5179.0: Wednesday, October 24, 2001 - 2:54 PM

Abstract #27068

Malnutrition and mortality during a famine, Gode district, Ethiopia, July 2000

Peter Salama, MBBS, MPH, International Emergency and Refugee Health Branch, Centers for Disease Control and Prevention, 4770 Buford Highway, Atlanta, GA 30341, 770 488 4466, pqs0@cdc.gov

Background: The World Food Programme estimated that 10 million people were at risk of starvation in Ethiopia in 2000. However, no epidemiologic data to assist in determining humanitarian program priorities were available for the population of Gode district at the epicenter of the famine.

Methods: In July 2000, we collected anthropometric and retrospective mortality data during a two-stage cluster survey that included 595 households and 4032 people.

Results: From December 1999 through July 2000, a total of 293 deaths occurred in the sample population. The crude mortality rate was 3.1/10,000/day (95% confidence interval [CI]: 2.4-3.8/10,000/day), three times the cut-off level used to define an emergency. The death rate for children <5 years was 6.7/10,000/day (95% CI: 5.3-8.0/10,000/day). Approximately 72% of deaths occurred before major relief interventions began in April 2000. Malnutrition contributed to 72.3% of all deaths among children aged <5 years. Measles alone, or in combination with malnutrition, accounted for 22.0% of 159 deaths among children aged <5 years and for 16.6% of 72 deaths among children aged 5 to 14 years. Prevalence rates for acute malnutrition were 29.1% (95% CI: 24.7-33.4) for children aged <5 years and 22.7% (95% CI: 17.9- 27.5) for adults aged 18 to 59 years.

Conclusions: To prevent unnecessary deaths, humanitarian response to famine needs to be rapid and based on sound epidemiological evidence. Interventions, such as mass measles vaccination campaigns with coverage extended to children aged <14 years and feeding programs targeting malnourished adults and children, should be implemented immediately in Ethiopia.

Learning Objectives: Recognize the importance of early epidemiological assessments for targeting humanitarian relief. Describe the basic design of cluster surveys to assess nutrition and mortality. List the major causes of death among famine-affected populations.

Keywords: Disease Prevention, Children and Adolescents

Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: None
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.

The 129th Annual Meeting of APHA