Alimentation de sevrage et interventions nutrionnelles au Congo

Au Congo; les etats de denutrition apparaissent tot et leur prevalence est particulierement elevee pendant la periode de sevrage. En vue d'aider a l'elaboration et la mise en oeuvre d'interventions nutritionnelles; des donnees relatives a l'alimentation des enfants de moins de 24 mois; en milieu rural et en milieu urbain; ont ete collectees. La pratique de l'allaitement maternel est encore generalisee et de longue duree; en depit d'une tendance au raccourcissement en milieu urbain. En revanche; les pratiques alimentaires; notamment de sevrage; la qualite des bouillies contribuent fortement au mauvais etat nutritionnel et aux deficits de croissance des enfants. En milieu rural les bouillies sont donnees trop tot puis arretees egalement trop tot pour etre remplacees sans veritable transition par les aliments du plat familial. En milieu urbain l'installation des bouillies de sevrage est plus rationnelle et les enfants sont amenes plus progressivement au sevrage total. Leur alimentation est egalement moins monotone

Nutrition survey in the Republic of the Congo: results from a national survey conducted in 1987

The objective was to evaluate the nutritional status of preschool children in the rural areas in order to establish a baseline for the measurement of the impact of a Government Nutrition Education Project (NUTED) in forthcoming years. The household cross-sectional survey was carried out on a representative sample of the rural population. The sample was stratified in order to portray the nutritional status of the children in the northern regions (more thinly populated) and in the southern regions: one stratum for small towns (between 2000 and 30,000 inhabitants) and 4 strata for rural localities. The sampling method used was by clusters of 30 children, distributed randomly in 20 zones per stratum. The nutritional indices of 2429 children were calculated and analysed according to WHO recommendations. The prevalence of the different types of malnutrition was 27.5% (95% confidence interval (CI), 24.2-30.8) for stunting (height-for-age retardation) and 5.5% (CI = 4.2-6.8) for wasting (weight-for-height retardation). Both types coexisted among 1.9% of the children; 23% of children were underweight for their age (CI = 21.6-26.2), and 15.8% (CI = 14.7-16.9) aged greater than 12 months had a mid-arm circumference below 135 mm. No sex difference was observed in the results. Stunting seems to appear in the second trimester of life (3-5 months), and wasting appeared between 9 and 23 months (highest rate between 12 and 17 months: 14.0% (CI = 9.3-18.8], which presents a real public health problem. The stratification did not show any significant differences in nutritional status among the children living in rural zones and those living in the small towns. However, the prevalence of malnutrition in the rural zones was 2 or 3 times higher than that observed in 1986 in Brazzaville. The division of the country into five main ecological zones allows some useful comparisons, e.g., the prevalence of stunting ranges from 15.5% (CI = 12.8-18.2) in the northern inundated forest zone to 38.8% (CI = 32.9-44.7) in the southern forests of Mayombe and Chaillu. The diet also varied, the frequency of animal protein consumption on the preceding day ranging from 76.3% to 59.1% in the different zones. The Republic of the Congo differs from other African countries in having relatively lower rates of stunting but an astonishingly high prevalence of wasting