CLINICAL EPIDEMIOLOGY OF PEDIATRIC DISEASE AT NCHELENGE, NORTHEAST ZAMBIA

In a combined retrospective and prospective 4-year study of 6412 child ren consecutively admitted to St Paul's Hospital, Nchelenge, north-eas t Zambia, the clinical epidemiology of paediatric disease was describe d. One diagnosis per admission was noted. Protein-energy malnutrition (PEM) was diagnosed clinically and by means of a modified Wellcome sch eme using weight-for-height and Z scores. Correlation coefficients wer e calculated between monthly admission rates and relative humidity, ra infall and temperature. The age distribution of admitted children show ed several distinct groups. Type I (malaria, acute gastro-enteritis, p neumonia and meningitis) had its peak in the Ist 7 months of age, type II (burn wounds and measles) had its main prevalence between the ages of 2 and 4 years, and type III (trauma, typhoid fever, snake bite and tropical ulcer) occurred mainly between 4 and 14 years of age. Admiss ion rates for PEM, PEM subtypes, pneumonia, trauma and snake bite corr elated with wet season variables. Malaria and acute gastro-enteritis w ere extremely common throughout the year. A measles epidemic in the dr y season was initially followed by an increase in marasmus, whereas oe dematous malnutrition only assumed epidemic proportions associated wit h a post-measles rise in admission rates of pneumonia. Clinical epidem iological data at the district level is a powerful tool for understand ing the pattern of serious paediatric disease in the community.