Kwashiorkor and Marasmus

Introduction to Kwashiorkor and Marasmus

Adequate nutrition is the intake and utilization of energy-giving and body building foods and nutrients in the right proportions to maintain well-being, and productivity.
Malnutrition manifests as stunting, underweight, wasting (kwashiorkor and marasmus), obesity as well as deficiencies of micronutrients.

Epidemiology

High prevalence in under-developed countries, especially sub-Saharan Africa

Clinical features of Kwashiorkor and Marasmus

Kwashiorkor:

  • Growth retardation
  • muscle wasting
  • anaemia
  • apathy
  • moon face
  • lack luster skin easily plucked hair
  • pedal oedema
  • hypo-pigmented skin patches
  • exfoliation
  • diarrhoea

Marasmus:

  • Thin
  • protruding bones
  • hungry-looking ‘old-looking face,’
  • whimpering cry

Investigations

  1. Full Blood Count,
  2. ESR
  3. Stool microscopy
  4. Urinalysis,
  5. Serum proteins,
  6. Chest radiograph,
  7. Mantoux test

Non-drug treatment

  • Nutritional counselling
  • Adequate nutrient intake: may require assistance and special preparations e.g. nasogastric feeding,
  • Periodic growth monitoring

Drug treatment for Kwashiorkor and Marasmus

This may be indicated where there are specific infections/infestations