Levels of acute malnutrition are often chronically higher than emergency thresholds in the pastoral regions of Chad. In November/December 2009, Action Contre la Faim (ACF) conducted nutrition surveys in Noukou and Bahr el Gazel, departments in Chad's Kanem region (Figure 1). While the prevalence of acute malnutrition was above 15 percent in both areas, survey findings were particularly serious in Bahr el Gazel, where GAM prevalence was nearly double the WHO emergency threshold and mortality rates approached emergency levels. As food security in this area typically deteriorates between January and June, further increases in malnutrition and mortality are possible. Expanded screening of children and mothers, and emergency feeding programs are urgently needed in this area, in addition to longer-term initiatives to improve feeding and caring practices.
The survey in Bahr El Gazel was conducted between November 21 and December 3, 2009 and utilized the SMART methodology. Preliminary results indicate that the prevalence of Global Acute Malnutrition (GAM), defined as weight-forheight z-score (WHZ) <-2 SD (NCHS), was 26.9 percent [95% CI: 23.4-30.4], while the prevalence of Severe Acute Malnutrition (SAM), defined as WHZ <-3 SD (NCHS), was 4.5 percent [95% CI: 2.9-6.2]. These are significantly higher than relevant emergency thresholds. Rates of mortality were also high. Crude mortality was estimated at 0.94/10,000/day [95% CI: 0.67-2.50] and under-5 mortality was estimated at 1.59/10,000/day [95% CI: 0.53-1.34], compared to emergency thresholds of 1/10,000/day and 2/10,000/day respectively. These rates of acute malnutrition and mortality are even more concerning because households are typically better off during November/December, following crop harvests and given relatively good milk availability. The most recent national vulnerability assessment reported a GAM rate for the Kanem region of 23.8 percent, but this data was collected during April-June 2009, the area's peak hunger season.