Acute Malnutrition Among Children, Mortality, and Humanitarian Interventions in Conflict-Affected Regions - Nigeria, October 2016-March 2017.

Abstract

A public health emergency was declared by the Nigerian Federal Ministry of Health in northeastern Nigeria in June 2016 and escalated by the United Nations to a Level 3 Emergency in August 2016, after confirmation of wild poliovirus and measles outbreaks and evidence that prevalence of acute malnutrition exceeded emergency thresholds in areas newly liberated from Boko Haram control (1,2). To monitor rates of mortality, acute malnutrition among children, infectious disease morbidity, and humanitarian interventions after the emergency declaration, a series of cross-sectional household surveys were conducted in fall 2016 and winter 2017 in the northeastern states of Borno and Yobe using a cluster methodology. All-cause mortality among all age groups (crude mortality) and among children aged <5 years (under-five mortality) were above emergency thresholds in 2017 and significantly increased from 2016, despite evidence of increased preventive public health interventions, including measles vaccination. Access to treatment for common childhood illnesses remained very low, as evidenced by reports of fewer than one in six children in areas outside Borno's capital receiving any care for diarrhea. The data from these surveys provide evidence of excessively high mortality (particularly among children), highlight the impact of ongoing violence, and underscore the need for humanitarian efforts to scale up access to treatment services in conflict-affected areas.