Acute and chronic malnutrition and micronutrient deficiencies have been found in refugee camp populations (1). In southeastern Nepal, despite consistent access by refugees to general rations,* certain micronutrient deficiencies have posed a substantial health burden to the approximately 100,000 Bhutanese residing in seven refugee camps (2). Limited food diversity, frequent illness, and poor feeding practices have been cited as underlying causes of poor nutritional status in this population. Annual surveys to assess levels of acute malnutrition (ie, wasting) and chronic malnutrition (ie, stunting) have been conducted in these camps by the Association of Medical Doctors of Asia (AMDA) and United Nations High Commissioner for Refugees (UNHCR); however, the capacity to reliably evaluate micronutrient deficiencies has not existed locally in the camps (3). In January 2007, AMDA and CDC, at the request of UNHCR and the World Food Programme (WFP), conducted a nutritional survey of children aged 6-59 months, assessing 1) the prevalence of acute malnutrition, chronic malnutrition, underweight, anemia, and angular stomatitis (ie, riboflavin deficiency); 2) the cumulative incidence of diarrhea and acute respiratory illness (ARI); and 3) the feeding practices of the children's mothers. This report describes the results of that survey, which indicated that, although acute malnutrition was found in only 4.2% of the children, chronic malnutrition was found in 26.9% and anemia in 43.3%. These findings underscore the importance of monitoring both malnutrition and micronutrient deficiencies and addressing the underlying causes of nutritional deficits.

In 1991, approximately 100,000 Bhutanese mostly of Nepali origin began fleeing ethnic persecution in Bhutan and now live in seven refugee camps in southeastern Nepal. This refugee population has been stable since 1993 but remains dependent on food assistance. During January 28-February 6, 2007, a cross-sectional survey was conducted in the Bhutanese refugee camps. The number of households selected in each camp was proportional to the size of the camp; individual households were selected using a systematic random sampling method. Information was collected regarding all children aged 6-59 months in each household by interviewing their mothers. Questions were asked regarding foods eaten by their children within the preceding 24 hours, incidence of diarrhea (ie, three or more episodes within the preceding 24 hours) or ARI (ie, fever plus either cough or difficulty breathing) in children within the preceding 14 days, and beliefs regarding their practices for feeding their children. In addition, the children's weight and height measurements, hemoglobin levels, and presence of clinical signs of angular stomatitis were assessed.