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Results

Seasonal Events and Families' Energy and Protein Intakes

Two independent groups of families were studied: one group in year 1 and the second in year 2. There was no consistent pattern of higher protein or energy intakes for a given period across years. Repeated measurements of ANOVAs during different periods over two distinct years are summarized in table 4. These ANOVAs showed no differences in protein and energy intakes by year (P>0.05) or by the presence or absence of rains (P>0.05). Energy intakes during the non-harvest periods were marginally higher than those in the harvest months (P<0.10)

As shown in table 4, there was a different interaction between rainy and harvest periods in the energy and protein intakes of families in years 1 and 2 (P<0.001). However, the effects of the harvest and of the interaction of rain and the harvest on the energy and protein intakes of families were consistent across years (P>0.05)

Seasonal Events and Mothers' Energy and Protein Intakes

The information on mothers' diets expressed as intakes of energy and protein (x ± SEM) is summarized for the eight seasonal periods included in years 1 and 2 in table 5. The ANOVA analyses of main effects did not indicate any significant relationship of mothers' energy and protein intakes by year to the presence or absence of rains or to the presence or absence of harvest. Also, there were no significant interactions of rain, harvest, and years with mothers' energy and protein intakes.

The energy and protein intakes were not as low as others reported for rural areas of Guatemala. None of the mean intakes of energy for mothers, measured in the eight periods under analysis, was below 2,100 calories (see table 5). The rain/no harvest period in the second year showed the highest mothers' energy intake-2,388 calories. As for proteins, the highest mothers' intake is identified during the second year (the no rain/no harvest period).

There was a lack of a consistent pattern suggesting a significant increase in or reduction of mothers' energy or protein intakes across years, or in rainy, non-rainy, harvest or non-harvest periods.

TABLE 5. Energy and protein intakes of two groups of mothers (1977-1979)

TABLE 6. Energy and protein intakes for children (1977-1979)

Seasonal Events and Children's Energy and Protein Intakes

The means and the standard deviations for energy and protein intakes of children studied in eight periods for 24 months are summarized by period in table 6. When energy and protein intakes were corrected by age in the ANCOVAs, the only main effects that approached significance were: those of harvest (P<0.10) on energy intake; the co-variable for years, for protein intake (P<0.05); and years for protein intakes (P>0.10). The interactions of energy and protein intakes of children, corrected by age, showed that the marginally significant main effect of harvest was no. consistent across years since the interaction of the variables of year and harvest was significant (P<0.05). Similarly, there was an interaction for rain and harvest in energy intakes (P<0.05) that was consistent across years.

For the same group of study children classified into three age groups, the analyses of main effects for energy intake approached statistical significance in the co-variable for years (P<0.10) and for harvest (P<0.10). There were, however, highly significant effects (p<0.01) for protein intakes in the co-variable for years and for years 1 and 2. No other main effects were detected in protein intakes, but the interaction of year/age group is significant (P<0.05), as is the co-variate for year/harvest (P<0.05),

Seasonal events and food consumption

Family Diets

Table 7 presents data on family food consumption, expressed as grams per consumption unit, for frequently consumed foods (beans, maize, sugar, vegetables, solid miscellaneous). Analysis of variance of food consumption in families followed longitudinally in two distinct years indicated no significant differences in three of the five most frequently consumed food groups-beans, vegetables, and sugar-during the eight study periods. However, for maize, there was a significant difference with the harvest season (P<0.05) and with rain (P<0.01). Solid miscellaneous foods also showed significant variation with rainfall (P<0.01).

TABLE 7. Food consumption for families (1977-1979)

With regard to main effects, the consumption of maize was higher in non-rainy than in rainy periods (P<0.01).) and in harvest than in non-harvest months (P<0.05). Conversely, the consumption of solid miscellaneous foods was higher in rainy than in non-rainy months (P<0.01). No significant differences in the consumption of other frequently consumed foods were observed in harvest/ non-harvest months, rainy/non-rainy months, or periods (years) 1 and 2.

Children's Diets

Table 8 shows the values for mean consumption (grams) of the five foods most frequently consumed by children followed longitudinally for 24 months; the values have been adjusted by age through ANCOVAs. In the analyses of co variance derived from this data set, the only significant difference in consumption of foods was seen in maize for harvest/non-harvest months (P<0.05). The interaction rain/harvest for maize was also statistically significant (P<0.01)

TABLE 8 Food consumption for children (1977-1 979)

TABLE 9 Percentage of days ill for children (1977-1978)^a

a. N=171.

TABLE 10. Summary of ANOVAs for percentage of days of illness in children studied longitudinally for a year (1977-1978)^a

a. N=171.
b. P<0.05.
c. P<0.01.
d. P<0.001.

Seasonal Events and Incidence of Diseases in Children

Table 9 indicates the presence or absence in children of nasal secretion, fever, diarrhoea, cough, and stools with blood and mucus, expressed as a percentage of days ill (x + SEM), during four seasonal periods from November 1977 to October 1978. Nasal secretion and diarrhoea peaked in the rain/no harvest periods, with 21.5 per cent and 11.2 per cent of days of illness respectively. The rain/no harvest and no rain/no harvest periods exhibited the highest incidence of fever and cough. The higher incidence of stools with blood and mucus was seen from 1 August to 30 October 1978, that is, the rain/no harvest and rain/harvest periods.

The ANOVAs in table 10 suggest that the rain/no harvest period from 1 May to 30 July 1978 and the no rain/no harvest period from 1 February to 30 April 1978 exhibit the highest incidence in all diseases tested for, except stool with blood and mucus, which peaked during the rain/harvest period from 1 August to 30 October 1978. Figure 1 is a graphic representation of days of illness for 171 children, expressed as a percentage (x ± SEM) of days ill with respect to the entire period under analysis. As is also reflected in table 10, nasal secretion, diarrhoea, and cough were similar in their pattern of occurrence. The periods with rain also exerted important effects on the incidence of stools with blood and mucus (P<0.01) but a lack of harvest does not produce a similar effect (P>0.05). Presence or absence of rains and of harvest were not reflected in a higher percentage of days with fever (P>0.05).

Table 11 presents the percentage of days in a year that children in three age groups had nasal secretion, cough, and diarrhoea for the four periods under analysis. Children were classified into one of these groups according to their age at the initiation of the first study period (1 November 1977 to 30 January 1978): less than 12 months, 12 to 23 months, and 24 and more months old.

As confirmed by the ANOVAs summarized in table 12 for children followed for 12 months, the children below 12 months old had marginally more days with nasal secretion (P<0.10) and significantly more diarrhoea (p<0.01) than their older counterparts. However, this pattern did not hold true for cough (P>0.05), fever (P>0.05), or stool with mucus and blood (P>0.05). The consistency of the morbidity findings, across aye groups, is also reflected in table 10. For cough and for stools with blood and mucus the interaction of the variables rain and age is not significant (P>0.05).

Percentage of days ill (`x ± SEM) with nasal secretion, fever, cough, and stools with mucus and blood

TABLE 11. Percentage of days ill for children (1977-1978)^a

a.N = 48 cases aged 12 months; n = 40 cases aged 12 to 23 months; n = 71 cases aged 24 months or more.

TABLE 12. Summary of ANOVAs for percentage age of days of illness in children (1977-1978)

a. P<0.05.
b. P<0.01.
c. P<0.001.

The incidences of fever (P<0.05), diarrhoea (P<0.10) and nasal secretion (P<0.10) in the three age group studies were affected differently by the presence or absence of rain. Age as well as the harvest is an important factor in determining the percentage of days with diarrhoea (P<0.05). Finally, as reflected in tables 11 and 12, with the exception of cough (P<0.05) the interaction of rain and harvest does not produce a different pattern of morbidity across age groups. Thus, the presence of diarrhoea and diarrhoea with blood and mucus are more important in rainy than in non-rainy periods.

Cough as well as nasal secretion are more frequent in non harvest than in harvest periods. The effect of rains on the presence of nasal secretion, cough, and diarrhoea is modified during non-harvest months. Thus, during non harvest months and rainy periods and their combinations children are more vulnerable to diseases.

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