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close this bookRefugee Nutrition Information System (RNIS), No. 30 - Report on the Nutrition Situation of Refugees and Displaced Populations (UNSSCN, 2000, 72 p.)
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Open this folder and view contentsSub-Saharan Africa
Open this folder and view contentsAsia - Selected situations
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View the documentAbbreviations used in the text
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View the documentNotes on Annex 1 and other nutritional assessments in the text
View the documentACC/SCN publications available
View the documentIndicators

Notes on Annex 1 and other nutritional assessments in the text

1. Angola

a Malange This survey was conducted by MSF-H in Malange in January 2000, in conjunction with ADRA-International, Concern, GVC, Ministry of Health (Malange Province), MSF Holland, UNICEF and World Vision. Standard two-stage cluster methodology was employed. 939 children aged 6-59 months were measured. Acute malnutrition (<-2z scores and/or oedema) was estimated at 7.8% (95% CI 6.2-9.7%). Severe acute malnutrition (<-3z scores and/or oedema) was estimated at 1.1% (95% CI 0.5-2.0%). Oedema was not reported separately. Retrospective CMR was estimated for the six months prior to the survey at 1.6/10.000/day and under-five mortality was estimated at 2.5/10,000/day. 911 adults were measured. Adult malnutrition was defined as BMI < 18.5 and/or oedema above the ankle and was estimated at 34.6% (95% C.I. 31.5-37.8%). Adult severe malnutrition was defined as BMI < 16 and/or oedema above the ankle and was estimated at 10.9% (95% C.I. 9.0-13.1%).

b Lombe This survey was conducted by MSF-H in Lombe in January 2000. Standard two-stage cluster methodology was employed. 912 children aged 6-59 months were measured. Acute malnutrition (<-2z scores and/or oedema) was estimated at 17.1% (95% CI 14.7-19.7%). Severe acute malnutrition (<-3z scores and/or oedema) was estimated at 6.4% (95% CI 4.9-8.2%). Oedema was not reported separately. Retrospective CMR was estimated for the six months prior to the survey at 1.3/10,000/day and under-five mortality was estimated at 2.8/10,000/day. 913 adults were measured. Adult malnutrition was defined as BMI < 18.5 and/or oedema above the ankle and was estimated at 53.6% (95% C.I. 50.3-56.8%). Adult severe malnutrition was defined as BMI < 16 and/or oedema above the ankle and was estimated at 22.3% (95% C.I. 19.7-25.2%).

c Kuito Two surveys were conducted by the ICRC/MSF-H: one in Kuito town and also Kunje (a small town located 7 km from Kuito); and the second in camps located in the periphery of Kuito in late December, 1999. For each survey, a two-stage random cluster sampling methodology was applied. Acute malnutrition (<-3z scores and/or oedema) in the town was estimated at 7.9% (95% CI 5.8 - 10.9%), and in the camps at 16.1% (12.7 - 19.4%).%). Severe acute malnutrition (<-3z scores and/or oedema) was estimated at 1.5% (0.9 - 2.6%) in the towns, and at 1.3% (0.6 - 2.0%) in the camps. The mortality rate was estimated based on the head of each household reporting any deaths for November and December. The under-five mortality rate was 3.8/10,000/day in Kuito and Kunje town, and 4.5/10,000/day in the camps for the displaced. Coverage of measles vaccination according to cards was 43% for Kuito and Kunje town, and 59% for IDPs in camps.

d Matala These surveys were undertaken by ACH-S in camps for the newly displaced and more established refugees in Matala in January 2000. Exhaustive sampling methods were employed in the newly-arrived IDP camps. 1238 children aged 6-59 months were measured. Acute malnutrition was defined as <-2z scores and/or oedema and the prevalence was estimated at 9.9%. Severe acute malnutrition was defined as <-3z scores and/or oedema and the prevalence was estimated at 1.7%. Oedema was recorded in 0.9% of the sample. Retrospective mortality for children under five in the three months prior to the survey was estimated at 5.2/10,000/day. Measles immunisation information was collected by reference to cards, the rate was estimated at 79.9%. Standard two-stage cluster methodology was employed in the camps for the longer-established IDPs. 932 children aged 6-59 months were measured. Acute malnutrition was defined as <-2z scores and/or oedema and the prevalence was estimated at 6.7% (C.I. 4.6-9.5%). Severe acute malnutrition was defined as <-3z scores and/or oedema and the prevalence was estimated at 1.3% (C.I. 0.5-2.9%). Oedema was recorded in 0.6% of the sample. Retrospective mortality for children under five in the three months prior to the survey was estimated at 1.01/10,000/day, Measles immunisation information was collected by reference to cards, the rate was estimated at 6.9%.

e Ganda These surveys were undertaken by ACH-S in Ganda town and in the IDP camps in February 2000. Exhaustive sampling methods were employed in the IDP camps. 225 children aged 6-59 months were measured. Acute malnutrition was defined as <-2z scores and/or oedema and the prevalence was estimated at 29.3%. Severe acute malnutrition was defined as <-3z scores and/or oedema and the prevalence was estimated at 8%. Oedema was recorded in 3.6% of the sample. Retrospective mortality for children under-five in 47 days prior to the surveys was estimated at 4.1/10,000/day. CMR was estimated at 3.14/10,000/day. Standard two-stage cluster methodology was employed for the survey in the town. 900 children aged 6-59 months were measured. Acute malnutrition was defined as <-2z scores and/or oedema and the prevalence was estimated at 10% (C.I. 7.4-13.3%). Severe acute malnutrition was defined as <-3z scores and/or oedema and the prevalence was estimated at 2.4% (C.I. 1.3-4.5%). Oedema was recorded in 0.9% of the sample.

2. Great Lakes

a Kayanza This survey was undertaken by ACF-F in Kayanza Province, Burundi in November 1999. Standard two stage cluster methodology sampling method was employed. 897 children aged 6-59 months were measured. The prevalence of acute malnutrition (<-2z scores weight-for-height and/or oedema) was estimated at 9.8% (C.I. 7.2-13.1%) and that of severe acute malnutrition (<-3z scores weight-for-height and/or oedema) at 1.7% (C.I. 0,7-3.5%). Oedema was found in 0.9% of the children. Measles immunisation information (children aged 18-59 months) was collected either from the vaccination card or from interview with the mother. The rate estimated by card was 66.4%. 802 non-pregnant mothers were also measured. Retrospective mortality of children under five for the 90 days prior to the survey was estimated at 0.93/10,000/day. 890 adults were measured. Adult nutritional status was defined using the BMI, MUAC and oedema. The prevalence of severe under-nutrition (BMI<16.0 kg/m2) was estimated at 8.4%, moderate undernutrition (BMI 16.0-16.9 kg/m2) at 12.0%, marginal under-nutrition (BMI 17.9-18.4 kg/m2) at 27.3%. Oedema was recorded in 1.2% of the sample population. CMR for the 90 days prior to the survey was estimated at 0.56/10,000/day.

b Brazzaville These surveys were undertaken by ACF-F in Brazzaville city, RoC in March 2000. The RNIS does not currently have the full survey reports and no data on the methodology is currently available. In south Brazzaville, the prevalence of acute malnutrition (<-2z scores and/or oedema) was estimated at 6.6% (C.I. 4.5-9.4%) and that of severe acute malnutrition (<-3z scores and/or oedema) at 0.2% (C.I. 0.0-1.4%). No information on oedema was available. Adult nutritional status was defined using the BMI and oedema. The prevalence of severe undernutrition (BMI<16.0 kg/m2 and/or oedema for adults aged 18-49 years, BMI<15kg/m2 and/or oedema for those aged more than fifty) was estimated at 3.0%. The prevalence of moderate malnutrition (BMI 16.0-17 kg/m2 and/or oedema for adults aged 18-49 years, BMI 15-16 kg/m2 and/or oedema for those aged more than fifty) was estimated at 4.4%. In north Brazzaville, the prevalence of acute malnutrition (<-2z scores and/or oedema) was estimated at 5.4% (C.I. 3.6-8.1%) and that of severe acute malnutrition (<-3z scores and/or oedema) at 0.3% (C. I. 0.0-1.2%). No information on oedema was available. Adult nutritional status was defined using the BMI and oedema. The prevalence of severe undernutrition (BMI<16.0 kg/m2 and/or oedema for adults aged 18-49 years, BMI<15kg/m2 and/or oedema for those aged more than fifty) was estimated at 1.8%. The prevalence of moderate malnutrition (BMI 16.0-17 kg/m2 and/or oedema for adults aged 1849 years, BMI 15-16 kg/m2 and/or oedema for those aged more than fifty) was estimated at 2.4%.

c Mayama This survey was undertaken by ACF-F in Mayama, Pool, RoC in February 2000. The RNIS does not currently have the full survey report and no data on the methodology is currently available. 624 children between 75-130 cm were measured. Very low MUAC (<110 mm) was found in 17.6% of the sample and 24.1% had MUAC<125mm.

d Pool These data were collected by ACF-F from various locations in the north Pool Region, RoC in March 2000. The RNIS does not currently have the full survey report and no data on the methodology is currently available. 1903 children between 75-130 cm were measured. Very low MUAC (<110 mm) was found in 2% of the sample and 9.9% had MUAC<125mm.

e Lemera This survey was undertaken by ACF-USA in Lemera, South Kivu Province, DRC in January 2000. Standard two-stage cluster methodology sampling method was employed. 895 children aged 6-59 months were measured. The prevalence of acute malnutrition (<-2z scores weight-for-height and/or oedema) was estimated at 10.9% (C.I. 8.2-14.4%) and that of severe acute malnutrition (<-3z scores weight-for-height and/or oedema) at 4.8% (C.I. 3.1-7.4%). Oedema was found in 3.5% of the children. Retrospective mortality of children under five for the 90 days prior to the survey was estimated at 2.46/10,000/day. 809 non-pregnant mothers were measured. Maternal nutritional status was defined using the BMI, MUAC and oedema. The prevalence of severe undernutrition (BMI<16.0 kg/m2 and/or oedema) was estimated at 3.2%, moderate undernutrition (BMI 16.0-16.9 kg/m2) at 3.6%, marginal undernutrition (BMI 17.9-18.4 kg/m2) at 13.2%. Oedema was recorded in 1.2% of the sample population. CMR for the 90 days prior to the survey was estimated at 0.72/10,000/day.

3. Eritrea

a Debub and Gash Barka These data were collected by SCF-UK/UNICEF/Ministry of Health as part of a nutritional surveillance programme in 32 sites in Debub and Gash Barka Zones of Eritrea. The surveillance is linked to a supplementary ration programme in the camps, so the majority of the children are measured every month. However, there is quite a lot of movement in and out of the camps (in order to prepare fields or harvest etc) and therefore the population numbers are not stable. The prevalence of wasting (defined using medians) varied between sites. Oedema was measured, but the results were excluded from the analysis as they were felt to be inaccurate. The authors reported that there was only a small amount of oedema.

b Konso Special Woreda. This survey was conducted by MSF-H in January 2000. Standard two-stage cluster methodology was employed. 915 children aged 6-59 months were measured. Acute malnutrition (<-2z scores and/or oedema) was estimated at 12.9% (95% Cl 9.7-16.1%). Severe acute malnutrition (<-3z scores and/or oedema) was estimated at 1.0% (95% Cl 0.9-3.1%). Oedema was recorded in 0.9% of the children. Measles vaccination rates were estimated by reference to cards.

6. Liberia/Sierra Leone Region

a Sinje Camp These surveys were undertaken by ACF-F in Sinje camps I and II, Cape Mount County, Liberia in December 1999. Systematic sampling methods were employed. Acute malnutrition was defined as <-2z scores and/or oedema. Severe acute malnutrition was defined as <-3z scores and/or oedema. Retrospective mortality in the three months prior to the surveys was estimated by questionnaire. Measles immunisation information was collected either from the vaccination card or from interview with the mother. In camp I, 357 children aged 6-59 months were measured. The prevalence of acute malnutrition was estimated at 9.0% (C.I. 6.3-12.6%) and severe acute malnutrition was 0.6% (C.I. 0.1-2.2%). No oedema was recorded. CMR was estimated at 0.59/10,000/day and under-five mortality at 1.05/10,000/day. Measles vaccination coverage according to card was estimated at 56.8%. In camp II, 461 children aged 6-59 months were measured. The prevalence of acute malnutrition was estimated at 6.5% (C.I. 4.5-9.3%) and severe acute malnutrition was 0.9% (C.I. 0.2-2.4%). Oedema was recorded in one child. CMR was estimated at 0.98/10,000/day and under-five mortality at 1.61/10,000/day. Measles vaccination coverage was estimated at 57.1% by reference to cards.

b Bo town This survey was conducted by ACF-F in Bo town, in November 1999. Standard two-stage cluster methodology was employed. 940 children aged 6-59 months were measured. Acute malnutrition (<-2z scores and/or oedema) was estimated at 7.2% (95% CI 5.1-10.1%). Severe acute malnutrition (<-3z scores and/or oedema) was estimated at 0.7% (95% CI 0.2-2.2%). One oedematous child was found. Retrospective CMR was estimated at 0.74/10,000/day and under-five mortality was estimated at 3.1/10,000/day. Measles vaccination coverage was estimated at 33.6% by reference to cards.

7. Somalia

a Hudur This survey was undertaken by UNICEF in Hudur town, Bakool in September 1999. Standard two-stage cluster sampling methodology was employed. A total of 910 children between 6 and 59 months or between 65 and 110 cm were measured. The prevalence of wasting (<-2z scores) was estimated at 15.5% and that of severe wasting (<-3z scores) at 5.7%. Oedema was recorded in 1.5% of the sample. Parents or caretakers were interviewed about measles immunisation (reference to cards was also made), vitamin A supplementation in the six months prior to the survey and morbidity in the two weeks prior to the survey. Measles vaccination rate was estimated at 43.0%.

b Rabdure This survey was undertaken by UNICEF in Rabdure, Bakool. A total of 498 children between 6 and 59 months or between 65 and 110 cm were screened during the survey. The prevalence of acute malnutrition (<-2z scores and/or oedema) was estimated at 30% and that of severe acute malnutrition (<-3z scores and/or oedema) was estimated at 6%. Two percent of the sample was oedematous. Measles vaccination rate was estimated at 28.0%. The RNIS has not yet received this report and thus no further details are currently available.

c Bardera This survey was undertaken by UNICEF in Bardera town, Gedo in December 1999. Standard two-stage cluster sampling methodology was employed. A total of 903 children between 6 and 59 months or between 65 and 110 cm were measured. The prevalence of wasting (<-2z scores) was estimated at 17.5% and that of severe wasting (<-3z scores) at 4.5%. Oedema was recorded in 1% of the sample. Parents or caretakers were interviewed about measles immunisation (reference to cards was also made), vitamin A supplementation in the six months prior to the survey and morbidity in the two weeks prior to the survey. Measles vaccination rate was estimated at 76.0%.

d Belet Weyne These survey were conducted by IMC in Belet Weyne town and villages, Hiran in August-September 1999. Standard two-stage cluster methodology was employed. In Belet Weyne town, 900 children aged 6-59 months were measured. Wasting (<-2z scores weight-for-height) was estimated at 23.6%. Severe wasting (<-3z scores weight-for-height) was estimated at 4.7%. Stunting (-2z scores height-for-age) was estimated at 29.5%. Severe stunting (-3z scores height-for-age) was estimated at 6.3%. The prevalence of oedema was estimated at 0.5%. Retrospective under-five mortality was estimated for the year prior to the survey at 1.6/10,000/day. Measles vaccination status was confirmed either by card or by mother’s/carer’s report and was estimated at 23.3% (using cards). In Belete Weyne Villages, 900 children aged 6-59 months were measured. Wasting (<-2z scores weight-for-height) was estimated at 15.6%. Severe wasting (<-3z scores weight-for-height) was estimated at 2.1%. Stunting (-2z scores height-for-age) was estimated at 28.9%. Severe stunting (-3z scores height-for-age) was estimated at 8.3%. The prevalence of oedema was estimated at 5.7% (although the authors commented that this estimated prevalence may have been incorrect due to methodological problems). Retrospective under-five mortality was estimated for the year prior to the survey at 1.9/10,000/day. Measles vaccination status was confirmed either by card or by mother’s/carer’s report and was estimated at 29.5% (using cards).

8. Sudan

a Athoc This survey was conducted by MEDAIR in Athoc payam, southern Bor County, Upper Nile in December 1999. Standard two-stage cluster sampling methodology was employed. 986 children aged 6-59 months or 65 to 115 cm were measured. Wasting (<-2z scores) was estimated at 21.7%. Severe wasting (<-3z scores) was estimated at 2.1%. Oedema was not reported. Parents or caretakers were interviewed about measles immunisation (reference to cards was also made), and morbidity in the month prior to the survey, The measles vaccination rate was estimated at 55%.

b Akuem This survey was conducted by MDM in Akuem, Aweil East County, BEG in November 1999. Standard two-stage cluster methodology was employed. 795 children aged 6-59 months were measured. Wasting (<-2z scores) was estimated at 11.9% (95% CI 9.8-14.3%). Severe wasting (<-3z scores) was estimated at 1.3% (95% CI 0.5-2.1%). Oedema was recorded in 20 children (2.5%). Measles vaccination rates were estimated at 56.4 by reference to cards. Under-five mortality rate was obtained by asking mothers about deaths of their children during the previous rainy season (six months) and was estimated at 3.1/10,000/day.

c Panthou This survey was conducted by MSF-B in Panthou, Aweil East County, BEG in October 1999. Standard two-stage cluster methodology was employed. 450 children aged 6-59 months were measured. Acute malnutrition (<-2z scores and/or oedema) was estimated at 18.2% (95% CI 11.2-25.2%). Severe acute malnutrition (<-3z scores and/or oedema) was estimated at 1.3% (95% CI 0.0-2.6%). No oedema was reported.

d Malualkon This survey was conducted by Tearfund in three payams of Malualkon, Aweil East County, BEG in January 2000. Standard two-stage cluster methodology was employed. 900 children aged 6-59 months were measured. Acute malnutrition (<-2z scores and/or oedema) was estimated at 12.2% (95% CI 10.2-14.3%). Severe acute malnutrition (<-3z scores and/or oedema) was estimated at 1.3% (95% CI 0.0-3.4%). No oedema was found. The measles vaccination rate was estimated at 32.7% by asking mothers (no vaccination cards were issued during the measles campaign).

e Aweil West This survey was conducted by CONCERN in three payams of Aweil West County, BEG in November 1999. Standard two-stage cluster methodology was employed. 881 children aged 6-59 months were measured. Acute malnutrition (<-2z scores and/or oedema) was estimated at 10.4%. Severe acute malnutrition (<-3z scores and/or oedema) was estimated at 3.1%. Oedema was not reported separately. The measles vaccination rate was estimated at 30% by asking mothers and reference to cards. CMR was estimated at 0.84/10,000/day and under-five mortality at 1.9/10,000/day.

f Gogrial This survey was conducted by World Vision Sudan in Panthou and Toch Payams of Gogrial County, BEG in November 1999. As the survey is not available to the RNIS the methodology is unknown. Wasting (<80% median weight-for-height) was estimated at 5.9%. Severe wasting (<70% median weight-for-height) was estimated at 1.2%. No further details are currently available.

g Tonj This survey was conducted by World Vision Sudan in the five Payams of Tonj County, BEG in November 1999. As the survey is not available to the RNIS the methodology is unknown. Wasting (<80% median weight-for-height) was estimated at 8.0%. Severe wasting (<70% median weight-for-height) was estimated at 0.6%. No further details are currently available.

h Juba This survey was conducted by ACF-F in Juba, Equatoria in December 1999. Standard two-stage cluster methodology was employed. 900 children aged 6-59 months were measured. Acute malnutrition (<-2z scores and/or oedema) was estimated at 11.1% (95% CI 8.4-14.5%). Severe acute malnutrition (<-3z scores and/or oedema) was estimated at 1.0% (95% CI 0.3-2.6%). One oedematous child was found. The measles vaccination rate was estimated at 44.5% by reference to cards.

9. Uganda

a. Kitgum District These surveys were undertaken by ACF-USA in non-displaced villages and IDP camps in Kitgum District, Uganda in December 1999. Two stage cluster methodology sampling method was used for both surveys. Acute malnutrition was defined as <-2z scores weight-for-height and/or oedema. Severe acute malnutrition was defined as <-3z scores weight-for-height and/or oedema. Chronic malnutrition was defined as <-2z scores height-for-age. Severe chronic malnutrition was defined as <-3z scores height-for-age. Retrospective mortality for children under five in the three months prior to the surveys was estimated by questionnaire. Measles immunisation information was collected either from the vaccination card or from interview with the mother. In the non-displaced villages, 947 children aged 6-59 months were measured. The prevalence of acute malnutrition was estimated at 3.5% (C.I. 2.1-5.7%) and severe acute malnutrition was 0.1% (C.I. 0.0-1.2%). No oedema was recorded. The prevalence of chronic malnutrition was estimated at 39.7% (C.I. 35.3-44.3%) and severe acute malnutrition was 16.5% (C.I. 13.3-20.2%). Under-five mortality was estimated at 1.27/10,000/day. Measles vaccination coverage according to card was estimated at 18.2%. In the IDP camps, 939 children aged 6-59 months were measured. The prevalence of acute malnutrition was estimated at 6.6% (C.I. 4.6-9.4%) and severe acute malnutrition was 1.4% (C.I. 0.6-3.1%). Oedema was recorded in 0.3% of the sample. The prevalence of chronic malnutrition was estimated at 36.8% (C.I. 32,5-41.5%) and severe acute malnutrition was 14.7% (C.I. 11.7-18.3%). Under-five mortality was estimated at 1.32/10,000/day. Measles vaccination coverage according to card was estimated at 16.2%.

b Gulu District These surveys were undertaken by ACF-USA in IDP camps with and without health facilities in Gulu District, Uganda in September-October 1999. Two stage cluster methodology sampling method was used for both surveys. Acute malnutrition was defined as <-2z scores weight-for-height and/or oedema. Severe acute malnutrition was defined as <-3z scores weight-for-height and/or oedema. Chronic malnutrition was defined as <-2z scores height-for-age. Severe chronic malnutrition was defined as <-3z scores height-for-age. Retrospective mortality for children under five in the three months prior to the surveys was estimated by questionnaire. Measles immunisation information was collected either from the vaccination card or from interview with the mother. In the camps with health facilities, 950 children aged 6-59 months were measured. The prevalence of acute malnutrition was estimated at 4.9% (C.I. 3.2-7.4%) and severe acute malnutrition was 0.7% (C.I. 0.2-2.1%). Oedema was recorded in 0.2% of the sample. The prevalence of chronic malnutrition was estimated at 37.8% (C.I. 33.542.4%) and severe acute malnutrition was 14.7% (C.I. 11.7-18.3%). Under-five mortality was estimated at 1.16/10,000/day. Measles vaccination coverage according to card was estimated at 37.3%.

In the camps without health facilities, 958 children aged 6-59 months were measured. The prevalence of acute malnutrition was estimated at 3.8% (C.I. 2.3-6.0%) and severe acute malnutrition was 0.4% (C.I. 0.0-1.7%). Oedema was recorded in 0.3% of the sample. The prevalence of chronic malnutrition was estimated at 39.8% (C.I. 35.4-44.3%) and severe acute malnutrition was 15.2% (C.I. 12.0-18.7%). Under-five mortality was estimated at 0.6/10,000/day. Measles vaccination coverage according to card was estimated at 29.1%.

11. Afghanistan

a Panjshir This assessment was conducted by ACF-F in Panjshir in November-December 1999. Three of the most vulnerable groups of IDPs were chosen (those living in either official or unofficial camps, public buildings) and ten clusters were selected randomly from within these groups. Because of problems associated with estimating the population numbers this assessment cannot be considered a survey. 477 children aged 6-59 months were measured. In the official camps, public buildings and unofficial camps, acute malnutrition (<-2z scores and/or oedema) was estimated at 12.0%, 12.6%, 7.5% respectively. Severe acute malnutrition (<-3z scores and/or oedema) was estimated at 1.9%, 3.1%, 1.3%. Oedema was reported separately. Measles vaccination rates were estimated by reference to card or by asking the mother/carer.

12. Nepal a Nepal This survey was undertaken by CDC in the Bhutanese refugee camps in Nepal in October 1999. Adolescent survey subjects were chosen by systematic random sampling from computerized registration data after data for all camps were combined. Survey workers registered adolescent subjects, obtained consent, conducted dietary interviews, measured weight, height, sitting height and MUAC, examined and referred subjects as necessary, and obtained blood specimens. Laboratory samples included a fingerstick blood sample for haemoglobin from all survey subjects. From half the survey subjects blood was collected by venipuncture for testing for levels of riboflavin, serum transferrin receptors (TfR), and serum retinol (vitamin A). In addition, each adolescents with a severe case of AS had blood drawn for riboflavin level. Riboflavin status was assessed by measuring the activity of a riboflavin-dependent enzyme, erythrocyte glutathione reductase (EGR) in red blood cells (Mount et al -1987). The serum levels of folate and B12 were measured directly using a commercial radioimmunoassay kit (BioRad Laboratories, Hercules, California). TfR testing was done with a commercial kit (Ramco Laboratories). The serum collected in this survey was assayed for retinol by high-performance liquid chromatography at the CDC laboratories.

13. Indonesia

a Belu This survey was undertaken by UNICEF in Belu district, West Timor in December 1999. Standard two-stage cluster sampling methodology was employed, except the youngest child in the household was measured. 842 children aged 6-59 months were measured. The prevalence of wasting (<-2z scores weight-for-height) was estimated at 23.6% and severe wasting (<-3z scores weight-for-height) at 3.6%. Oedema was not re- corded. The prevalence of stunting (<-2z scores height-for-age) was estimated at 46.8% and severe stunting (<-3z scores height-for-age) at 17.9%.

b Kupang This survey was undertaken by UNICEF in Kupang district, West Timor in January 2000. Standard two-stage cluster sampling methodology was employed. 893 children aged 6-59 months were measured. The prevalence of wasting (<-2z scores weight-for-height) was estimated at 12.1% and severe wasting (<-3z scores weight-for-height) at 1.0%. Oedema was not recorded. The prevalence of stunting (<-2z scores height-for-age) was estimated at 43.1% and severe stunting (<-3z scores height-for-age) at 17.5%.

c Naen Camp This assessment was undertaken by MSF-H in Naen Camp, West Timor in February 2000. Exhaustive sampling methods were employed, but the lists were thought to be incomplete. 186 children aged 6-59 months were measured for height and weight and 221 for MUAC. Wasting (<-2z scores) was estimated at 33% and severe wasting (<-3z scores) at 7%. Oedema was not reported. Low MUAC (<135 mm) was estimated at 29.5% and severe low MUAC (<110 mm) at 10.0%. Note that MUAC included children aged 6-12 months which is not normal practice.

14. Balkans Region

a Kosovo This survey was undertaken by AAH-UK in Kosovo in January 2000. Two stage cluster methodology sampling method was employed. Among children aged 6-59 months (of who 934 were measured), the prevalence of acute malnutrition (<-2z scores weight-for-height and/or oedema) was estimated at 4.7% (C.I. 3.0-7.2%) and that of severe acute malnutrition (<-3z scores weight-for-height and/or oedema) at 1.1% (C.I. 0.4-2.6%). The prevalence of chronic malnutrition (<-2z scores height-for-age) was estimated at 7.5% (C.I. 5.4-10.4%) and that of severe chronic malnutrition (<-3z scores height-for-age) at 1.9% (C.I. 0.9-3.8%). Measles immunisation information (children aged 18-59 months) was collected either from the vaccination card or from interview with the mother. The rate estimated by card was 18.0%. 802 non-pregnant mothers were also measured. Maternal nutritional status was defined using the BMI and MUAC. The prevalence of severe undernutrition (BMI<16.0 kg/m2) was estimated at 0.2%, moderate undernutrition (BMI 16.0-16.9 kg/m2) at 0.9%, marginal undernutrition (BMI 17.9-18.4 kg/m2) at 4.2%, overweight (BMI 25-29.9 kg/m) at 23.6% and obesity (BMI>30 kg/m) at 10.4%. 224 older persons (more than 65 years old) were also measured. Their nutritional status was defined using the BMI and MUAC. The prevalence of severe undernutrition (BMI<16.0 kg/m2) was estimated at 1.3%, moderate undernutrition (BMI 16.0-16.9 kg/m2) at 0.4%, marginal undernutrition (BMI 17.9-18.4 kg/m2) at 3.6%, overweight (BMI 25-29.9 kg/m) at 32.0% and obesity (BMI>30 kg/m) at 16.0%.

b Konik camp This screening was undertaken by ACF-F in Konik Camp, Montenegro in November 1999. Exhaustive sampling methods were employed. 416 children aged 6-59 months were measured. The prevalence of wasting (<-2z scores weight-for-age) was estimated at 2.9% and severe wasting (<-3z scores weight-for-age) at 0.96%. Oedema was found in one child. The prevalence of chronic malnutrition (<-2z scores height-for-age) was estimated at 16.1% and that of severe chronic malnutrition (<-3z scores height-for-age) at 1.9%.