatal food and micronutrient supplementation, reduced infant mortality and were reported to be very cost-effective. However, the multiple micronutrients (MMS) supplement was associated with an increased risk of stunted growth in infancy and early childhood. This unfavourable outcome was not included in the previous cost-effectiveness analysis. The aim of this study is to evaluate whether the MINIMat interventions remain cost-effective in view of both favourable (decreased under-five-years mortality) and unfavourable (increased stunting) outcomes.

methodPregnant women in rural Bangladesh, where food insecurity still is prevalent, were randomized to early (E) or usual (U) invitation to be given food supplementation and daily doses of 30 mg, or 60 mg iron with 400 μg of folic acid, or MMS with 15 micronutrients including 30 mg iron and 400 μg of folic acid. E reduced stunting at 4.5 years compared with U, MMS increased stunting at 4.5 years compared with Fe60, while the combination EMMS reduced infant mortality compared with UFe60. The outcome measure used was disability adjusted life years (DALYs), a measure of overall disease burden that combines years of life lost due to premature mortality (under five-year mortality) and years lived with disability (stunting). Incremental cost effectiveness ratios were calculated using cost data from already published studies.

resultsBy incrementing UFe60 (standard practice) to EMMS, one DALY could be averted at a cost of US$24.

conclusionWhen both favourable and unfavourable outcomes were included in the analysis, early prenatal food and multiple micronutrient interventions remained highly cost effective and seem to be meaningful from a public health perspective.

Indexed as

AdultBangladeshChild, PreschoolCost-Benefit AnalysisDietary SupplementsFemaleFolic AcidFood SupplyGrowth DisordersHumansInfantInfant MortalityInfant, NewbornInfant Nutritional Physiological PhenomenaIronMaleFolic AcidIronMicronutrientsTrace ElementsVitamins

Identifiers

PMID29447176
PMCPMC5814099
OpenAlexW2786565366

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.