Micronutrients
While clinical manifestations of micronutrient deficiencies have been known for many years, it has been only in the last two decades that the public health burden of micronutrient deficiencies in developing countries was fully recognized. Globally, more than 2 billion people are at risk of iron, vitamin A and iodine deficiencies. While achievements have been made to reduce prevalence of child malnutrition related to stunting, underweight and wasting, micronutrient deficiencies remain significant nutritional and public health problems. These micronutrient deficiencies impair function and increase the severity of common infections (e.g. measles, diarrhea), while compromising intellectual potential, growth, development and adult productivity.
The three most prevalent deficiencies are vitamin A, iron and iodine. For these reasons USAID programs focus on these key micronutrient deficiencies. Vitamin A deficiency is estimated to affect as many as 250 million children under the age of 5. Alleviation of vitamin A deficiency in many parts of the world will mean a substantial reduction in child deaths due to common infections as well as the prevention of irreversible blindness and improved health and development. USAID-funded studies demonstrate that vitamin A supplements can reduce child mortality by 23 to 34 percent in areas where vitamin A deficiency is common and basic child survival services are lacking.
A recent analysis found that iron deficiency affects approximately one-third of the worlds' women and children and is one of the most common causes of anemia. Twenty percent of maternal mortality, 22 percent of perinatal mortality and 18 percent of mental retardation can be attributed to iron deficiency globally. Iron deficiency in children compromises mental development and learning capacity.
Iodine deficiency remains a public health problem in many countries in spite of USAID, the United Nations Children's Fund (UNICEF)/Kiwanis and other actors' global efforts for universal salt iodization. Although more than two-thirds of household salt is iodized worldwide, iodine deficiency still remains the leading cause of preventable mental retardation with as many as 50 million infants born annually at risk of iodine deficiency.
Recent research has demonstrated that zinc deficiency increases the risk of mortality from diarrhea, pneumonia and malaria. Zinc supplementation has been demonstrated to significantly reduce the duration of diarrheal episodes, leading the World Health Organization (WHO) to endorse the use of zinc supplementation as adjunctive therapy for diarrhea.
The interactions between micronutrients - both positive and negative - are currently under investigation. Research is ongoing into the role of vitamin A and maternal mortality and the most effective combinations of vitamins and minerals for maternal and child health in chronically infected malnourished populations.
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