Sentinel site community surveillance of mortality and nutritional status in southwestern Central African Republic, 2010

Population Health Metrics

Research

Serge Balandine¹  Rebecca Freeman Grais¹  Francesco Checchi²  Jonathan Polonsky³  Grazia M Caleo⁴  Aly Penda Sy⁵  Pedro Pablo Palma⁵ 

[1] Epicentre, 8 rue Saint-Sabin, Paris, France;Epicentre, 8 rue Saint-Sabin, Paris, France;Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, Keppel Street, London, United Kingdom;Epicentre, 8 rue Saint-Sabin, Paris, France;Health and Nutrition Tracking Service, Nou de la Rambla, 26, Geneva, Switzerland;European Programme for Intervention Epidemiology Training (EPIET), European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden;Epicentre, 8 rue Saint-Sabin, Paris, France;Médecins Sans Frontières, Operational Centre Barcelona-Athens, Nou de la Rambla, 26, Barcelona, Spain;

关键词: Mortality;    Malnutrition;    Central African Republic;    Surveillance;    Rural;    Humanitarian;   

DOI  :  10.1186/1478-7954-10-18

 received in 2011-11-03, accepted in 2012-08-27,  发布年份 2012

来源: Springer

【 摘 要 】

BackgroundDuring 2010, a community-based, sentinel site prospective surveillance system measured mortality, acute malnutrition prevalence, and the coverage of a Médecins Sans Frontières (MSF) intervention in four sous-préfectures of Lobaye prefecture in southwestern Central African Republic. We describe this surveillance system and its evaluation.MethodsWithin 24 randomly selected sentinel sites, home visitors performed a census, weekly demographic surveillance of births, deaths, and in- or out-migration, and weekly anthropometry on a sample of children. We evaluated the system through various methods including capture-recapture analysis and repeat census.ResultsThe system included 18,081 people at baseline. Over 32 weeks, the crude death rate was 1.0 (95% confidence interval [CI]: 0.8-1.2) deaths per 10,000 person-days (35 deaths per 1,000 person-years), with higher values during the rainy season. The under-5 death rate was approximately double. The prevalence of severe acute malnutrition (SAM) was 3.0% (95% CI: 2.3-4.0), almost half featuring kwashiorkor signs. The coverage of SAM treatment was 29.1%. The system detected >90% of deaths, and >90% of death reports appeared valid. However, demographic surveillance yielded discrepancies with the census and an implausible rate of population growth, while the predictive value of SAM classification was around 60%.DiscussionWe found evidence of a chronic health crisis in this remote region. MSF's intervention coverage improved progressively. Mortality data appeared valid, but inaccuracies in population denominators and anthropometric measurements were noted. Similar systems could be implemented in other remote settings and acute emergencies, but with certain technical improvements.

【 授权许可】

Unknown   
© Caleo et al.; licensee BioMed Central Ltd. 2012. This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.