ORIGINAL RESEARCH article
Front. Nutr.
Sec. Nutritional Epidemiology
Volume 12 - 2025 | doi: 10.3389/fnut.2025.1570683
This article is part of the Research TopicIron Deficiency and Excess: Diagnosis, Management and Impact on Human HealthView all 9 articles
Value for Health: How Fortified Infant Cereals Provide Cost-Effective Solutions to Iron Deficiency Anaemia in Egypt
Provisionally accepted
- 1American University in Cairo, Cairo, Egypt
- 2Nestle (Switzerland), Vevey, Switzerland
- 3Nestle Institute of Health Sciences (NIHS), Lausanne, Vaud, Switzerland
- 4Nestlé Nutrition, Cairo, Egypt
- 5Government of Egypt, Cairo, Egypt
- 6Ain Shams University, Cairo, Cairo, Egypt
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Background: Anaemia prevalence among Egyptian children under 5 years of age increased from 27.2% in 2014 to 43% in 2024, primarily attributed to iron deficiency anaemia (IDA). The World Health Organization and the United Nations International Children's Emergency Fund recommend iron-fortified foods and supplements to combat IDA. In the absence of longitudinal data among Egyptian children with anaemia, a microsimulation and costeffectiveness analysis was conducted to evaluate the economic and health impacts of consuming iron-fortified cereals (IFC) in reducing IDA prevalence among Egyptian children under 2 years of age.Methods: Data of 1707 children under 2 years of age from Egyptian Family Health Survey 2021 (EFHS) were used to create a virtual cohort of 100,000 through Monte Carlo simulations, stratified by age, gender, wealth index, and anaemia severity. A Markov model projected transitions in anaemia severity over 10 years for IFC and non-IFC consumers. Costs for IFC and home-based foods were derived from market research and existing literature, with costeffectiveness evaluated using the incremental cost-effectiveness ratio (ICER), indicating the additional cost required to gain one additional unit of effectiveness (in our case the disabilityadjusted life years [DALY]) when two approaches are compared.The per-day cost of home-based food was 0.37 United State Dollar (USD) per child, with an additional 0.17 USD for IFC consumers. Based on 5% IFC consumption (EFHS 2021) anaemia prevalence was projected to reduce to 32% over 10 years. DALYs averted among IFC consumers were 0.006 DALY/day and 22 DALYs over a period of 10 years. The obtained ICER of -4.14 suggests that an IFC intervention can be more effective and less costly than no intervention.: IFC interventions among Egyptian children under 2 years of age are crucial for reducing IDA. IFC consumption lowers DALYs and offers significant cost savings over 10 years, making it an effective health and economic strategy. With 40.58 million children under 2 years of age in Egypt, IFC interventions could save 7.79 million USD for one day of disability averted. This study provides evidence-based policy insight, urging prioritisation of IFC recommendation in public health strategies to combat IDA in children and reduce economic burdens.
Keywords: Iron deficiency anaemia, Dietary Supplements, fortified infant cereals, Health Economics, cost-effectiveness analysis
Received: 04 Feb 2025; Accepted: 13 Jun 2025.
Copyright: © 2025 Elmrayed, Colombo, Dainelli, Salib, Ghaffar and El Gendy. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Seham Elmrayed, American University in Cairo, Cairo, Egypt
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