Nutrition and mortality assessment--southern Sudan, March 1993
Mmwr. Morbidity and Mortality Weekly Report 42(16): 304-308
1993
ISSN/ISBN: 0149-2195 PMID: 8474423 Document Number: 268280
A rapid assessment of nutritional status of children (aged <5 years) and mortality (all ages) during March 1993 was done at four sites in southern Sudan. Two of the sites, Ayod and Kongor, are in the current epicentre of the famine in this area. Modified cluster analysis using every fifth household or consecutive households was done to produce sample sizes of 43-58 households. In some areas, samples may not have been fully representative because of local logistical arrangements. Each team measured height, weight and mid-upper-arm circumference (MUAC) of children 65-110 cm tall (proxy for age 6-59 months), and weight-for-height (WFH) <2 standard deviations below the reference median and MUAC <12.5 cm were used as indicators of severe undernutrition. A total of 371 children were measured and the prevalence of wasting (WFH <2 SD) was high at all sites (32-84%) and particularly at those sites in the epicentre where also 40-44% of children were critically malnourished (<3 SD). The prevalences of low MUAC were lower at all sites. An editorial note states that the prevalence of severe undernutrition in this region is among the highest ever recorded. In Somalia in 1991-92, prevalences ranged from 32% to 81% but in non-crisis times they are generally <5%. The severe undernutrition was also associated with substantial excess mortality. At the sites within the epicentre, the crude mortality rate (all ages) ranged from 164/1000 to 276/1000 which should be compared with 20-24/1000 in the Horn of Africa during non-famine times. While comparisons between the Sudanese data and those from other areas have to be interpreted carefully, the seriousness of the situation in southern Sudan is without question and famine of this magnitude is probably widespread.D.I. Thurnham.