Therapeutic feeding in Sarajevo during the war.

OBJECTIVE To monitor the growth of underweight children enrolled in a therapeutic feeding programme in Sarajevo during the war. DESIGN About 17% of the total child population in the age group one to 14 years were assessed for eligibility to join a therapeutic feeding programme. All those who were found to be underweight (weight for age < 10th percentile), or suffering from certain diseases or disabilities were included in the programme. SETTING Monitoring took place in health centres and clinics in besieged Sarajevo. SUBJECTS A total of 49,780 children aged one to 14 years were estimated to be living in Sarajevo between May 1993 and March 1994 and 8361 (16.8%) were assessed during this period. Of these, 1283 (2.6% of the total child population) were found to be underweight and enrolled in the programme. INTERVENTIONS The public were informed about the therapeutic feeding programme through the media. All children who came forward for initial assessment were weighed, had their heights measured and were medically examined by a team of medical personnel. Those found to be underweight were included in the programme which provided high quality food items, donated as food parcels. Children were re-weighed at three monthly intervals. When a child's weight increased to 0.5 kg above 10th percentile, the child left the programme. RESULTS Of 1283 children enrolled in the programme, 650 (50.7%) were suffering from chronic diseases while the remaining 633 (49.3%) were underweight only. Undernutrition was highest in the four to six year old age group (19.3% with low weight for age). Over half (58.3%) of the children who were underweight but not sick gained a satisfactory weight during the study period and left the programme. CONCLUSIONS The results suggest that the therapeutic feeding programme was successful in improving growth in a self-selected sample of underweight children.