Nutritional deficiency disorders and high mortality among children of the Great Andamanese tribe.

ABSTRACT

BACKGROUND: The population of the Great Andamanese tribe of the Andaman Islands has been declining at a rapid pace. The case fatality rate during a recent outbreak of dysentery was 30.8%, all the deaths being among under-fives. As malnutrition is known to potentiate susceptibility to death due to infectious diseases, we undertook a study to determine the prevalence of malnutrition among the Great Andamanese tribe and its role in contributing to the high mortality among them due to infectious diseases. METHODS: The study included a diet survey, nutritional anthropometry, clinical examination, haemoglobin estimation and stool examination for intestinal parasitic infestations. Information was also collected about every pregnancy in all ever-married women in the community and deaths of their children. All 36 members of the tribe were covered. RESULTS: The Andamanese had a poor intake of iron, vitamin A and riboflavin but a good intake of energy, protein and fats. More than 85% of the children below 6 years were under-nourished and more than 77% of children and adolescents below 19 years were stunted, wasted or both. Anaemia, vitamin A deficiency and goitre were also common among them. Almost the entire population suffered from intestinal parasitic infestations. They also have a comparatively high fertility rate and a high infant mortality rate. CONCLUSION: The population attributable risk for death due to malnutrition is probably one of the foremost reasons for the observed high infant mortality rate among the Great Andamanese tribe and could be one of the reasons for the continuous decline in their population.