| Titre : | No improvement in weight-for-age of young children in southern Senegal, 1969-1992, despite a drastic reduction in mortality. Evidence from a growth monitoring programme : Perinatal and paediatric epidemiology. (2004) |
| Auteurs : | Sybil PINCHINAT ; Géraldine Duthé ; Catherine ENEL ; LAGARDE (Emmanuel) : FRA. U88. Institut National de la Santé et de la Recherche Médicale (Inserm). Hôpital National de Saint-Maurice. Saint Maurice. ; Gilles Pison ; Francois SIMONDON ; Kirsten-B SIMONDON ; Institut de Recherche pour le Développement. (I.R.D.). Ur024. Montpellier. FRA |
| Type de document : | Article |
| Dans : | International journal of epidemiology (vol. 33, n° 6, 2004) |
| Pagination : | 1202-1208 |
| Langues: | Anglais |
| Mots-clés : | Maladie nutrition ; Mortalité ; Poids corporel ; Développement staturopondéral ; Epidémiologie ; Mortalité infantile ; Enfant ; Homme |
| Résumé : | [BDSP. Notice produite par INIST-CNRS ZUZR0xjW. Diffusion soumise à autorisation]. Background : Undernutrition is associated with an increased risk of death among young children in developing countries. Infant and child nutritional status and mortality were monitored in a rural area of Casamance, Senegal. Methods : Analysis of weight measurements taken at 3-24 months of age during routine growth monitoring in the community's private dispensary 1969-1992 (3912 children, 4642 child-years) and of mortality rates of children estimated from maternal recall for 1960-1985 and yearly census 1985-1995. Results : Between 1960-1964 and 1990-1994, under-5 and child (1-4 years) mortality rates decreased from 312 to 127 and from 201 to 68 per 1000, respectively. About 90% of resident children attended growth monitoring in 1985-1992. Mean weight-for-age was at a minimum at 15 months of age (-1.60 z-scores [SD : 0.95]) ; the prevalence of underweight was 33.2% (95% CI : 31.5,34.9). The latter increased significantly over time, both when comparing all years of follow-up (P for trend<0.01) and over three pre-defined time periods (28.6,34.6, and 35.0% in 1969-1974,1975-1984, and 1985-1992, respectively, P for trend<0.05). Mean weight-for-age decreased over time in infancy and in the second year of life. Conclusion : No improvement in nutritional status was found among young children 1969-1992 despite a drastic decrease in mortality. Focused public health interventions such as vaccinations and malaria prevention probably did not enhance weight-for-age. Paradoxically, growth monitoring may have been more helpful in improving health than growth. |
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