Résumé :
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[BDSP. Notice produite par INIST lbgOuR0x. Diffusion soumise à autorisation]. Objectives To examine the relationship of anthropometrical indicators of fatness and muscularity with mortality in children in a rural African community. Background A prospective cohort study was carried out in the rural health zone of Bwamanda, Northern Congo using a random cluster sample of 5167 children, aged 0-5 years. Main Short-and long-term mortality rates, being deaths within 3 months and deaths outcome in 3-month periods observed 3-30 months after enrolment. Rates of all cause measures mortality and of mortality from kwashiorkor or marasmus, by level of baseline fatness and muscularity. Indicators of fatness and muscularity were obtained by correcting anthropometric arm fat and arm muscle areas for age, sex, weight and height. Results The relationship of both the fatness and muscularity scores with short-term mortality was marked by a clear threshold (-0.5 SDS) below which there was a significant rise in mortality from all causes as well as from kwashiorkor and marasmus. These excess mortalities were also found in normal weight children. Fatness and muscularity scores remained significant determining factors of short-term mortality in a multiple logistic regression analysis with sex, age, season and weight-for-age. A ROC curve analysis showed that fat and muscularity scores had better predictive abilities than weight-for-age. Low fat status had a bad prognosis on the long-term in underweight children. (...)
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