Kwashiorkor
Kwashiorkor
What Are the Symptoms of Kwashiorkor?
Kwashiorkor (kwash-e-OR-kor) is a form of severe malnutrition that affects children living in poverty in tropical and subtropical parts of the world. It is caused by a lack of protein in the diet. Kwashiorkor stunts growth and causes children to have bloated bellies and thin arms and legs.
KEYWORDS
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Malnutrition
Marasmus
Protein energy malnutrition
Tanya’s Story
Tanya lived outside of Tubmanburg in Liberia with her parents and four older brothers and sisters. Her family was poor, and her parents had a hard time feeding all of the children. Nevertheless, Tanya was a healthy infant because she was breastfed; breast milk contains all of the protein and other nutrients a baby needs. But when Tanya was just over a year old, her mother had another baby and Tanya could no longer breastfeed. Instead, she had to eat the only food available: white rice, cassava, and yams. These foods contain mostly carbohydrates and have almost no protein. Because of the lack of protein in Tanya’s diet, she developed kwashiorkor: her stomach was bloated, her arms and legs grew very thin, her skin flaked, and she was very weak. Tanya is typical of children from all around the world whose families are too poor to feed their children the nourishing food they need.
What Is Kwashiorkor?
Kwashiorkor is a disease caused by the lack of protein in a child’s diet. Kwashiorkor is a type of protein energy malnutrition (PEM) that is widespread throughout the developing world. Infants and children growing up in tropical or subtropical areas (such as Africa, Asia, and South America) where there is much poverty are at risk for kwashiorkor.
The term “kwashiorkor” comes from a word used in Ghana that means a “disease of a baby deposed from the breast when the next one is born.” Kwashiorkor usually happens when a baby is weaned from protein-rich breast milk (for any reason) and switched to protein-poor foods. In impoverished countries, protein-rich foods are difficult to acquire.
What Are the Symptoms of Kwashiorkor?
Children with kwashiorkor have edema (excess water retention in body tissues), which makes them look puffy and bloated. They are weak and irritable, and in many cases their skin flakes, and their hair loses its curliness and color. If left untreated, kwashiorkor causes enlargement of the liver, loss of fluids (dehydration) from the bloodstream even when the child has edema, stunted growth, and severe infection due to a weakened immune system. It also can result in jaundice, drowsiness, and a lowered body temperature.
How Is Kwashiorkor Treated?
An international team of medical workers traveling in Liberia saw Tanya sitting on the ground too tired to play and realized how sick she was. They took her to the hospital in Tubmanburg, where she was kept warm and given fluids to replace those she had lost. Initially, she was given small amounts of milk and vitamin and mineral supplements. Zinc supplements helped stop her skin from flaking. After the edema went away, the doctors gave her a high-calorie diet rich in protein.
Of the children who are hospitalized and treated for kwashiorkor, 85 percent survive. Most children properly treated for kwashiorkor early enough recover completely. However, children who develop kwashiorkor before the age of two, like Tanya, usually experience stunted growth.
Can Kwashiorkor Be Prevented?
Because kwashiorkor is a dietary deficiency disease, it can be prevented by eating a well-balanced diet. However, in many parts of the world, people are too poor to provide their families with protein-rich foods, or such foods are not available. International efforts to provide food and to teach people about growing different kinds of foods, eating the right foods, and ways to limit family size are helpful in the fight against malnutrition, but it remains an ongoing problem in developing countries.
See also
Dietary Deficiencies
Jaundice
Resource
Tamberlane, William. Yale Guide to Children’s Nutrition. New Haven:
Yale University Press, 1997.
Kwashiorkor
Kwashiorkor
The term kwashiorkor , meaning "the disease of the displaced child" in the language of Ga, was first defined in the 1930s in Ghana. Kwashiorkor is one of the more severe forms of protein malnutrition and is caused by inadequate protein intake. It is, therefore, a macronutrient deficiency.
Kwashiorkor is largely a problem in the developing world, although it can be found in geriatric and hospitalized patients in Western nations. Generally, kwashiorkor occurs when drought, famine , or societal unrest leads to an inadequate food supply. Protein-depleted diets in such areas are mostly based on starches and vegetables, with little meat and animal products. A lack of maternal understanding regarding balanced diets further contributes to the problem. Finally, infections and other disease states negatively impact nutrient intake, digestion, and absorption .
Children are most at risk due to their increased dietary needs. Inadequate caloric and protein intake manifests itself with certain physical characteristics. Symptoms may include any of the following: failure to gain weight, stunted linear growth, generalized edema , protuberant (swollen) abdomen, diarrhea, skin desquamation (peeling) and vitiligo (white spots on the skin), reddish pigmentation of hair, and decreased muscle mass. Mental changes include lethargy, apathy, and irritability. Physiologic changes include a fatty liver, renal failure , and anemia . During the final stages of kwashiorkor, patients can experience, shock , coma, and, finally, death.
Treatment of kwashiorkor begins with rehydration. Subsequent increase in food intake must proceed slowly, beginning with carbohydrates followed by protein supplementation. If treatment is initiated early, there can be a regression of symptoms, though full height and weight potential will likely never be reached.
see also Malnutrition; Marasmus; Nutritional Deficiency; Protein.
Seema P. Kumar
Bibliography
Latham, Michael (1997). Human Nutrition in the Developing World. Rome: Food and Agricultural Organization of the United Nations.
Trowell, H. C.; Davis, J. N. P.; and Dean, R. F. A. (1982). Kwashiorkor. New York: Academic Press.
Internet Resources
World Health Organization (1996). WHO Global Database on Child Growth and Malnutrition. Available from <http://www.who.int/nutgrowthdb>
Kwashiorkor
Kwashiorkor
One of many severe protein energy malnutrition disorders that are a widespread problem among children in developing countries. The word's origin is in Ghana, where it means a deposed child, or a child that is no longer suckled. The disease usually affects infants between one and four years of age who have been weaned from breast milk to a high starch, low protein diet. The disease is characterized by lethargy, apathy, or irritability. Over time the individual will experience retarded growth processes both physically and mentally. Approximately 25% of children suffer from recurrent relapses of kwashiorkor, interfering with their normal growth.
Kwashiorkor results in amino acid deficiencies which inhibit protein synthesis in all tissues. The lack of sufficient plasma proteins, specifically albumin, results in systemic pressure changes, ultimately causing generalized edema. The liver swells with stored fat because there are no hepatic proteins being produced for digestion of fats. Kwashiorkor additionally results in reduced bone density and impaired renal function. If treated early on in its development the disease can be reversed with proper dietary therapy and treatment of associated infections. If the condition is not reversed in its early stages, prognosis is poor and physical and mental growth will be severely retarded.
See also Sahel; Third World