RESUMO
This study compared the predictive power of selected nutritional (anthropometric), socioeconomic, and diarrheal disease morbidity variables for subsequent childhood mortality over a 1-year period. The data consisted of observations of approximately 1,900 children aged 6-36 months obtained from a longitudinal demographic surveillance system located in a rural area of Bangladesh in 1988-1990. The results suggested that weight-for-age (%) was the best predictor of subsequent mortality over a 1-year period, followed by weight velocity (monthly weight gain or loss in grams). Standardization of weight velocity by the US National Center for Health Statistics standard did not improve the mortality-discriminating power of this variable. Reported diarrheal morbidity was also a useful criterion for predicting mortality. Neither maternal education nor sex of the child had significant mortality-discriminating power.
PIP: The predictive power of selected nutritional (anthropometric), socioeconomic, and diarrheal disease morbidity variables for subsequent childhood mortality were compared over a 1-year period. The data were obtained from the Sample Registration System of the International Centre for Diarrhoeal Disease Research, Bangladesh, located in a rural area of Bangladesh in 1988-90. In 1988 the weights of approximately 1900 children aged 6-36 months were measured to the nearest 100 gm on a bar scale to assess the impact of the flood on the nutritional status of children in the area. The weights of the children were measured again after 3 months for examination of any changes in nutritional status. Information on diarrheal disease during the previous 24-hour period and also during the previous week, including the day of the interview/weight measurement, was also collected. Measurements for 1874 children were available from the 1st weight measurement, and measurements for 1900 children were available from the 2nd weight measurement. The 1664 children for whom measurements were available from both time periods were included in this study; 27 of these died during the 12-month period following the last weight measurement. Below a threshold point of 70% mortality increased very sharply for weight-for-age (percent) and around 70 gm month for the weight velocity index. The sensitivity and specificity curves weight-for-age (percent) appeared to be superior to the weight velocity index as a predictor of mortality. Weight velocity was a weaker predictor than was weight-for-age (percent), and the power of the weight velocity index was lower than that of weight velocity. Neither maternal education nor sex of the child had significant mortality-discriminating power. The discriminating powers of the variables of diarrhea on the day of assessment and diarrhea during the previous week were significant (p 0.05).