Prevented cases of neural tube defects and cost savings after folic acid fortification of flour in Brazil
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| Publicatiedatum: | 2026 |
| Andere auteurs: | , , |
| Formaat: | Article |
| Taal: | eng |
| Bron: | Repositório Institucional da UnB |
| Download full: | https://doi.org/10.1371/journal.pone.0281077 http://repositorio.unb.br/handle/10482/54735 https://orcid.org/0000-0002-2389-820X |
Samenvatting: | Anencephaly, encephalocele, and spina bifida are congenital neural tube defects and are the main causes of neonatal morbidity and mortality and impose a heavy economic burden on health systems. This study to estimates the direct costs of neural tube defects from the perspective of the Brazilian Ministry of Health, and the prevented cases and cost savings during the period in which mandatory folic acid fortification was in effect in the country (2010–2019). It is a top-down cost-of-illness oriented study based on the prevalence of the disorders in Brazil. Data were collected from the Brazilian Ministry of Health’s outpatient and hospital information system databases. The direct cost was estimated from the total patient-years, allocated by age and type of disorder. Prevented cases and cost savings were determined by the difference in the prevalence of the disorders in the pre- and post-fortification periods based on the total number of births and the sum of outpatient and hospital costs during the period. The total cost of outpatient and hospital services for these disorders totaled R$ 92,530,810.63 (Int$ 40,565,896.81) in 10 years; spina bifida accounted for 84.92% of the total cost. Hospital costs were expressive of all three disorders in the first year of the patient’s life. Between 2010 and 2019, mandatory folic acid fortification prevented 3,499 live births with neural tube defects and resulted in R$ 20,381,586.40 (Int$ 8,935,373.25) in hospital and outpatient cost savings. Flour fortification has proved to be a valuable strategy in preventing pregnancies with neural tube defects. Since its implementation, there has been a 30% decrease in the prevalence of neural tube defects and a 22.81% decrease associated in hospital and outpatient costs. |
| _version_ | 1871442411742298112 |
|---|---|
| author | Rodrigues, Viviane Belini |
| author2 | Silva, Everton Nunes da Santos, André Marques dos Santos, Leonor Maria Pacheco |
| author2_role | author author author |
| author_browse | Rodrigues, Viviane Belini Santos, André Marques dos Santos, Leonor Maria Pacheco Silva, Everton Nunes da |
| author_facet | Rodrigues, Viviane Belini Silva, Everton Nunes da Santos, André Marques dos Santos, Leonor Maria Pacheco |
| author_role | author |
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| bitstream.url.fl_str_mv | http://repositorio.unb.br/bitstream/10482/54735/1/ARTIGO_PreventedCasesOfNeural.pdf |
| collection | Repositório Institucional da UnB |
| dc.contributor.affiliation.none.fl_str_mv | University of Brasılia, Graduate Program in Collective Health University of Brasılia, Faculty of Ceilandia Company ATsau´de Consultancy, São Paulo University of Brasılia, Public Health Department |
| dc.contributor.author.fl_str_mv | Rodrigues, Viviane Belini Silva, Everton Nunes da Santos, André Marques dos Santos, Leonor Maria Pacheco |
| dc.date.accessioned.fl_str_mv | 2026-06-11T14:15:38Z |
| dc.date.available.fl_str_mv | 2026-06-11T14:15:38Z |
| dc.date.issued.fl_str_mv | 2023-2-22 |
| dc.identifier.citation.fl_str_mv | RODRIGUES, Viviane Belini; SILVA, Everton Nunes da; SANTOS, André Marques dos; SANTOS, Leonor Maria Pacheco. Prevented cases of neural tube defects and cost savings after folic acid fortification of flour in Brazil. [S.l ]; PLOS ONE, v. 18, n. 2, e0281077, 2023. DOI: https://doi.org/10.1371/journal.pone.0281077. Disponível em: https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0281077. Acesso em: 11 jun. 2026. |
| dc.identifier.doi.pt_BR.fl_str_mv | https://doi.org/10.1371/journal.pone.0281077 |
| dc.identifier.orcid.pt_BR.fl_str_mv | https://orcid.org/0000-0002-2389-820X |
| dc.identifier.uri.fl_str_mv | https://doi.org/10.1371/journal.pone.0281077 http://repositorio.unb.br/handle/10482/54735 |
| dc.language.iso.fl_str_mv | eng |
| dc.publisher.none.fl_str_mv | Public Library of Science (PLoS) |
| dc.rights.driver.fl_str_mv | info:eu-repo/semantics/openAccess |
| dc.source.none.fl_str_mv | reponame:Repositório Institucional da UnB instname:Universidade de Brasília (UnB) instacron:UNB |
| dc.subject.keyword.pt_BR.fl_str_mv | Ácido fólico Defeitos do Tubo Neural (DTNs) Farinhas - fortificação |
| dc.title.pt_BR.fl_str_mv | Prevented cases of neural tube defects and cost savings after folic acid fortification of flour in Brazil |
| dc.type.driver.fl_str_mv | info:eu-repo/semantics/article |
| dc.type.status.fl_str_mv | info:eu-repo/semantics/publishedVersion |
| description | Anencephaly, encephalocele, and spina bifida are congenital neural tube defects and are the main causes of neonatal morbidity and mortality and impose a heavy economic burden on health systems. This study to estimates the direct costs of neural tube defects from the perspective of the Brazilian Ministry of Health, and the prevented cases and cost savings during the period in which mandatory folic acid fortification was in effect in the country (2010–2019). It is a top-down cost-of-illness oriented study based on the prevalence of the disorders in Brazil. Data were collected from the Brazilian Ministry of Health’s outpatient and hospital information system databases. The direct cost was estimated from the total patient-years, allocated by age and type of disorder. Prevented cases and cost savings were determined by the difference in the prevalence of the disorders in the pre- and post-fortification periods based on the total number of births and the sum of outpatient and hospital costs during the period. The total cost of outpatient and hospital services for these disorders totaled R$ 92,530,810.63 (Int$ 40,565,896.81) in 10 years; spina bifida accounted for 84.92% of the total cost. Hospital costs were expressive of all three disorders in the first year of the patient’s life. Between 2010 and 2019, mandatory folic acid fortification prevented 3,499 live births with neural tube defects and resulted in R$ 20,381,586.40 (Int$ 8,935,373.25) in hospital and outpatient cost savings. Flour fortification has proved to be a valuable strategy in preventing pregnancies with neural tube defects. Since its implementation, there has been a 30% decrease in the prevalence of neural tube defects and a 22.81% decrease associated in hospital and outpatient costs. |
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| identifier_str_mv | RODRIGUES, Viviane Belini; SILVA, Everton Nunes da; SANTOS, André Marques dos; SANTOS, Leonor Maria Pacheco. Prevented cases of neural tube defects and cost savings after folic acid fortification of flour in Brazil. [S.l ]; PLOS ONE, v. 18, n. 2, e0281077, 2023. DOI: https://doi.org/10.1371/journal.pone.0281077. Disponível em: https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0281077. Acesso em: 11 jun. 2026. |
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| language | eng |
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| publishDate | 2026 |
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| publisher.none.fl_str_mv | Public Library of Science (PLoS) |
| reponame_str | Repositório Institucional da UnB |
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| spelling | Rodrigues, Viviane BeliniSilva, Everton Nunes daSantos, André Marques dosSantos, Leonor Maria PachecoUniversity of Brasılia, Graduate Program in Collective HealthUniversity of Brasılia, Faculty of CeilandiaCompany ATsau´de Consultancy, São PauloUniversity of Brasılia, Public Health Department2026-06-11T14:15:38Z2026-06-11T14:15:38Z2023-2-22RODRIGUES, Viviane Belini; SILVA, Everton Nunes da; SANTOS, André Marques dos; SANTOS, Leonor Maria Pacheco. Prevented cases of neural tube defects and cost savings after folic acid fortification of flour in Brazil. [S.l ]; PLOS ONE, v. 18, n. 2, e0281077, 2023. DOI: https://doi.org/10.1371/journal.pone.0281077. Disponível em: https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0281077. Acesso em: 11 jun. 2026.https://doi.org/10.1371/journal.pone.0281077http://repositorio.unb.br/handle/10482/54735https://doi.org/10.1371/journal.pone.0281077https://orcid.org/0000-0002-2389-820XengPublic Library of Science (PLoS)© 2023 Rodrigues et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.info:eu-repo/semantics/openAccessPrevented cases of neural tube defects and cost savings after folic acid fortification of flour in Brazilinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleÁcido fólicoDefeitos do Tubo Neural (DTNs)Farinhas - fortificaçãoAnencephaly, encephalocele, and spina bifida are congenital neural tube defects and are the main causes of neonatal morbidity and mortality and impose a heavy economic burden on health systems. This study to estimates the direct costs of neural tube defects from the perspective of the Brazilian Ministry of Health, and the prevented cases and cost savings during the period in which mandatory folic acid fortification was in effect in the country (2010–2019). It is a top-down cost-of-illness oriented study based on the prevalence of the disorders in Brazil. Data were collected from the Brazilian Ministry of Health’s outpatient and hospital information system databases. The direct cost was estimated from the total patient-years, allocated by age and type of disorder. Prevented cases and cost savings were determined by the difference in the prevalence of the disorders in the pre- and post-fortification periods based on the total number of births and the sum of outpatient and hospital costs during the period. The total cost of outpatient and hospital services for these disorders totaled R$ 92,530,810.63 (Int$ 40,565,896.81) in 10 years; spina bifida accounted for 84.92% of the total cost. Hospital costs were expressive of all three disorders in the first year of the patient’s life. Between 2010 and 2019, mandatory folic acid fortification prevented 3,499 live births with neural tube defects and resulted in R$ 20,381,586.40 (Int$ 8,935,373.25) in hospital and outpatient cost savings. Flour fortification has proved to be a valuable strategy in preventing pregnancies with neural tube defects. Since its implementation, there has been a 30% decrease in the prevalence of neural tube defects and a 22.81% decrease associated in hospital and outpatient costs.Faculdade de Ciências da Saúde (FS)Departamento de Saúde Coletiva (FS DSC)Programa de Pós-Graduação em Ciências da Saúdereponame:Repositório Institucional da UnBinstname:Universidade de Brasília (UnB)instacron:UNBORIGINALARTIGO_PreventedCasesOfNeural.pdfARTIGO_PreventedCasesOfNeural.pdfapplication/pdf622646http://repositorio.unb.br/bitstream/10482/54735/1/ARTIGO_PreventedCasesOfNeural.pdf9d7f0e6c071038011bc4c23fd06c895fMD51open access10482/547352026-06-12 08:21:43.715open accessoai:repositorio.unb.br:10482/54735Repositório InstitucionalPUBhttps://repositorio.unb.br/oai/requestrepositorio@unb.bropendoar:2026-06-12T11:21:43Repositório Institucional da UnB - Universidade de Brasília (UnB) |
| spellingShingle | Prevented cases of neural tube defects and cost savings after folic acid fortification of flour in Brazil Rodrigues, Viviane Belini Ácido fólico Defeitos do Tubo Neural (DTNs) Farinhas - fortificação |
| status_str | publishedVersion |
| title | Prevented cases of neural tube defects and cost savings after folic acid fortification of flour in Brazil |
| title_full | Prevented cases of neural tube defects and cost savings after folic acid fortification of flour in Brazil |
| title_fullStr | Prevented cases of neural tube defects and cost savings after folic acid fortification of flour in Brazil |
| title_full_unstemmed | Prevented cases of neural tube defects and cost savings after folic acid fortification of flour in Brazil |
| title_short | Prevented cases of neural tube defects and cost savings after folic acid fortification of flour in Brazil |
| title_sort | Prevented cases of neural tube defects and cost savings after folic acid fortification of flour in Brazil |
| topic | Ácido fólico Defeitos do Tubo Neural (DTNs) Farinhas - fortificação |
| url | https://doi.org/10.1371/journal.pone.0281077 http://repositorio.unb.br/handle/10482/54735 https://orcid.org/0000-0002-2389-820X |