Rao V G, Sugunan A P, Sehgal S C
Regional Medical Research Centre, Indian Council of Medical Research, Aberdeen Bazar, Port Blair, Andaman Islands, India.
Natl Med J India. 1998 Mar-Apr;11(2):65-8.
The population of the Great Andamanese tribe of the Andaman Islands has been declining at a rapid pace. The case fatality rate during a recent outbreak of dysentery was 30.8%, all the deaths being among under-fives. As malnutrition is known to potentiate susceptibility to death due to infectious diseases, we undertook a study to determine the prevalence of malnutrition among the Great Andamanese tribe and its role in contributing to the high mortality among them due to infectious diseases.
The study included a diet survey, nutritional anthropometry, clinical examination, haemoglobin estimation and stool examination for intestinal parasitic infestations. Information was also collected about every pregnancy in all ever-married women in the community and deaths of their children. All 36 members of the tribe were covered.
The Andamanese had a poor intake of iron, vitamin A and riboflavin but a good intake of energy, protein and fats. More than 85% of the children below 6 years were under-nourished and more than 77% of children and adolescents below 19 years were stunted, wasted or both. Anaemia, vitamin A deficiency and goitre were also common among them. Almost the entire population suffered from intestinal parasitic infestations. They also have a comparatively high fertility rate and a high infant mortality rate.
The population attributable risk for death due to malnutrition is probably one of the foremost reasons for the observed high infant mortality rate among the Great Andamanese tribe and could be one of the reasons for the continuous decline in their population.
安达曼群岛的大安达曼部落人口一直在迅速减少。最近一次痢疾疫情期间的病死率为30.8%,所有死亡病例均为5岁以下儿童。由于已知营养不良会增加因传染病死亡的易感性,我们开展了一项研究,以确定大安达曼部落中营养不良的患病率及其在导致该部落因传染病而高死亡率方面所起的作用。
该研究包括饮食调查、营养人体测量、临床检查、血红蛋白测定以及肠道寄生虫感染的粪便检查。还收集了该社区所有曾婚妇女的每次怀孕情况及其子女死亡情况的信息。该部落的所有36名成员均被纳入研究。
安达曼人铁、维生素A和核黄素摄入量低,但能量、蛋白质和脂肪摄入量良好。6岁以下儿童中超过85%营养不良,19岁以下儿童和青少年中超过77%发育迟缓、消瘦或两者皆有。贫血、维生素A缺乏和甲状腺肿在他们当中也很常见。几乎整个人口都患有肠道寄生虫感染。他们的生育率和婴儿死亡率也相对较高。
营养不良导致死亡的人群归因风险可能是大安达曼部落观察到的高婴儿死亡率的首要原因之一,并且可能是其人口持续减少的原因之一。