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©
2005
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Updated
20 Nov 2005
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MALNUTRITION
Assefa F, Jabarkhil MZ, Salama P, Spiegel P. Malnutrition and mortality in
Kohistan District, Afghanistan, April 2001. JAMA 286(21):2723-8, 2001.
Abstract:
CONTEXT: The humanitarian situation in Afghanistan has been deteriorating for
more than 3 years because of civil war and severe drought. Because of recent
events, the international community is predicting a severe worsening of the
country's current situation. OBJECTIVE: To assess the magnitude and causes of
mortality and prevalence of malnutrition in Kohistan district, Faryab province,
Afghanistan. DESIGN: Two-stage, 30-cluster household survey conducted April 4
through 10, 2001, which included anthropometric measurements, assessment of food
coping mechanisms, and retrospective mortality data collection for November 26,
2000, through April 4, 2001. SETTING AND PARTICIPANTS: A total of 378 households
comprising 3165 people living in Kohistan district, Faryab province,
Afghanistan. MAIN OUTCOME MEASURES: Crude mortality rate, mortality rate among
children younger than 5 years, causes of death, prevalence of wasting and
stunting among children aged 6 to 59 months (weight-for-height and
height-for-age z scores <-2, respectively), and food coping mechanisms. RESULTS:
The crude mortality rate among the 3165 persons surveyed during the period of
interest was 2.6 (95% confidence interval [CI], 1.7-3.5) per 10 000 per day and
the mortality rate among 763 children younger than 5 years was 5.9 (95% CI,
2.0-8.8) per 10 000 per day. Diarrhea (25.0%), respiratory tract infections
(19.4%), measles (15.7%), and scurvy (6.5%) caused most of the 108 deaths. The
prevalences of wasting and stunting among 708 children aged 6 to 59 months were
7.0% (95% CI, 5.9%-9.0%) and 63.7% (95% CI, 58.6%-68.8%), respectively. Evidence
of late-stage food coping mechanisms and prefamine indicators existed among the
population. CONCLUSIONS: These data indicate that, by April 2001, a humanitarian
crisis already existed in Kohistan. Essential humanitarian services, including
food aid and public health programs, are urgently required in such regions of
Afghanistan and will be crucial if a worsening humanitarian crisis is to be
avoided. For these services and programs to be implemented, the international
community needs to create adequate humanitarian space (ie, a secure and
accessible location where humanitarian organizations can provide services to
emergency-affected populations) to ensure that humanitarian organizations have
access to populations within Afghanistan as well as to refugees who flee to
surrounding countries.
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