Asunto(s)
Salud de la Familia , Mortalidad , Estado Nutricional , Preescolar , Humanos , Lactante , Recién Nacido , PerúRESUMEN
Among Amerindian children living at high altitude in the Andes in southern Peru, high child mortality rates have been reported in the literature, especially in the perinatal and neonatal period. We compared mortality rates in children calculated from retrospective survey data in 86 rural families from 2 Aymara and 3 Quechua peasant communities living at the same level of altitude (3825 m) in southern Peru. Relations between land tenure, socio-cultural factors and child mortality were studied, and methodological considerations in this field of interest are discussed. Checks on consistency of empirical data showed evidence for underreporting of neonatal female deaths with birth order 3 and more. Perinatal (124 vs 34 per 1000 births) and infant mortality (223 vs 111 per 1000 live births) was significantly higher in Aymara compared with Quechua children, but no difference was found after the first year of life. A short pregnancy interval was associated with an elevated perinatal and infant mortality rate, and a similar albeit insignificant association was found with increased maternal age. Amount of land owned and birth order were not related with child mortality. Although levels of maternal education are generally low in both cultures, a consistent decline in infant and child mortality was found with the amount of years mothers had attended school. However, the results suggest a U-shaped relationship between the amount of years of parental education and perinatal mortality in offspring. Late fetal and early neonatal mortality were particularly high in one Aymara community where mothers were found to have more years of education. Infanticide, a known phenomenon in the highlands of the Andes, is discussed in relation with the findings of the study. Although maternal and child health services are utilized by the majority of families in 4 of 5 study communities, 43 of 51 mothers under the age of 45 years reported that they delivered their last baby in the absence of traditional midwives or official medical supervision.
Asunto(s)
Características Culturales , Encuestas Epidemiológicas , Indígenas Centroamericanos , Mortalidad Infantil , Adulto , Altitud , Niño , Preescolar , Femenino , Humanos , Lactante , Recién Nacido , Infanticidio , Masculino , Perú/epidemiología , Proyectos de Investigación , Estudios Retrospectivos , Factores SocioeconómicosRESUMEN
Physical growth of Amerindian children living in two Aymara and three Quechua peasant communities in the Andean highlands of southern Peru (altitude 3,810-3,840 m) was studied, taking into account differences in the microclimate, agronomic situation, and sociodemographic variables. Anthropometric measurements were taken in 395 children aged under 14 years of age in a sample of 151 families in these communities, who were surveyed for sociodemographic variables as well. Data on the land system were available for 77 families. In comparison with reference populations from the United States (NCHS) and The Netherlands, stature, weight, head circumference, and midupper arm circumference (but not weight for stature) in the sample children were reduced. Growth retardation increased after the age of 1 year. Stature and weight in the present sample were very similar compared with previously published data on growth of rural Aymara children living near Lake Titicaca in Bolivia. Head circumference, midupper arm circumference, and weight for stature were significantly larger in Aymara children compared with Quechua children. Land was significantly more fragmented in Aymara compared with Quechua families, but amount of land owned was not different. Perinatal and infant mortality was elevated in Aymara vs. Quechua communities. Most families in Aymara communities used protected drinking water. One Quechua community had a severe microclimate, grim economic outlook, and weak social cohesion. Children in this community showed significant reductions in weight and midupper arm circumference compared with their peers in the other communities. We conclude that (presumably nutritionally mediated) intervillage and Aymara-Quechua differences in childhood physical growth existed in this rural high-altitude population in Peru and were associated with microclimate and the village economy, sociodemographic factors, and differences in the land system.
Asunto(s)
Altitud , Trastornos del Crecimiento/epidemiología , Indígenas Sudamericanos , Adolescente , Antropometría , Niño , Preescolar , Características Culturales , Femenino , Trastornos del Crecimiento/diagnóstico , Trastornos del Crecimiento/etnología , Encuestas Epidemiológicas , Vivienda/normas , Humanos , Lactante , Masculino , Microclima , Encuestas Nutricionales , Estado Nutricional , Perú/epidemiología , Factores de Riesgo , Población Rural , Factores SocioeconómicosRESUMEN
During the fieldwork on illness in children in an Aymara peasant community in Southern Peru, data was collected on child mortality. In 35 families surveyed in the village, the total child mortality rate was estimated diachronically at 380 per 1,000 live births. The majority of the child death in these families occurred in the first days after birth. These deaths were also counted as perinatal deaths, and thus the perinatal mortality rate was found to be high as well at 252 per 1,000 total births (99% confidence interval: 181-330 per 1,000). Congenital malformations incompatible with life, neonatal tetanus, and other neonatal disorders did not have an especially high frequency in the village. These disorders seem to explain only a part of the early neonatal deaths responsible for the high mortality rates in children. As perinatal deaths were concentrated in 13 of the 35 families in the survey (especially in those families with many total births and at least two living children), the possibility of infanticide was put forward to explain the high death rates in children in the first days of life. This hypothesis was supported by practices in the village concerning the baptism of dead children by which the cause of death was left unsanctioned. Infanticide could be important to curb recent and future population growth and the resulting pressure on the land.