NUTRITIONAL CHANGE AND ECONOMIC-CRISIS IN AN URBAN CONGOLESE COMMUNITY

Background. In 1986, the government of Congo undertook a structural ad justment programme to cope with the economic crisis. We present the re sults of a study whose objectives were to assess the evolution of nutr itional status of an urban community between 1986 and 1991 and to iden tify specific groups for which the nutritional status may have worsene d. Methods. Two cross-sectional surveys were carried out on representa tive samples of Brazzaville children <6 years old: 2295 children were surveyed in 1986 and 2373 in 1991. Anthropometric assessment of nutrit ional status was performed. For children, weight-for-height and height -for-age indices were used according to WHO recommendations. Wasting a nd stunting were respectively defined as indices under -2 z-scores. Bo dy mass index of mothers was calculated and risk of chronic energy def iciency (CED) was defined as <18.5 kg/m(2). Socioeconomic data relativ e to the households were also collected. Multivariate statistical meth ods were used to obtain adjusted estimates of nutritional changes in t he community. Results. Data analysis led to several converging results : increase in the percentage of low birthweight (10.2% in 1985 versus 18.7% in 1990), increase in the percentage of CED (from 7.9% to 10.5%) , and increase in the prevalence of wasting (from 2.9% to 4.2%). By co ntrast, the overall prevalence of stunting decreased from 13.9% to 11. 0%. After statistical adjustment, the factors found to influence the e volution of anthropometric status were: age of child, age of mother, s chooling of mother and household characteristics such as number of pre school children, economic level and head of household's occupation. Co nclusions. The study enables the negative effects of the economic cris is to be quantified. Body mass index is shown to be sensitive to econo mic changes. It could be recommended as a possible indicator for monit oring the nutritional status at population level. The results also cal l for a new impetus in preventive health programmes and the implementa tion of nutritional surveillance activities.