Kwashiorkor: Causes, Risk Factors, Symptoms, Treatment

Kwashiorkor

Kwashiorkor is one of the two main types of severe protein-energy undernutrition. People with kwashiorkor are especially deficient in protein, as well as some key micronutrients. Severe protein deficiency causes fluid retention in the tissue’s edema, which distinguishes kwashiorkor from other forms of malnutrition. People with kwashiorkor may look emaciated in their limbs but swollen in their hands and feet, face and belly. The distended abdomen typical of kwashiorkor can be misleading in people who are critically malnourished. Kwashiorkor is rare in developed countries. It’s mostly found in developing countries with high rates of poverty and food scarcity. Poor sanitary conditions and a high prevalence of infectious diseases also help set the stage for malnutrition. Kwashiorkor can affect all ages, but it’s most common in children, especially between the ages of 3 to 5. This is an age when many children have recently transitioned from breastfeeding to a less adequate diet, the one higher in carbohydrates but lower in protein and other nutrients.

Symptoms of Kwashiorkor

If you suspect you or someone else is experiencing Kwashiorkor, it is crucial to seek immediate medical attention by calling emergency services or consult with a Nutritionist.

Causes

Social and economic factors: Poverty that results in low food availability, overcrowded and unsanitary living conditions and improper child care is a frequent cause. A decline in the practice and duration of breastfeeding, combined with inadequate weaning practices are the important causes of kwashiorkor. Biological factors: Infectious diseases are majorly contributing and precipitating factors of kwashiorkor. Diarrhoeal diseases, measles and respiratory and other infections results in negative protein and energy balance. This is due to anorexia, decreased absorption and increased catabolic processes. Environmental Factors: Overcrowded and unsanitary living conditions lead to frequent infections like diarrhea. Agricultural patterns, droughts, floods, earthquakes, wars and forced migrations lead to cyclic, sudden or prolonged food scarcities. Post-harvest losses of food can occur due to bad storage conditions and inadequate food distribution.

Risk Factors

Ø Conditions that interfere with protein absorption such as cystic fibrosis Ø Dietary changes for management of milk allergies in infants and children Ø Diets that is low in protein such as a vegan diet Ø Drought or famine Ø Infections that interfere with protein absorption Ø Limited food supply, as may occur during political unrest Ø Parasites such as intestinal worms Ø Poor education about proper nutrition Ø Prolonged hospitalization or residence in a nursing home

Symptoms

Ø Low birth weight in spite of Edema (swelling with fluid, especially in the ankles and feet) showing growth failure. Ø Mental changes like apathy and irritability are common. Ø Bloated stomach with ascites (a build-up of fluid in the abdominal cavity). Ø Dry, brittle hair, hair loss and loss of pigment in hair. Ø Dermatitis— dry, peeling skin, scaly patches or red patches. Ø Enlarged liver, a symptom of fatty liver disease. Ø Depleted muscle mass but retained subcutaneous fat (under the skin). Ø Dehydration. Ø Loss of appetite anorexia. Ø Irritability and fatigue. Ø Stunted growth in children.

Diagnosis

Kwashiorkor can be diagnosed by physically examining the child and observing its telltale physical signs. Ask about the child’s diet and history of illnesses or infections. Measuring the child’s weight-to-height ratio and height-to-age and score them according to various charts. The weight-to-height score tells how severe the child’s condition is. The height-to-age score tells how much the child's growth has been affected by malnutrition.

Treatments

Ø Periodic surveillance. Ø Treatment of infections and diarrhea. Ø Development of programs for early rehydration of children with diarrhea. Ø Development of supplementary feeding programs during epidemics. Ø Deworming of heavily infested children.

Preventive Measures

Ø Education of the disease: Some populations simply aren’t informed of basic nutrition, the benefits of breastfeeding or the nutritional needs of children and mothers. Ø Nutritional support: The WHO and other organizations are working to reintroduce native crops that offer sources of protein and micronutrients in affected countries. They have developed nutritional formulas made from locally available resources, such as skim milk and peanuts. Ø Disease control: Widespread diseases and infections weaken the immunity of high-risk populations. Diseased bodies require more nutritional resources and could shed calories through chronic diarrhea. Diseases also deplete a community’s material resources, breeding poverty. Improved sanitation and immunizations can go a long way toward preventing malnutrition.

Do's & Don’t's

Do's Don't
Provide therapeutic feeding Avoid high-fat diets
Offer protein-rich foods Don't rely solely on carbohydrates
Ensure sufficient calorie intake Avoid excessive fluid intake
Administer vitamin and mineral supplements Don't give foods high in refined sugars
Monitor and treat infections promptly Avoid overfeeding abruptly
Use fortified foods or therapeutic formulas Don't force-feed or overstuff the child
Gradually reintroduce a balanced diet Avoid foods that may exacerbate symptoms
Provide clean water and proper hygiene Don't neglect regular medical check-ups
Encourage breastfeeding or appropriate alternative Avoid neglecting the child's emotional needs

If you suspect you or someone else is experiencing Kwashiorkor, it is crucial to seek immediate medical attention by calling emergency services or consult with a Nutritionist.

Frequently Asked Questions
Kwashiorkor is a type of severe malnutrition characterized by a deficiency of protein in the diet. It often occurs in children, particularly in areas where there is a lack of access to a balanced and nutritious diet.
The primary cause of Kwashiorkor is insufficient protein intake, often in combination with a diet lacking essential nutrients. It is prevalent in regions where there is limited access to protein-rich foods.
Symptoms of Kwashiorkor include swelling (edema), particularly in the legs and feet, along with a distended belly. Other signs may include skin changes, hair discoloration, fatigue, irritability, and a failure to grow or gain weight.
Diagnosis is typically based on clinical signs and symptoms, such as edema and nutritional deficiencies. Laboratory tests may also be conducted to assess protein levels and other nutritional markers.
Yes, Kwashiorkor can be treated with a well-balanced and nutritious diet that includes sufficient protein, calories, vitamins, and minerals. In severe cases, hospitalization may be necessary to provide specialized care.
Kwashiorkor is more prevalent in developing countries where there is a lack of access to adequate nutrition. It can occur in regions facing food shortages, poverty, and inadequate healthcare.
Yes, Kwashiorkor can be prevented by ensuring access to a balanced and nutritious diet that includes sufficient protein, vitamins, and minerals. Public health measures, education, and support for vulnerable populations are crucial for prevention.
While Kwashiorkor is most commonly associated with children, severe malnutrition can affect individuals of any age. However, children are particularly vulnerable due to their rapid growth and development.
If treated promptly and effectively, the majority of children with Kwashiorkor can recover without significant long-term consequences. However, in severe cases or if left untreated, Kwashiorkor can lead to lasting developmental and health issues.
Individuals can contribute to the prevention of Kwashiorkor by supporting organizations that work on improving nutrition in vulnerable communities, raising awareness about the importance of balanced diets, and advocating for policies that address food insecurity and poverty.
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