Bandim Health Project, Copenhagen, Denmark.
Int J Epidemiol. 2011 Aug;40(4):971-84. doi: 10.1093/ije/dyr010. Epub 2011 Feb 4.
The humanitarian response to the crisis in Darfur is the largest humanitarian operation in the world. To investigate the evolution of the conditions of the affected population, we analysed trends in malnutrition and mortality, the most widely accepted indicators for assessing the degree of severity of a crisis.
We did a meta-analysis of 164 publicly available surveys taking into account changes in the contextual situation and humanitarian aid; type of population [residents and internally displaced persons (IDPs)]; and seasonal variations. Data on global acute malnutrition (GAM), severe acute malnutrition (SAM), crude death rate (CDR) and under-five death rate (U5DR) were analysed using a random effect model.
GAM and SAM decreased by 16% and 28%, respectively, in 2004-05, whereas CDR dropped by 44-75% per year depending on state and type of population and U5DR decreased by an overall 50% yearly. Both security and the humanitarian contexts became increasingly complex after 2005, but levels of malnutrition stabilized in North and South Darfur. In West Darfur, GAM remained stable but SAM tended to increase for IDPs, although mortality rates remained constant. Mortality increased slightly for residents in South Darfur after 2005, even though nutritional status was stable. GAM, SAM, CDR and U5DR fluctuated markedly with seasons.
A meta-analysis of myriads of surveys permitted us to draw an overall picture of the situation in Darfur and to identify some of its influencing factors. The large humanitarian operation, which gained momentum through 2004-05, was able to contain the crisis despite huge difficulties, but did not compensate for seasonal variations. The situation has remained fragile with some negative patterns tending to emerge. It is crucial that the humanitarian situation continues to be closely monitored.
达尔富尔危机的人道主义应对是世界上规模最大的人道主义行动。为了调查受灾人口状况的演变，我们分析了营养不良和死亡率的趋势，这是评估危机严重程度最常用的指标。
我们对 164 项公开可获得的调查进行了荟萃分析，考虑到了情况和人道主义援助的变化；人口类型[居民和境内流离失所者（IDP）]；以及季节性变化。使用随机效应模型分析全球急性营养不良（GAM）、严重急性营养不良（SAM）、粗死亡率（CDR）和五岁以下儿童死亡率（U5DR）的数据。
2004-05 年，GAM 和 SAM 分别下降了 16%和 28%，而 CDR 每年下降 44-75%，具体取决于州和人口类型，U5DR 每年下降 50%。2005 年后，安全和人道主义情况变得越来越复杂，但南北达尔富尔的营养不良水平稳定下来。在西达尔富尔，GAM 保持稳定，但 IDP 的 SAM 呈上升趋势，尽管死亡率保持不变。2005 年后，南达尔富尔的居民死亡率略有上升，尽管营养状况稳定。GAM、SAM、CDR 和 U5DR 随季节波动很大。
对大量调查进行荟萃分析使我们能够全面了解达尔富尔的情况，并确定一些影响因素。尽管面临巨大困难，但从 2004-05 年开始的大规模人道主义行动成功遏制了危机，但未能弥补季节性变化。情况仍然脆弱，出现了一些负面趋势。继续密切监测人道主义局势至关重要。
