The impact of oedema on anthropometric measurements in nutritional surveys: a case study from Zaire

Six surveys for protein-energy malnutrition were carried out in sequence in Bas-Zaire beginning at the end of 1978 at the estimated height of the famine and continuing throughout the recovery period. Utilizing a stratified multi-stage sampling technique, over 1000 children aged 6 months to 6 years were measured anthropometrically and examined for the presence or absence of bilateral pedal oedema in each survey. The proportions of children who were less than 80% of the reference median weight-for-height and who had oedema decreased, respectively, from 12.8% and 14.4% initially to 2.1% and 1.8% in the final survey. The proportion of oedematous children who were found to be not less than 80% of the reference median weight-for-height was high, varying from 71.7 +/- 7.0% to 94.4 +/- 10.6%. The importance of these findings for the interpretation of anthropometric data from nutritional surveys in developing countries is discussed.