Establishment of an Epidemiological Survey Model, for the Under Five-Year Old Children's Nutrition, at the Health Districts in the Democratic Republic of Congo (DRC)

Background

From pediatricians’ and public health experts’ point of view, early delayed growth of children affects their physical and mental development. This delay in growing may be due to perinatal infection but, most frequently, it is secondary to nutritional causes and infection, while lack of nutrients aggravates the infectious process

Despite several efforts undertaken par the DR Congo’s Government and its partners in the fight for the children’s nutritional improvement, the prevalence of acute malnutrition has not reduced and still affects two millions children between 6 and 59 months in its severe form

This study aims at examining the fundamental reasons  for this controversial situation. It was initiated in order to propose an epidemiological survey based system, standard, simple and cost effective approach that could quickly detect changes in the children and environment and provoke early alarm leading to appropriate actions. 

Methods

We engaged a descriptive and transversal epidemiological survey targeting the nutritional status of under-five year old children and their breastfeeding mothers in relation to food security in the randomized sanitary districts of the Southern Austrian former Katanga province in the DR of Congo,  between 1st September 2012 and 31st March 2013 . Nutritional data related to children, mothers and environmental food availability were collected using pre-established questionnaires during three precise periods of the year. We sourced for data through three types of exercises and at three precise periods; then the data was analyzed to determine changes in children and families that lead to nutritional status classification and to specific actions

The study followed laid down criteria for inclusion and exclusion,  and encompassed subjects sampled in  rural and urban sites. Twelve health   centers sites were identified: three urban (25%): two in Katuba commune: namely Katuba, Kisanga health centers, one in Kamalondo, kamalondo Health centre) and nine rural centres (75%): four in Malemba Nkulu Zone : Lwamba, Malemba Nkulu, Mulongo, Mukanga; three in Mutshatsha Zone: Lualaba, Kanzeze, Mutshatsha and two in Dilolo zone: Kasaji and Dilolo

Results 

Findings from the study were as follows.

·   A weak input of exclusive breastfeeding both in rural and in urban sites. The exclusive breastfeeding  has a mean  breastfeeding duration of 6,898 ±5,334 or a duration of one month and three weeks

·   There was no relationship between breastfed child malnutrition and  mother’s age

·   Furthermore the results distribution allowed different classifications of sanitary sites as  “acceptable, limited or poor”

·   With reference to food safety calculated with two scores the CSA (family alimentary consumption score) and the CSI (Coping strategy index) the classification of sites as “under control”, “to follow closely” and “red alert”.

·   This provided a regional food safety map useful to families, sanitary zones and districts in charge, including all task forces and decision making bodies.

Conclusion

The developed epidemiological survey system allows a simple, cost- effective and efficient follow up of   “risky” sanitary areas and  provide  bases for decisions taking in  favour of children in general and under five- year old in particular