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Seasonal variation in malnutrition in Africa
CORRESPONDENCE
431
SEASONALVARIATIONIN MALNUTRITION IN AFRICA SIR,--I was interested in Poskitt's article appearing in the Transactions showing the relationship between seasonal variation in infection and malnutrition. Similar observations were made in an area of Africa which had only one annual wet season, where malaria does not occur, parasitic infestation apart from giardlasis is rare, and where gastro-enteritis is very common especially during the hot season. Sekhukuniland is a Bantu reserve situated in the N o r t h Eastern Transvaal, South Africa; the average altitude is 4,000 feet, annual rainfall 12-23 inches falling during one hot season between October and March. T h e winters are cold and dry. T h e economy is a subsistence one, using unproductive agricultural methods. Maize is the staple diet, though sorghum and millett are grown. Prolonged breast feeding, poverty, superstition and ignorance shape the child's life, and his mean growth curve lies along the Boston 3rd percentile, falling below it at about 9 months of age. T h e broad spectrum of weights falls well below the Boston'3rd percentile, into an area designated as dangerously malnourished. T h e relationship between gastro-enteritis and a precipitous onset of kwashiorkor in Sekhukunlland was established by recording the monthly admissions to the children's ward of the Jane Furse Memorial Hospital between 1957 and 1962. T h e peak of gastro-enteritis admissions occuring during the hot, rainy months of November to March was sharply followed by a peak incidence of admissions of children suffering from kwashiorkor. 4.5% of children admitted to the hospital suffered from overt protein-calorie malnutrition as the primary diagnosis. It appears likely that in an area where the child population has borderline malnutrition, even in the absence of malaria and parasitic infestation, gastro-enteritis can precipitate overt kwashiorkor• I am, etc., E. WALDMANN, Grantham Hospital, Aberdeen, 12 May, 1973 Hong Kong. REFERENCES
POSKITT, E. M. E. (1972). Trans. R. Soc. trop. Med. Hyg., 66, 931. WALDMANN, E. (1960). Centr. Aft. 07. Med., 6~ 298. • (1968). (unpublished). Growth of Pedi infants.
431
SEASONALVARIATIONIN MALNUTRITION IN AFRICA SIR,--I was interested in Poskitt's article appearing in the Transactions showing the relationship between seasonal variation in infection and malnutrition. Similar observations were made in an area of Africa which had only one annual wet season, where malaria does not occur, parasitic infestation apart from giardlasis is rare, and where gastro-enteritis is very common especially during the hot season. Sekhukuniland is a Bantu reserve situated in the N o r t h Eastern Transvaal, South Africa; the average altitude is 4,000 feet, annual rainfall 12-23 inches falling during one hot season between October and March. T h e winters are cold and dry. T h e economy is a subsistence one, using unproductive agricultural methods. Maize is the staple diet, though sorghum and millett are grown. Prolonged breast feeding, poverty, superstition and ignorance shape the child's life, and his mean growth curve lies along the Boston 3rd percentile, falling below it at about 9 months of age. T h e broad spectrum of weights falls well below the Boston'3rd percentile, into an area designated as dangerously malnourished. T h e relationship between gastro-enteritis and a precipitous onset of kwashiorkor in Sekhukunlland was established by recording the monthly admissions to the children's ward of the Jane Furse Memorial Hospital between 1957 and 1962. T h e peak of gastro-enteritis admissions occuring during the hot, rainy months of November to March was sharply followed by a peak incidence of admissions of children suffering from kwashiorkor. 4.5% of children admitted to the hospital suffered from overt protein-calorie malnutrition as the primary diagnosis. It appears likely that in an area where the child population has borderline malnutrition, even in the absence of malaria and parasitic infestation, gastro-enteritis can precipitate overt kwashiorkor• I am, etc., E. WALDMANN, Grantham Hospital, Aberdeen, 12 May, 1973 Hong Kong. REFERENCES
POSKITT, E. M. E. (1972). Trans. R. Soc. trop. Med. Hyg., 66, 931. WALDMANN, E. (1960). Centr. Aft. 07. Med., 6~ 298. • (1968). (unpublished). Growth of Pedi infants.