MMWR Morb Mortal Wkly Rep. 2007 Oct 26;56(42):1109-13.
Approximately 10 million children aged <5 years die each year in developing countries. The leading infectious causes of these deaths include acute respiratory infections, diarrhea, measles, and malaria; malnutrition contributes to approximately 50% of these deaths. To address multiple conditions that contribute to mortality, child-survival programs require effective interventions and implementation strategies. To assess the effectiveness of multiple interventions, CDC has joined with partners to create the Nyando Integrated Child Health and Education (NICHE) project to combine several proven approaches to child survival in an impoverished rural district of western Kenya. During March-April 2007, CDC began the NICHE project with a baseline survey. This report summarizes preliminary data from that survey, which determined that 1) 86.1% of surveyed households were in the poorest Kenya socioeconomic quintile and 2) among children aged 6-35 months, 21.5% had experienced an acute respiratory infection and 9.1% had experienced diarrhea in the preceding 24 hours, 28.0% had chronic malnutrition, 66.2% had anemia, and 19.8% had a positive malaria smear. Comprehensive interventions will be needed to improve living conditions and reduce the risk for death before age 5 years among children in this population.
在发展中国家,每年约有1000万5岁以下儿童死亡。这些死亡的主要感染性病因包括急性呼吸道感染、腹泻、麻疹和疟疾;营养不良导致了约50%的此类死亡。为应对导致死亡的多种情况,儿童生存项目需要有效的干预措施和实施策略。为评估多种干预措施的有效性,美国疾病控制与预防中心(CDC)与合作伙伴共同开展了尼扬多儿童综合健康与教育(NICHE)项目,将几种经证实的儿童生存方法结合起来,应用于肯尼亚西部一个贫困农村地区。2007年3月至4月期间,CDC通过基线调查启动了NICHE项目。本报告总结了该调查的初步数据,该数据显示:1)86.1%的受访家庭处于肯尼亚社会经济最贫困的五分之一群体;2)在6至35个月大的儿童中,21.5%在过去24小时内患过急性呼吸道感染,9.1%患过腹泻,28.0%患有慢性营养不良,66.2%患有贫血,19.8%的疟疾涂片检查呈阳性。需要采取综合干预措施来改善生活条件,并降低该人群中5岁以下儿童的死亡风险。