Saira Afzal Dean of Public Health and Preventive Medicine KEMU Grow Healthy Pakistan Current Situation Epidemiology Clinical features of kwashiorkor and Marasmus and their Differences ID: 919499
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Slide1
Grow Healthy Pakistan
Prof Dr Saira AfzalDean of Public Health and Preventive Medicine, KEMU
Slide2Grow
Healthy PakistanCurrent SituationEpidemiologyClinical features of kwashiorkor and Marasmus and their DifferencesBiochemical and Metabolic Changes
Prevention
A way forward
Slide3Stunted Growth
Children are defined as stunted if their height-for-age is more than two standard deviations below the WHO Child Growth Standards median.
Slide4Stunting is the impaired growth and development that children experience from:
poor nutrition, repeated infection, and poor sanitation condition.
Slide5Among Children 6-23 months of age, only 12% are fed according to the criteria of minimum acceptable diet
Slide6More than one in every
three children born in Pakistan today is stunted.240 Million Children have growth retardation
(https://www.thenews.com.pk/print/361890-number-of-stunted-and-wasted-children-in-pakistan
)
Slide7Types of PEM
Weight for age less than60%
Weight for age less than 80%
Weight for age less than 60% with edema
Slide8Slide9Epidemiology of Malnutrition
Global Burden- Starts In Womb And Ends In TombAffects every 4th Child worldwideMore than 50% deaths are associated with MalnutritionMedian Case fatality rate is 23.5% in severe malnutrition and 50% in edematous Malnutrition
Slide10Pathogenesis Of
Marasmus
Muscle wasting
Slide11Pathogenesis of Kwashiorkor
Hepatomegaly
Hypoalbuminemia
Decreased
Oncotic
Pressure
Fluid Imbalance
Edema
Slide12Kwashiorkor
Condition of Protein Malnutrition Moon Face with little interest in surroundings
Edema of legs
Swollen Abdomen
Protein Intake deficient
Generalised
Muscle Wasting
Hyponatremia
Marasmus
Severe Growth Retardation
Total Caloric Malnutrition
Fat wasting
Oedema
Mental Changes
Weight for Height Low
Slide14Clinical
features Kwashiorkor
Marasmus
Growth Failure
Present
Present
Wasting
present
Present , Marked
Edema
Present , Mild sometimes
Absent
Hair Changes
Common
Less Common
Mental Changes
Very
Common
Uncommon
appetite
Poor
Good
Anemia
Severe
Sometimes
Present , Less severe
Fatty
infiltration of Liver
Present
Absent
Subcutaneous Fat
Reduced but present
Absent
Face
Edematous maybe
Drawn in Monkey like
Slide15Differential Diagnosis of Malnutrition
Slide16Biochemical and Metabolic Changes
Hypoalbuminemia (10-25g/l)Plasma Cortisol and Growth levels are highPercentage of body water increasedElectrolytes especially K are depleted
Decreased Urinary Excretion of Urea
Iron Deficiency Anemia and Metabolic Acidosis
Slide17Prevention
Provision of Adequate NutritionProvision of ProteinHigh Energy Food during PregnancyEducationFood SupplementsBetter School Health ServicesBetter Feeding PracticesAwareness Campaigns
Slide18First two years of life
Maternal Nutrition and LiteracyBetter Feeding PracticesEducational and Policy ReformsSchool Health Services
Slide19Thank You