title: Evaluating the cost-effectiveness of preventive zinc supplementation.
abstract: BACKGROUND
  Even though the WHO currently recommends zinc for diarrhea management, no consensus has been reached with respect to routine distribution of zinc for preventive reasons. We reviewed the health impact of preventive zinc interventions, and evaluated the relative cost effectiveness of currently feasible interventions.
  
  
  METHODS
  Using the latest relative risk estimates reported in the literature, we parameterized a health impact model, and calculated the expected benefits of zinc supplementation in a representative low-income country. We then computed the cost and cost-effectiveness for three delivery mechanisms: the direct distribution of zinc supplements, the distribution of micronutrient biscuits including zinc, and the distribution of zinc through water filtration systems.
  
  
  RESULTS
  Combining all health outcomes and impact estimates, we find that systematic zinc supplementation among children of ages one to five would avert 1.423 DALYs per 100 households and year in least developed countries. The estimated cost per DALY is US$ 606 for pill supplementation, US$ 1211 for micronutrient biscuits, and US$ 879 per DALY saved for water filtration systems.
  
  
  CONCLUSIONS
  Preventive zinc supplementation to children of ages 1-5 appears to be a highly cost-effective intervention in typical developing country settings. More research will be needed to determine the most effective mechanism to deliver zinc to this target population.
authors.forename: Günther
authors.initials: G
authors.lastname: Fink
authors.affiliation: Department of Global Health and Population, Harvard School of Public Health, 665 Huntington Avenue, 02115 Boston, MA, USA. jah495@mail.harvard.edu.
authors.forename: Jesse
authors.initials: J
authors.lastname: Heitner
mesh_terms: D002648:Child; D002675:Child, Preschool; D003362:Cost-Benefit Analysis; D003906:Developing Countries; D003967:Diarrhea / Q000517:prevention & control*; D019587:Dietary Supplements / Q000191:economics*; D005260:Female; D014943:Global Health; D006801:Humans; D007223:Infant; D008297:Male; D018977:Micronutrients / Q000008:administration & dosage*; D018803:Models, Economic; D040242:Risk Reduction Behavior; D015032:Zinc / Q000008:administration & dosage*
chemical_list: D018977:Micronutrients; D015032:Zinc