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Research Letter
April 10, 2018

Acute Malnutrition and Anemia Among Rohingya Children in Kutupalong Camp, Bangladesh

Author Affiliations
  • 1Centers for Disease Control and Prevention, Atlanta, Georgia
  • 2Action Against Hunger, Dhaka, Bangladesh
  • 3United Nations High Commissioner for Refugees, Geneva, Switzerland
  • 4United Nations Children’s Fund, Dhaka, Bangladesh
JAMA. 2018;319(14):1505-1506. doi:10.1001/jama.2018.2405

Nearly 700 000 ethnic minority Rohingya people have crossed the border between Myanmar and Bangladesh after violence in Rakhine State, which escalated in August 2017, joining an estimated 200 000 who fled in earlier waves of displacement since the 1990s. The population of 2 preexisting refugee camps and surrounding makeshift settlements have more than doubled with the new influx. Concerns have been raised about the nutritional status of the Rohingya children.

To assess the health and nutritional status of children aged 6 to 59 months, we conducted a cross-sectional population-representative survey in the Kutupalong refugee camp from October 22 through 28, 2017. Households were randomly selected from a list updated the week preceding data collection. Weight, height, mid–upper arm circumference (MUAC), and presence of bilateral pitting edema were measured using standard procedures.1 Weight-for-height z score (WHZ) and height-for-age z score (HAZ) were calculated based on 2006 World Health Organization (WHO) growth standards.2 Two definitions of global acute malnutrition (GAM) and severe acute malnutrition (SAM) were investigated because both can be criteria for admission to treatment programs. GAM was defined as a WHZ less than −2 or MUAC less than 125 mm. SAM was defined as WHZ less than −3 or MUAC less than 115 mm. All acute malnutrition categories additionally included children with edema. Chronic malnutrition was defined as an HAZ less than −2. Anemia screening was conducted by measuring hemoglobin (Hb 301, HemoCue) and classified according to WHO cutoffs.3 Children aged 6 to 23 months (the target group for fortified food distributions) consuming at least 4 of 7 food groups during the day preceding the survey were classified as receiving minimum dietary diversity.4 Respondents self-reported registration as refugees with the United Nations High Commissioner for Refugees. Wilson score CIs and results of the Pearson χ2 test were used to compare registered and unregistered children. Two-sided tests were considered significant at a P value of less than .05. The US Centers for Disease Control and Prevention determined this study was exempt from human subjects research review because it collected data for programmatic purposes.

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