Renaudin P
Service de Pédiatrie, Hôpital Central, Moundou, Tchad.
Med Trop (Mars). 1997;57(1):49-54.
The purpose of this study carried out in the pediatric ward of the regional hospital in Moundou, Chad, between June 1992 and May 1993 was to assess the prevalence of protein-energy malnutrition in children under 5 years of age and its relationship with various diseases and in-hospital mortality. A total of 1050 children ranging in age from 1 to 59 months were hospitalized in the ward during the study period and included in the study. Nutritional status was assessed using weight-for-height (W/H) and height-for-age (H/A) charts. Diarrhea, dehydratation, malaria, anemia, acute respiratory infection, and meningitis accounted for 85.5% of the underlying diseases and for 76% of deaths. At entry into study the prevalence of malnutrition was 63.1% (W/H < -2 Z-score) including 37% with severe malnutrition (W/H < -3 Z-score) and 16.1% with stunted growth (H/A < -2 Z-score). Malnutrition was more prevalent in children under than over 2 years of age (80% vs. 42.7% respectively). The same trend was observed with regard to severe malnutrition. The prevalence of malnutrition was highest in children with acute respiratory infections or diarrhea (61.3% and 89.8% respectively). Mortality was significantly higher in severely malnourished children and malnourished children with respiratory infection especially at ages under 1 year. Death was attributed to malnutrition in 30% of cases. Better low cost nutritional care is currently feasible. The most cost efficient methods of fighting against this problem are prevention and education especially concerning breast feeding.
1992年6月至1993年5月在乍得蒙杜地区医院儿科病房开展的这项研究的目的是评估5岁以下儿童蛋白质 - 能量营养不良的患病率及其与各种疾病和住院死亡率的关系。研究期间,共有1050名年龄在1至59个月的儿童住进该病房并纳入研究。采用身高别体重(W/H)和年龄别身高(H/A)图表评估营养状况。腹泻、脱水、疟疾、贫血、急性呼吸道感染和脑膜炎占潜在疾病的85.5%,占死亡病例的76%。研究开始时,营养不良患病率为63.1%(W/H < -2 Z评分),其中重度营养不良(W/H < -3 Z评分)占37%,生长发育迟缓(H/A < -2 Z评分)占16.1%。2岁以下儿童的营养不良情况比2岁以上儿童更普遍(分别为80%和42.7%)。重度营养不良情况也呈现相同趋势。急性呼吸道感染或腹泻患儿的营养不良患病率最高(分别为61.3%和89.8%)。重度营养不良儿童以及患有呼吸道感染的营养不良儿童的死亡率显著更高,尤其是1岁以下儿童。30%的死亡病例归因于营养不良。目前可行更好的低成本营养护理。对抗这个问题最具成本效益的方法是预防和教育,特别是关于母乳喂养的教育。