Epicentre, Paris, France.
PLoS One. 2009 Nov 26;4(11):e8077. doi: 10.1371/journal.pone.0008077.
Certain population groups have been rendered vulnerable in Chad because of displacement of more than 200,000 people over the last three years as a result of mass violence against civilians in the east of the country. The objective of the study was to assess mortality and nutritional patterns among displaced and non-displaced population living in camps, villages and a town in the Ouddaï and Salamat regions of Chad.
Between May and October 2007, two stage, 30-cluster household surveys were conducted among 43,900 internally displaced persons (IDPs) living in camps in Ouaddai region (n = 898 households), among 19,400 non-displaced persons (NDPs) living in 42 villages in Ouaddai region (n = 900 households) and among 17,000 NDPs living in a small town in Salamat region (n = 901 households). Data collection included anthropometric measurements, measles vaccination rates and retrospective mortality. Crude mortality rate (CMR), mortality rate among children younger than 5 years (U5MR), causes of death and the prevalence of wasting (weight-for-height z score <-2) among children aged 6 to 59 months were the main outcome measures.
The CMR among the 4902 IDPs in Gozbeida camps, 4477 NDPs living in a village and 4073 NDPs living in a town surveyed was 1.8 (95% CI, 1.2-2.8), 0.3 (95% CI, 0.2-0.4), 0.3 (95% CI, 0.2-0.5) per 10,000 per day, respectively. The U5MR in a camp (n = 904), a village (n = 956) and a town (n = 901) was 4.1 (95% CI, 2.1-7.7), 0.5 (95% CI, 0.3-0.9) and 0.7 (95% CI, 0.4-1.4) per 10,000 per day, respectively. Diarrhoea was reported to be the main cause of death. Acute malnutrition rates (according to the WHO definition) among 904 IDP children, 956 NDPs children living in a village, 901 NDP children living in a town aged 6 to 59 months were 20.6% (95% CI, 17.9%-23.3%), 16.4% (95% CI, 14.0%-18.8%) and 10.1% (95% CI, 8.1%-12.2%) respectively. The study found a high mortality rate among IDPs and an elevated prevalence of wasting not only in IDP camps but also in villages located in the same region. The town-dweller population remains at risk of malnutrition. Appropriate contingency plans need to be made to ensure acceptable living standards for these populations.
由于该国东部发生大规模暴力侵害平民事件，导致 20 多万人在过去三年中被迫流离失所，乍得的某些人群因此变得脆弱。本研究的目的是评估在乍得奥达伊和萨拉马特地区的营地、村庄和城镇中，流离失所者和非流离失所者的死亡率和营养模式。
在 2007 年 5 月至 10 月期间，对居住在奥达伊地区营地中的 43900 名境内流离失所者（IDP）（898 户家庭）、居住在奥达伊地区 42 个村庄中的 19400 名非流离失所者（NDP）（900 户家庭）和居住在萨拉马特地区一个小镇中的 17000 名 NDP（901 户家庭）进行了两阶段、30 个聚类家庭调查。数据收集包括人体测量、麻疹疫苗接种率和死亡率回顾性评估。主要观察指标为粗死亡率（CMR）、5 岁以下儿童死亡率（U5MR）、死因和 6 至 59 个月大儿童消瘦率（体重身高 z 分数<-2）。
在戈兹贝达营地的 4902 名 IDP、居住在一个村庄的 4477 名 NDP 和居住在一个城镇的 4073 名 NDP 中，CMR 分别为 1.8（95%CI，1.2-2.8）、0.3（95%CI，0.2-0.4）和 0.3（95%CI，0.2-0.5）/10000/天。在一个营地（n=904）、一个村庄（n=956）和一个城镇（n=901）中，U5MR 分别为 4.1（95%CI，2.1-7.7）、0.5（95%CI，0.3-0.9）和 0.7（95%CI，0.4-1.4）/10000/天。腹泻被报道为主要死因。在 6 至 59 个月大的 904 名 IDP 儿童、956 名居住在村庄的 NDP 儿童和 901 名居住在城镇的 NDP 儿童中，急性营养不良率（根据世卫组织的定义）分别为 20.6%（95%CI，17.9%-23.3%）、16.4%（95%CI，14.0%-18.8%）和 10.1%（95%CI，8.1%-12.2%）。研究发现 IDP 死亡率较高，不仅在 IDP 营地，而且在同一地区的村庄中，消瘦的流行率也很高。城镇居民仍然面临营养不良的风险。需要制定适当的应急计划，以确保这些人群能够接受的生活水平。
