Assessment of nutritional status of children under five years of age, pregnant women, and lactating women living in relief camps after the tsunami in Sri Lanka

Background. A strong earthquake that hit Aceh on December 26, 2004, triggered a powerful tsunami, resulting in an unprecedented catastrophe in Sri Lanka. The initial phase of the disaster was marked by limited access to food coupled with an inadequate supply of safe water and poor environmental hygiene and sanitation, all of which placed children at increased risk for undernutrition. Objective. To assess the nutritional status of children under five years of age, pregnant women, and lactating women residing in 40 relief camps after the tsunami. Methods. A cross-sectional, 30-cluster study was performed. Thirty children under five from each cluster (camp) and all pregnant and lactating women in selected camps were studied. Data were collected by interviews with the primary caregivers of the children, interviews with key informants in the camps, direct observation, and focus group discussions with mothers. Weight, height, or length was measured on children and pregnant women. Mid-upper-arm circumference of lactating women was measured. Results. A total of 878 children were assessed, of whom 16.1%, 20.2%, and 34.7% were wasted, stunted, and underweight, respectively. The prevalence of each indicator was higher in boys than in girls. During the 2 weeks before the survey, 69.5% of the children had acute respiratory tract infections and 17.9% had diarrhea. Although the general food distribution was well in place, the food supply lacked diversity, and 70.9% of the children did not get appropriate supplementary food. The prevalence of undernutrition among pregnant women (n = 168) was 37%. Thirty-one percent of lactating women (n = 97) were underweight, and 20% were overweight. Conclusions. The prevalence of both acute and chronic undernutrition among children in the camps is significantly higher than the national Sri Lankan average. There is a need to establish nutritional surveillance systems to monitor the nutritional status of displaced and nondisplaced children and mothers.