Effect of nutrition improvement project on morbidity from infectious diseases in preschool children in Vietnam: comparison with control commune

Abstract

Objective: To evaluate the effect of a nutrition improvement project based on home garden production and nutrition education on morbidity from acute respiratory infection and diarrhoeal disease in preschool children.

Design: The morbidity survey comprised five data collections undertaken by trained interviewers to ascertain the incidence and severity of respiratory infections and the incidence of diarrhoeal disease in children in two communes.

Setting: A project commune and a control commune in Vietnam.

Subjects: Preschool children to 6 years of age living in the project commune Khai Xuan (average 469 children) and the control commune Ching Cong (average 251 children).

Main outcome measures: Differences between the two communes over time in the incidence and severity of respiratory infections and the incidence of diarrhoeal disease.

Results: In Khai Xuan there was a significant reduction (P < 0.0001) in the incidence of respiratory infections (from 49.5% to 11.2%) and diarrhoeal infections (18.3% to 5.1%); the incidence of pneumonia and severe pneumonia was also significantly reduced (P < 0.0001). In Ching Cong there was no significant change in the incidence and severity of respiratory disease nor in the incidence of diarrhoeal disease.

Conclusions: These findings emphasise the successful health outcome of a nutrition project based on household food production and nutrition education and the value of evaluating nutrition projects by reference to measurable health outcomes.

PIP: A nutrition program based on home garden food production and nutrition education for mothers of young children was associated with significant reductions in morbidity from acute respiratory infection and diarrheal disease in preschool children in Viet Nam's Vinh Phu province. The nutrition program was implemented in Khai Xuan commune during 1991-93; Ching Cong commune, which did not receive the intervention, served as the control community. In Khai Xuan, the incidence of respiratory infections among children under 6 years of age decreased from 49.5% to 11.2% during the study period, while that of diarrheal disease dropped from 18.3% to 5.1%. The nutrition project was also associated with significant declines in severe pneumonia. No changes in morbidity occurred in the control commune. The intervention resulted in significantly higher intakes of vegetables, fruit, energy, protein, vitamin A, and iron by project children compared with controls. It is recommended that nutrition improvement be adopted as an infectious disease control strategy in international and national development programs, especially those in countries where respiratory and diarrheal infections are the major cause of child morbidity and mortality.