Global, regional, and national burden of vitamin A deficiency (1990-2021) and projections to 2042: associations with sociodemographic development.
Level 4 - case-series / case-control
Observational epidemiological and ecological modeling study using GBD 2021 data (design analogy).
PubMed 41459070 · doi:10.3389/fnut.2025.1689903
What was done
The authors extracted death and disability-adjusted life year (DALY) data attributable to vitamin A deficiency (VAD) across 204 countries and territories between 1990 and 2021 from the Global Burden of Disease (GBD) 2021 database. They calculated absolute counts, age-standardized rates (ASRs), estimated annual percentage changes (EAPCs), and relative changes across regions, socio-demographic index (SDI) quintiles, and countries. Pearson correlation and frontier analyses evaluated the relationship between VAD burden and SDI, and Bayesian age-period-cohort models projected ASRs through 2042.
What was found
From 1990 to 2021, global deaths attributable to VAD declined from 188,458.416 to 17,374.404, with the mortality ASR decreasing from 3.04 to 0.27 per 100,000 population (EAPC: -7.81%). Global VAD-attributable DALYs fell from 18.79 million to 2.63 million, with the DALY ASR dropping from 303.72 to 40.10 per 100,000 population (EAPC: -6.70%). The greatest declines occurred in East Asia, Southeast Asia, and high-middle SDI regions, while low SDI regions and Oceania showed the smallest reductions. Males consistently had a higher burden than females. Diarrheal diseases were the leading cause of VAD-related deaths. SDI strongly negatively correlated with VAD burden, and models projected continued declines through 2042.
Why it matters
This study tracks three decades of global progress against vitamin A deficiency and highlights where the remaining burden is concentrated. The findings demonstrate that while global mortality and morbidity have fallen dramatically, interventions remain disproportionately needed in low-SDI areas and Oceania.
Limits
The findings depend on mathematical modeling from the GBD framework rather than direct, prospective clinical or biochemical surveillance across all populations. In low-SDI regions where primary health data are often sparse, estimates carry higher uncertainty. The abstract does not report uncertainty intervals or individual-level dietary, socioeconomic, and supplement-coverage data.
Cited by
- contradicts Vitamin A deficiency causes approximately 1 million deaths per year worldwide.