BIBLIOGRAPHIC INPUT SHEET TEMPORARY Patterns of mortality ...
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BIBLIOGRAPHIC INPUT SHEET TEMPORARY Patterns of mortality ...

BIBLIOGRAPHIC INPUT SHEET TEMPORARY Patterns of mortality ... BIBLIOGRAPHIC INPUT SHEET TEMPORARY Patterns of mortality ...

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Chapter IX. NutritionalDeficiency 173 deaths of children under 5 years of age are given for the 13 Latin American projects combined in Table 92, and by individual projects and age groups in Table 93. The division by type is: vitamin deficiency (260-266) ; protein malnutrition (267); nutritional marasmus (268) ; and other nutritional deficiency (269). Protein malnutrition (267), or kwashiorkor, was assigned as a cause in 1,562 deaths, or 13.1 per cent of the total deaths from nutritional deficiency (11,913). This multiple deficiency syndrome is a severe form of generalized deficiency; it develops as the result of deficits in protein-rich foods over a period of several months or longer. For this reason the finding of this type of deficiency in infants less than one year of age indicates lack of sufficient food and damage by disease early in life. In those suffering from this condition, the changes in body composition and function are profound. Nutritional miarasmus (268), which was assigned in 2,544 deaths (21.4 per cent of the total), is the result of an overall deficit in food intake or utilization and is apt to develop dvlpvery eyeryiilfta early in life, that is, s intefrt3 the first few nmnnths. Infants suffering from this condition may recover partially or cornpletely or they may develop the more serious kwashiorkor type of protein malnutrition and die from some complication. TABLE 02. Mortality' from Nutritional Deficiency, by Type, in Children Under 5 Years of Age in 13 Latin American Projects Combined. Type ordeciency Total _ate Total ............................ 1.,l1 660.3 Vitamin deficiency (200-266) ........ 15 0.8 Protein malnutrition (207) ......... 1.,502 80.0 Nutritional marasmus (268) ......... 2,544 141.0 Other deficiency (269) .............. 7,792 431.0 aRates per 100,000 population. In the 13 projects, 7,792 deaths (65.4 per cent of the total) were assigned to category 269, othernutritionaldeficiency. Whenever the clinical evidence was not sufficient to permit a specific assignment to category 267 or 268, or when the deficiency was Grade II or equivalent, the assignment was made to category 269.9 (other and unspecifled nutritional deficiency). Only 15 deaths were assigned to a deficiency of a specific vitamin or to aritaminosis unspecified (260-266) as underlying or associated cause. Ten of these deaths were due to vitamin D deficiency (265), four to the unspecified group (266.9), and one to ascorbic acid deficiency (264), as can be seen below: Cafc- Project Age at deatt Caus gory Argentina, rural departments, San Juan Province Brazil, Silo Paulo Chile, Santiago 8months Associated 265.0 I year Underlying 265.0 I year Underlying 265.0 8months Associated 265.0 4months Associathd 265.0 4 nmonths As;sociated Associated 265.0 205.0 Colombia, Cali 2years Associated 265.9 5 months Associated 265.0 Colombia, Medellin 3years 9 months Associatedl Associated 266.9 20.9 27 tiys a Associated 266.9 4months Associated 266.9 El Salvador, rural municipins 0months Associated 265.0 Jamaica, St. Andrew, rural I year Underlying 204 The overall rate for all types of nutritional deficiency in children under 5 years of age in the 13 projects combined-660.3 per 100,000 population-is indicative of the seriousness of this health problem (Table 92). The combined mate for protein inalnutrition was 86.6 per 100,000. In eight of tile

174, Pat*ernof-Mortalityin Childhood TAntz 93. Mortality' from Specific Types of Nutritional Deficiency in Children Under 5 Years, by Age Group, in 13 Projects. Vitamin Protein Other Vitamin Protein Other deft- mal- Nutritional nutritional defi- Mal. Nutritional nutritioLal nutrition marnamus defciency Total ciency nutrition marasmu (268) deficiency Project Total (260-.26 ceay (207) (268) (289) (280-208) (267) (209) No., Rate No. Rate No. Rate No. Rate No. Ratt No. RateNo. Rate No. Rate No. Rate No. Rate UNDER 5 YEARS UNDER I YEAR Total .................. 1.,913 60.3 15 0.8 1,562 88.02,544 141.07,792 431.07.701 18,67.6 10 2.4 325 78.8 1,811 439.215,555 1.347.2 ARGENTINA Chaco Province ..... 601 860.7 - - 34 44.3 96 125.0 531 691.4 485 2.755.7 - - I1 62.5 66 375.0 408 2,318.2 San Jua Province .... 607 581.1 I 1.0 10 9.6 177 160.4 419 401.1 511 2,187.5 1 4.3 2 8.0 158 676.4 350 1,408.3 BOLIVIA project ...... 1.532 06.3 - - 116 73.4 176 111.4 1.240 784.6 771 2,050.0 - - 23 61.2 82 218.0 680 1,770.8 DRAZI.I 5 Rect ........... 1.,79 1,355.0 - - 322 259.0 499 402.7 858 692.4 1,080 3.552.6 -- 70 259.0 340 1.119.4 601 2,174.3 Ribeirlo Prfto. 405 490.0 - - 31 37.6 113 137.0 201 316.4 29 1,639.3 - - 3 10.4 89 487.0 207 1,134.9 An Paulo1...........1,313 538.8 3 1.2 58 23.8 299 122.7 053 32. 1.002 1820.0 I 1.7 14 20.1 255 438.4 792 1,301.8 CHILE project ........ .60 322.0 3 1.4 20 0.01 177 85.2 460 225.7 560 1,285.0 3 0.0 2 4.8 149 341.0 400 931.6 COWAMBIA Call................. 53 586.0 2 2.0 130 128.5 133 130.4 323 319.21 300 1,450.2 I 4.7 26 123.2 89 421.8 190 000.5 Cartagena ......... 561 852.3 - - 201 233.7 09 115.1 281 303.V 278 1,553.1 - - 58 324.0 64 357.5 156 871.5 Medallin ........ 570 610.9 4 4.3 94 100.8 107 114.7 365 391.21 308 1,587.6 3 15.5 8 41.2 88 453.0 209 1,077.3 ELSAI.VADORproject 1.,25 1,217.2 I 0.8 348 277.8 298 237.8 878 700.8 705 2,562.9 1 3.2 40 128.9 109 544.8 585 1,885.9 JAMICAII Eingtont.Andrew., 370 201.9 I 0.5 58 31.7 83 45.3 228 124.4243 593.3 -- 25 61.0 50 144.0 159 388.2 MEXICO . Monterrey ............ 1,428 655.3 - 140 64.2 282 120.4 1.006 461.81,003 1,892.1 - - 34 64.1 203 382.9 780 1,445.0 I YEAR 2-4 YEARS Total .. .......... 2.580 687.5 3 0.8 6 184.8 478 120.9 1.412 375.0 155. 2 9.2 541 51.0 : 202 515. 5 24.5 4585 825 70.2 7. 9: ARGENTINA Chaco Province ..... 127 708.7 - - 22 138.0 21 131.7 84 527.C 4 110.4 - - I 2.3 9 20.3 30 87.9 San Juan Province. . 63 290.4 - - 4 19.0 12 57.0 47 233.4 %3 52.3 - - 4 6.3 7 11.1 22 34.8 IOIJVIA project .... 508 1,502.5 - - 50 195.2 60 177.5 382 1,129.8 253 281.7 - - 27 .30.4 31 38.3 192 216.0 DRAZIl, Recife.... ... .35 1,319. - - 130 484.7 103 384.0 121 451.2 355.1 - - 113 163.8 56 81.2 78 110.2 Ribeirlo Prto........ 50 292.0 - - 14 82.0 10 58.0 26 152.3 1 4 80 116.7 - - 14 29.2 14 29.2 28 58.3 Sn Paulo ............ 146 209.72 3.7 27 40 26 48.0 01 168.1 1 10 78.2 - - 17 12.7 18 13.4 70 52.1 CHILE projeet....... 75 186.3 - - 12 29.8 18 44.7 45 11. 34 20.7 - - 6 4.7 10 7.9 IS 14.1 COI.OMRIA Call .......... 169 830.6 - - 51 252.5 34 108.3 84 415.9 118 194.4 I 1.6 53 87.3 15 24.7 49 80.7 Cartagena ........ 197 1,145.3 - - 106 610.3 25 145.3 66 33.7 16.7 - - 37 71.7 10 19.4 30 75.6 Medellin ........... II 828.0 - - 41 220.4 15 80.8 88 520.9 108 102.9 I 1.8 45 80.4 4 7.1 58 103.6 ELALVADORtroJect. 409 1,494.9 - - 134 489.8 96 350.0 179 654.2 321 463.7 - - 174 251.3 33 47.7 114 164.7 JAMAICA Kingston-St. Andrew.. 90 230.1 I 2.6 26 60.5 18 40.0 45 115.1 37 35.4 - - 7 6.7 a 5.7 24 23.0 MEXICO Monterrey ........... 247 A48.0 - - 03 139.9 40 88.8 144 39. 1 178 142.0 - - 43 34.5 39 31.2 96 76.9 projects very few deaths were assigned to this category, and the rates there were under 100 per 100,000, but in the other five projects they ranged from 100.8 up to 277.8 (Table 93). The overall rate for nutritional inarasmus was 141.0. In all projects except Cartagena more than half the nutritional deficiency deaths were assigned to the un­

174, Pat*ern<strong>of</strong>-Mortalityin Childhood<br />

TAntz 93. Mortality' from Specific Types <strong>of</strong> Nutritional Deficiency in Children Under 5 Years, by Age<br />

Group, in 13 Projects.<br />

Vitamin Protein Other Vitamin Protein Other<br />

deft- mal- Nutritional nutritional defi- Mal. Nutritional nutritioLal<br />

nutrition marnamus defciency Total ciency nutrition marasmu (268) deficiency<br />

Project Total (260-.26 ceay (207) (268) (289) (280-208) (267)<br />

(209)<br />

No., Rate No. Rate No. Rate No. Rate No. Ratt No. RateNo. Rate No. Rate No. Rate No. Rate<br />

UNDER 5 YEARS<br />

UNDER I YEAR<br />

Total .................. 1.,913 60.3 15 0.8 1,562 88.02,544 141.07,792 431.07.701 18,67.6 10 2.4 325 78.8 1,811 439.215,555 1.347.2<br />

ARGENTINA<br />

Chaco Province ..... 601 860.7 - - 34 44.3 96 125.0 531 691.4 485 2.755.7 - - I1 62.5 66 375.0 408 2,318.2<br />

San Jua Province .... 607 581.1 I 1.0 10 9.6 177 160.4 419 401.1 511 2,187.5 1 4.3 2 8.0 158 676.4 350 1,408.3<br />

BOLIVIA project ...... 1.532 06.3 - - 116 73.4 176 111.4 1.240 784.6 771 2,050.0 - - 23 61.2 82 218.0 680 1,770.8<br />

DRAZI.I<br />

5<br />

Rect ........... 1.,79 1,355.0 - - 322 259.0 499 402.7 858 692.4 1,080 3.552.6 -- 70 259.0 340 1.119.4 601 2,174.3<br />

Ribeirlo Prfto. 405 490.0 - - 31 37.6 113 137.0 201 316.4 29 1,639.3 - - 3 10.4 89 487.0 207 1,134.9<br />

An Paulo1...........1,313 538.8 3 1.2 58 23.8 299 122.7 053 32. 1.002 1820.0 I 1.7 14 20.1 255 438.4 792 1,301.8<br />

CHILE project ........ .60 322.0 3 1.4 20 0.01 177 85.2 460 225.7 560 1,285.0 3 0.0 2 4.8 149 341.0 400 931.6<br />

COWAMBIA<br />

Call................. 53 586.0 2 2.0 130 128.5 133 130.4 323 319.21 300 1,450.2 I 4.7 26 123.2 89 421.8 190 000.5<br />

Cartagena ......... 561 852.3 - - 201 233.7 09 115.1 281 303.V 278 1,553.1 - - 58 324.0 64 357.5 156 871.5<br />

Medallin ........ 570 610.9 4 4.3 94 100.8 107 114.7 365 391.21 308 1,587.6 3 15.5 8 41.2 88 453.0 209 1,077.3<br />

ELSAI.VADORproject 1.,25 1,217.2 I 0.8 348 277.8 298 237.8 878 700.8 705 2,562.9 1 3.2 40 128.9 109 544.8 585 1,885.9<br />

JAMICAII<br />

Eingtont.Andrew., 370 201.9 I 0.5 58 31.7 83 45.3 228 124.4243 593.3 -- 25 61.0 50 144.0 159 388.2<br />

MEXICO .<br />

Monterrey ............ 1,428 655.3 - 140 64.2 282 120.4 1.006 461.81,003 1,892.1 - - 34 64.1 203 382.9 780 1,445.0<br />

I YEAR<br />

2-4 YEARS<br />

Total .. .......... 2.580 687.5 3 0.8 6 184.8 478 120.9 1.412 375.0 155. 2 9.2 541 51.0 : 202 515.<br />

5 24.5 4585 825 70.2 7.<br />

9:<br />

ARGENTINA<br />

Chaco Province ..... 127 708.7 - - 22 138.0 21 131.7 84 527.C 4 110.4 - - I 2.3 9 20.3 30 87.9<br />

San Juan Province. . 63 290.4 - - 4 19.0 12 57.0 47 233.4 %3 52.3 - - 4 6.3 7 11.1 22 34.8<br />

IOIJVIA project .... 508 1,502.5 - - 50 195.2 60 177.5 382 1,129.8 253 281.7 - - 27 .30.4 31 38.3 192 216.0<br />

DRAZIl,<br />

Recife.... ... .35 1,319. - - 130 484.7 103 384.0 121 451.2 355.1 - - 113 163.8 56 81.2 78 110.2<br />

Ribeirlo Prto........ 50 292.0 - - 14 82.0 10 58.0 26 152.3 1 4<br />

80 116.7 - - 14 29.2 14 29.2 28 58.3<br />

Sn Paulo ............ 146 209.72 3.7 27 40 26 48.0 01 168.1 1 10 78.2 - - 17 12.7 18 13.4 70 52.1<br />

CHILE projeet....... 75 186.3 - - 12 29.8 18 44.7 45 11. 34 20.7 - - 6 4.7 10 7.9 IS 14.1<br />

COI.OMRIA<br />

Call .......... 169 830.6 - - 51 252.5 34 108.3 84 415.9 118 194.4 I 1.6 53 87.3 15 24.7 49 80.7<br />

Cartagena ........<br />

197 1,145.3 - - 106 610.3 25 145.3 66 33.7 16.7 - - 37 71.7 10 19.4 30 75.6<br />

Medellin ...........<br />

II 828.0 - - 41 220.4 15 80.8 88 520.9 108 102.9 I 1.8 45 80.4 4 7.1 58 103.6<br />

ELALVADORtroJect. 409 1,494.9 - - 134 489.8 96 350.0 179 654.2 321 463.7 - - 174 251.3 33 47.7 114 164.7<br />

JAMAICA<br />

Kingston-St. Andrew.. 90 230.1 I 2.6 26 60.5 18 40.0 45 115.1 37 35.4 - - 7 6.7 a 5.7 24 23.0<br />

MEXICO<br />

Monterrey ........... 247 A48.0 - - 03 139.9 40 88.8 144 39. 1 178 142.0 - - 43 34.5 39 31.2 96 76.9<br />

projects very few deaths were assigned to<br />

this category, and the rates there were under<br />

100 per 100,000, but in the other five<br />

projects they ranged from 100.8 up to 277.8<br />

(Table 93). The overall rate for nutritional<br />

inarasmus was 141.0. In all projects except<br />

Cartagena more than half the nutritional<br />

deficiency deaths were assigned to the un­

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