J. Vandenbroeck et al., CHILD MORBIDITY PATTERNS IN 2 TROPICAL SEASONS AND ASSOCIATED MORTALITY-RATES, International journal of epidemiology, 22(6), 1993, pp. 1104-1110
Cross-sectional morbidity recorded during two successive quarterly sur
vey rounds and subsequent 27-months mortality were studied in a random
sample of 4238 preschool children in a rural Zairian area. Analysis f
ocuses on morbid patterns, i.e. any combination of the principal signs
and symptoms encountered in tropical areas (oedema, marasmus, cough,
fever, diarrhoea and tachypnoea). Almost half the children (45-48%) ha
d signs of morbidity, a very high rate. The 3-6 month age group emerge
d as particularly vulnerable with the highest prevalences of all morbi
d patterns except for isolated fever. Isolated cough was more prevalen
t in the dry season probably as an effect of nightly indoor woodburnin
g. All other morbid patterns were significantly more prevalent in the
rainy season. Diarrhoea with cough was found to constitute half of all
cases of diarrhoea. The results show that with a few simple questions
on major symptoms and a brief examination by paramedical health worke
rs, children with an increased risk of death can be identified. The me
thod can be applied at under-5 clinics. Prognosis is particularly bad
in severe malnutrition, especially when associated with diarrhoea, in
diarrhoea with cough, cough with fever/tachypnoea and for children who
are found sick both in the rainy and the subsequent dry season.