Human Nutrition 3(3+0)

Lesson 18 : Proteins

Kwashiorkor

A Ghanian word for "the evil spirit that infects the child", was first described in 1933 and typically occurs in children between 2 - 4 years old fed diets high in carbohydrates with little or no protein. Signs and symptoms of kwashiorkor include:

Kwashiorkor
A disease occurring primarily in young children when disease and infections add to high demands for growth. When the child consumes insufficient k calories and protein, kwashiorkor may result. Edema, moderate weight deficit and weakness /Nutritional deficiencies are common symptoms.

1. Growth Failure: This is manifested by decreased body length and low body weight. This growth retardation is primarily due to the general quantitative lack of proteins.

2. Mental Changes: Several workers have stressed on the constant finding of mental changes described as apathy and peevishness. In advanced cases, children tend to live in an inert listless condition and show no interest in the surroundings.

3. Oedema: Oedema occurs at first in the feet and lower legs and they may involve the hands, the thighs and face. The oedema is mainly due to lowered serum albumin and probably also due to high sodium and low potassium levels in serum.

4. Muscle wasting: Muscle wasting is a constant feature of Kwashiorkor and a reduction in the circumference of the upper arm is usually evident. It is less affected by oedema than in the forearm or leg.

5. Moon –face: The full well-rounded face, known as moon-face, is often present in kwashiorkor.

6. Liver changes: Liver is slightly enlarged and fatty infiltration of liver is usually present..

7. Gastro-intestinal Tract: Loss of appetite and vomiting are common. Diarrhoea is present in most cases.

8. Skin and hair changes: The characteristic skin changes in kwashiorkor are known as the ‘cragy pavement’ dermatosis. This is most marked on the buttocks, backs of thigh and axille. These lesions consist of dark hyperpigmental brownish black areas of skin.

9. Anaemia: Anaemia is invariably present. It is due to the deficiency of iron and folic acid. Anaemia may be aggravated by parasitic infection which prevents the absorption of nutrients.

10. Vitamin deficiency: Signs and symptoms of vitamin A deficiency such as Xeropthalmia and keratomalacia are widely prevalent. Angular stomatitis and glossitis due to deficiency of riboflavin may be present.