A three-village nutrition and infection field study in Guatemala 1959-1964.

Between May 1959 and April 1964 researchers conducted a prospective field study of nutrition and infections among children under 5 years of age in Santa Maria Cauque (treatment village [mainly curative services and immunization]) Santa Catarina Barahona (the feeding village) and Santa Cruz Balanya (the control village in the highlands of Guatemala. More than 90% of the population in all 3 villages were Mayan Indians. The feeding program consisted of 2 parts: a food supplement and nutrition activities for mothers. Even though the feeding program intended to increase caloric intake 33% and increase intake of high quality protein by 50% the program did not reach these goals. The percent of children who did receive the intended amount of supplement fell steadily from 51% to 18% over the 5 years. The percent who were not part of the feeding program rose from 11% to 37% between 1960 and 1961 then hovered around 20% for the remaining 3 years. The original researchers closely controlled the project during the first 3 years but 1 researcher who was only interested in his own research was responsible for the project during the last 2 years. Mothers from all 3 villages exclusively breast fed their infants for the first 3 months of life. They tended to begin weaning at 8-9 months. Some mothers still breast fed for more than 24 months. Child mortality declined the most in the feeding village. Children who received at least 75% of the intended food supplements had the lowest total number of days with an infection and duration of illness episodes per child. The prevalence of infectious diseases their severity and consequences improved even in children who received more than 50% of the advised supplement. The leading infections were diarrhea and respiratory infections. This study showed that the only important benefit in the treatment village was that the medical center saved the lives of children who were severely ill. Yet these lives did not exceed those lives saved by the food supplement.