Trends in malnutrition and mortality in Darfur, Sudan, between 2004 and 2008: a meta-analysis of publicly available surveys

Background The humanitarian response to the crisis in Darfur is the largest humanitarian operation in the world. To investigate the evolution of the conditions of the affected population, we analysed trends in malnutrition and mortality, the most widely accepted indicators for assessing the degree o...

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Bibliographic Details
Published in:International journal of epidemiology 2011-08, Vol.40 (4), p.971-984
Main Authors: Nielsen, Jens, Prudhon, Claudine, de Radigues, Xavier
Format: Article
Language:English
Subjects:
Altruism
Analysis. Health state
Biological and medical sciences
Epidemiology
General aspects
Geography
Humans
Malnutrition - epidemiology
Medical sciences
Metabolic diseases
Mortality
Nutritional Status
Other nutritional diseases (malnutrition, nutritional and vitamin deficiencies...)
Public health. Hygiene
Public health. Hygiene-occupational medicine
Risk Factors
Seasons
Sudan - epidemiology
Transients and Migrants - statistics & numerical data
Tropical medicine
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Summary:Background The humanitarian response to the crisis in Darfur is the largest humanitarian operation in the world. To investigate the evolution of the conditions of the affected population, we analysed trends in malnutrition and mortality, the most widely accepted indicators for assessing the degree of severity of a crisis. Methods We did a meta-analysis of 164 publicly available surveys taking into account changes in the contextual situation and humanitarian aid; type of population [residents and internally displaced persons (IDPs)]; and seasonal variations. Data on global acute malnutrition (GAM), severe acute malnutrition (SAM), crude death rate (CDR) and under-five death rate (U5DR) were analysed using a random effect model. Results GAM and SAM decreased by 16% and 28%, respectively, in 2004-05, whereas CDR dropped by 44-75% per year depending on state and type of population and U5DR decreased by an overall 50% yearly. Both security and the humanitarian contexts became increasingly complex after 2005, but levels of malnutrition stabilized in North and South Darfur. In West Darfur, GAM remained stable but SAM tended to increase for IDPs, although mortality rates remained constant. Mortality increased slightly for residents in South Darfur after 2005, even though nutritional status was stable. GAM, SAM, CDR and U5DR fluctuated markedly with seasons. Conclusion A meta-analysis of myriads of surveys permitted us to draw an overall picture of the situation in Darfur and to identify some of its influencing factors. The large humanitarian operation, which gained momentum through 2004-05, was able to contain the crisis despite huge difficulties, but did not compensate for seasonal variations. The situation has remained fragile with some negative patterns tending to emerge. It is crucial that the humanitarian situation continues to be closely monitored.
ISSN:0300-5771
1464-3685
DOI:10.1093/ije/dyr010