Background It is well documented that treatment for severe acute malnutrition (SAM) is effective. However, little is known about the long-term outcomes for children treated for SAM. We sought to trace former SAM patients 11 to 30 years after their discharge from hospital, and to describe their longer-term survival and their growth to adulthood. Methods A total of 1,981 records of subjects admitted for SAM between 1988 and 2007 were taken from the archives of Lwiro hospital, in South Kivu, DRC. The median age on admission was 41 months. Between December 2017 and June 2018, we set about identifying these subjects (cases) in the health zones of Miti-Murhesa and Katana. For deceased subjects, the cause and year of death were collected. A Cox proportional hazards multivariate regression analysis was used to identify the death-related factors. For the cases seen, age-and gender-matched community controls were selected for a comparison of anthropometric indicators. Results A total of 600 subjects were traced, and 201 subjects were deceased. Of the deceased subjects, 65�6% were under 10 years old at the time of their death. Of the deaths, 59�2% occurred within 5 years of discharge from hospital. The main causes of death were malaria (14�9%), kwashiorkor (13�9%), respiratory infections (10�4%), and diarrhoeal diseases (8�9%). The risk of death was higher in subjects with SAM, MAM combined with CM, and in male subjects, with HRs* of 1�83 (p = 0�043), 2.35 (p = 0�030) and 1.44 (p = 0�013) respectively. Compared with their controls, the cases had a low weight (-1�7 kg, p = 0�001), short

Our analysis shows that childhood obesity and physical activity increase the occurrence of injuries. However, we did not observe an association between obesity and severe injuries. Obesity as a risk factor for the occurrence of injuries has to be confirmed by other studies, and the understanding of the mechanism for the observed association needs more investigation.

SummaryBackground: Multilevel approaches involving environmental strategies are considered to be good practice to help reduce the prevalence of childhood overweight.

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We review the present knowledge of risk factors for arterial hypertension. Both genetic and environmental factors as well as their interaction and biological plausibility are reviewed. Recent data confirm that the interaction of genetics with multiple environmental risk factors explains the high prevalence of hypertension in the industrialised countries. The most important modifiable environmental risk factors are high salt intake, alcohol intake, obesity and low physical activity. The role of stress in the aetiology of high blood pressure is still under investigation, but recent clinical experimental and epidemiological data have shed light on how stress could be related to hypertension. The implications for prevention and treatment are discussed both at the population and individual levels. The population approach involves a public health policy aiming at modification of the major risk factors. The individual approach involves nonpharmacological measures to prevent the development of hypertension and to treat high normal blood pressure and mild hypertension with no additional cardiovascular risk factors. Pharmacological treatment of hypertension in most individuals should use agents that have been proven to be effective in randomised controlled trials with 'hard' endpoints such as cardiovascular and cerebrovascular morbidity and mortality.