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Article Dans Une Revue International Journal of Epidemiology Année : 2004

No Improvement in Weight-for-age of Young Children in Southern Senegal, 1969-1992, Despite a Drastic Reduction in Mortality

Sybil Pinchinat
  • Fonction : Auteur
Catherine Enel
  • Fonction : Auteur
Emmanuel Lagarde
François Simondon
  • Fonction : Auteur
Kirsten B. Simondon
  • Fonction : Auteur

Résumé

No improvement in nutritional status was found among young children 1969-1992 despite a drastic decrease in mortality, and focused public health interventions such as vaccinations and malaria prevention probably did not enhance weight-for-age. 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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hal-04006372 , version 1 (27-02-2023)

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Sybil Pinchinat, Catherine Enel, Gilles Pison, Géraldine Duthé, Emmanuel Lagarde, et al.. 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. International Journal of Epidemiology, 2004, 33 (6), pp.1202-1208. ⟨10.1093/IJE/DYH174⟩. ⟨hal-04006372⟩
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