Famine in Ethiopia 1983-1985: kwashiorkor and marasmus in four regions

Parts of southern Ethiopia were form 1983 to 1985 affected by drought and famine. This study describes the prevalence of marasmus and kwashiorkor in four drought-affected regions: Bale, Sidamo, Gamu Gofa and southern Shoa. An analysis of 37,511 children in the 1-5 year age group representing 212 communities has been performed. The study demonstrates that both marasmus and kwashiorkor are facets of drought. The epidemiologies of kwashiorkor and marasmus differ: marasmus is the most common form of acute malnutrition in all areas, while kwashiorkor is found in a limited number of communities only. These latter communities have a subsistence farming economy, most often in ensete-growing areas. In the lowland semi-arid regions, which have an agro-pastoralist economy, kwashiorkor is virtually absent. These epidemiological findings are discussed in relation to different theories of the aetiology and pathogenesis of kwashiorkor.

Measuring acute malnutrition: a need to redefine cut-off points for arm circumference?

Two relatively age-independent indicators--weight-for-height and mid upper-arm circumference--have been widely used to assess acute malnutrition in drought-affected communities in southern Ethiopia. Compared with weight for height, arm circumference (with cut-off points of 12.5 cm and 13.5 cm) greatly exaggerates acute malnutrition prevalence rates. New cut-off points (11 cm and 13 cm) are therefore proposed which significantly reduce false-positive rates and make weight for height and arm circumference classifications more comparable in the assessment of acute malnutrition.

Burkitt's lymphoma in South Ethiopia

In a retrospective study eleven cases with Burkitt's lymphoma have been diagnosed at three rural hospitals in the Sidamo and Gamu Gofa Regions of South Ethiopia. The clinical picture is heterogeneous with an abdominal mode of presentation being most frequently observed. It is concluded that South Ethiopia has an incidence of Burkitt's lymphoma between that of endemic countries (e.g. Uganda) and non-endemic countries such as the USA.

Kala-azar in south-west Ethiopia: seasonal variation in disease occurrence

In a 12-year retrospective study of patients with kala-azar from Gidole Hospital in south-west Ethiopia it is demonstrated that most patients are diagnosed during the months August to November with another small peak from March to May. It is suggested that transmission is associated with two main periods of annual rainfall.