239 TRANSACTIONS OF THE ROYAL SOCIETY OF TROPICAL MEDICINE AND HYGIENE, VOL. 72, No. 3, 1978
Water supply and nutritional Departments of Human Nutrition
Liverpool
School of Tropical
A. K. BRADLEY AND W. A. WILLIAMSON* Medicine Team, Malumfashi Project, Ahmadu
Introduction Protein-energy malnutrition (PEM) continues to be a major problem among pre-school children in many developing countries, especially in rural areas. The importance of diarrhoeal disease in precipitating malnutrition, as assessed by deficiencies in weight for age, is well recognized (MATA et al., 1976). Several studies in rural developing communities have shown considerable contamination of drinking water sources by faecal coliforms (WHITE et al., 1972; FEACHEM et al., 1977) and it is assumed by many that a considerable impact on the PEM/ gastro-enteritis complex could be made by introduction of clean water. However, recent studies suggest that the situation may not be so simple. it is increasingly recognized that a Firstly, classification of protein energy malnutrition which is based on a child’s weight for age alone cannot differentiate between a deficit in body height probably represents long-term (‘stunting’ -which malnutrition) and a deficit in body proportion (‘wasting’- which probably represents acute malnutrition). In any assessment of the prevalence of malnutrition or monitoring of intervention programmes, such as water improvement schemes, it seems important to be clear which type of malSecondly, certain recent nutrition is present. studies have shown that the introduction of piped water did not decrease the reported incidence of gastro-enteritis unless accompanied by an increase in water utilization (FEACHEM et al.. 1977). It has therefore been suggested that waterpurity may not be so critically important as is generally accepted. In rural populations of the Savanna areas, water is always at a premium but especially so at the end of has, tragically,
Nigeria
A. M. TOMKINS, B. S. DRASAR & Microbiology, London School of Hygiene & Tropical Medicine
Summary A high incidence of protein-energy malnutrition (PEM) was found in a community survey of preschool children in rural northern Nigeria among whom gastro-enteritis is common. Wasting ( < 80 ‘& Weight/Height) was more common (37.9 5,) among those with scanty, unprotected water supplies than in those with copious protected water (10.2:;) whereas the incidence of stunting ( 85
6.3
23.2
5.7
-
84-75
4.4
16.3
22.6
1.9
885 ma
( 5; STD) 400 i
>90
89-80
20.7
12.7
79-70
Water supply and nutritional Departments of Human Nutrition
Liverpool
School of Tropical
A. K. BRADLEY AND W. A. WILLIAMSON* Medicine Team, Malumfashi Project, Ahmadu
Introduction Protein-energy malnutrition (PEM) continues to be a major problem among pre-school children in many developing countries, especially in rural areas. The importance of diarrhoeal disease in precipitating malnutrition, as assessed by deficiencies in weight for age, is well recognized (MATA et al., 1976). Several studies in rural developing communities have shown considerable contamination of drinking water sources by faecal coliforms (WHITE et al., 1972; FEACHEM et al., 1977) and it is assumed by many that a considerable impact on the PEM/ gastro-enteritis complex could be made by introduction of clean water. However, recent studies suggest that the situation may not be so simple. it is increasingly recognized that a Firstly, classification of protein energy malnutrition which is based on a child’s weight for age alone cannot differentiate between a deficit in body height probably represents long-term (‘stunting’ -which malnutrition) and a deficit in body proportion (‘wasting’- which probably represents acute malnutrition). In any assessment of the prevalence of malnutrition or monitoring of intervention programmes, such as water improvement schemes, it seems important to be clear which type of malSecondly, certain recent nutrition is present. studies have shown that the introduction of piped water did not decrease the reported incidence of gastro-enteritis unless accompanied by an increase in water utilization (FEACHEM et al.. 1977). It has therefore been suggested that waterpurity may not be so critically important as is generally accepted. In rural populations of the Savanna areas, water is always at a premium but especially so at the end of has, tragically,
Nigeria
A. M. TOMKINS, B. S. DRASAR & Microbiology, London School of Hygiene & Tropical Medicine
Summary A high incidence of protein-energy malnutrition (PEM) was found in a community survey of preschool children in rural northern Nigeria among whom gastro-enteritis is common. Wasting ( < 80 ‘& Weight/Height) was more common (37.9 5,) among those with scanty, unprotected water supplies than in those with copious protected water (10.2:;) whereas the incidence of stunting ( 85
6.3
23.2
5.7
-
84-75
4.4
16.3
22.6
1.9
885 ma
( 5; STD) 400 i
>90
89-80
20.7
12.7
79-70
