title: Nutritional status and mortality of refugee and resident children in a non-camp setting during conflict: follow up study in Guinea-Bissau.
abstract: OBJECTIVE
  To study the effects on children of humanitarian aid agencies restricting help to refugee families (internally displaced people).
  
  
  METHODS
  Follow up study of 3 months.
  
  
  METHODS
  Prabis peninsular outside Bissau, the capital of Guinea-Bissau, which has functioned as a refugee area for internally displaced people in the ongoing war, and the study area of the Bandim health project in Bissau.
  
  
  METHODS
  422 children aged 9-23 months in 30 clusters.
  
  
  METHODS
  Mid-upper arm circumference and survival in relation to residence status.
  
  
  RESULTS
  During the refugee situation all children deteriorated nutritionally, and mortality was high (3.0% in a 6 week period). Rice consumption was higher in families resident in Prabis than in refugees from Bissau but there was no difference in food expenditure. Nutritional status, measured by mid- upper arm circumference, was not associated with rice consumption levels in the family, and the decline in circumference was significantly worse for resident than for refugee children; the mid-upper arm circumference of refugee children increased faster than that of resident children. For resident children, mortality was 4.5 times higher (95% confidence interval 1.1 to 30.0) than for refugee children. Mortality for both resident and refugee children was 7.2 times higher (1.3 to 133.9) during the refugee's stay in Prabis compared with the period after the departure of the refugees.
  
  
  CONCLUSIONS
  In a non-camp setting, residents may be more malnourished and have higher mortality than refugees. Major improvements in nutritional status and a reduction in mortality occurred in resident and refugee children as soon as refugees returned home despite the fact that there was no improvement in food availability.
authors.affiliation: Department of Epidemiology Research, Danish Epidemiology Science Centre, Statens Serum Institut, 2300 Copenhagen S, Denmark. paa@ssi.dk
authors.forename: P
authors.initials: P
authors.lastname: Aaby
authors.forename: J
authors.initials: J
authors.lastname: Gomes
authors.forename: M
authors.initials: M
authors.lastname: Fernandes
authors.forename: Q
authors.initials: Q
authors.lastname: Djana
authors.forename: I
authors.initials: I
authors.lastname: Lisse
authors.forename: H
authors.initials: H
authors.lastname: Jensen
mesh_terms: D004435:Eating; D005500:Follow-Up Studies; D006169:Guinea-Bissau; D006801:Humans; D007223:Infant; D007226:Infant Mortality; D009752:Nutritional Status; D012036:Refugees / Q000706:statistics & numerical data*; D014857:Warfare