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Management of kwashiorkor pdf

4.10 Dermatosis of kwashiorkor 19 5. Rehabilitation 20 5.1 Principles of management 20 5.2 Nutritional rehabilitation 20 Feeding children under 24 months 20 Feeding children over 24 months 21 Folic acid and iron 21 Assessing progress 22 5.3 Emotional and physical stimulation 22 The environment 23 Play activities 23 Physical activities 2 Children with marasmus, marasmic kwashiorkor, and kwashiorkor all have severe PEM. The treatment and management of these three forms of severe malnutrition are the same. 2. Management of the seriously ill patient It is important to recognize dehydration and specific infections Export document as PDF file. Management of Severe Malnutrition: A Manual for Physicians and other Senior Health Workers Management of malnutrition in disaster situations and refugee camps: 4.10 Dermatosis of kwashiorkor Kwashiorkor and marasmus 35 management of the disease, along with John Waterlow, in Jamaica, and John Brock and John Hansen, in South Africa. Peter Dean, Ruth Schwartz, and Hugh Trowell in Africa also made important contributions [9, 10]. To begin our research on kwashiorkor and maras - mus, Béhar negotiated three beds in the large, over

Objectives: (1) To improve case management of kwashiorkor at seven Nutritional Rehabilitation Centres (NRCs) through 2-4 weekly paediatric supervisory visits. (2) To evaluate the impact of the. Kwashiorkor, or oedematous malnutrition, affects children, and is characterised by bilateral pitting oedema, in the absence of another medical cause of oedema. Other clinical signs include a poor appetite, ulcerating dermatosis, and apathy. Aetiology remains ill defined, but is not entirely becau.. Clinical Management of Marasmus Protocol (Case Study) Shadia Mohamed1, Ali Adam Juma2, Bashir Awil Ismail3 1, 2, 3Univerity of Bahri, College Public Health and Environmental Health Abstract: According to the world health organization 49% of the 10.4 million deaths occurring in children younger than 5 year

Fig. 2 A severe case of kwashiorkor showing oedema and skin and hair changes. Kwashiorkor (see Figs 2 and 3) usually affects children aged 1-4 years, although it also occurs in older children and adults. The main sign is oedema, usually starting in the legs and feet and spreading, in more advanced cases, to the hands and face Management of Severe Malnutrition: a manual for physicians and other senior health workers and the following companion guidelines have been developed to improve inpatient treatment of severe malnutrition. The WHO/ UNICEF strategy of Integrated Management of Childhood Illness (IMCI) also aims to reduce these deaths by improving treatment Kwashiorkor is a form of acute malnutrition that occurs due to protein deficiency. Kwashiorkor is a serious condition that can happen when a person does not consume enough protein. Severe protein. Kwashiorkor is one of the most common nutritional disorders, which are found in the third world countries. It is a type of malnutrition which is caused when an individual is unable to get enough proteins in the body through food. Protein is required by the body to produce new cells and repair any damaged cells Kwashiorkor's Definition: Kwashiorkor disease is a form of severe protein malnutrition and is characterised by oedema and an enlarged liver with fatty infiltration. It is most often seen in regions which experience famine. Kwashiorkor usually is associated with a deficiency of protein in a regular diet

Acute malnutrition pertains to a group of linked disorders that includes kwashiorkor, marasmus, and intermediate states of marasmic kwashiorkor. They are distinguished based on clinical findings, with the primary distinction between kwashiorkor and marasmus being the presence of edema in kwashiorkor [16]. 3.1. Marasmu Kwashiorkor is a form of severe protein malnutrition characterized by edemaand an enlarged liver with fatty infiltrates. Recent pathophysology infection has been found as a risk factor for the development of kwashiorkor, many caretakers report diarrhea as a precipitating factor in kwashiorkor Background Kwashiorkor is the edematous form of protein-energy malnutrition. It is associated with extreme poverty in developing countries and with chronic malabsorptive conditions such as cystic fibrosis in developed countries. Rare cases of kwashiorkor in affluent countries unrelated to chronic illness have been reported

• List the possible management options for malignant ascites including advantages and drawbacks of each • Describe the placement and use of tunneled peritoneal catheters and other devices used in palliative treatment of recurrent ascites. • Kwashiorkor Low SAAG <1. Using of WHO guidelines for the management of severe malnutrition to cases of marasmus and kwashiorkor in a Colombia children's hospital. Protein source and quality in therapeutic foods affect the immune response and outcome in severe acute malnutrition. fisiopatologia de marasmo y kwashiorkor pdf NEVER be given to a child with kwashiorkor. Example of children with kwashiorkor and illustrating the pitting oedem

Kwashiorkor is a major public health problem in many parts of the world. While the primary cause of severe acute malnutrition (SAM), of which kwashiorkor is a specific expression, is the lack of sufficient food intake, the specific aetiology of kwashiorkor remains elusive despite well-designed studies over the last decades Kwashiorkor - Definition It is an acute form of childhood protein-energy malnutrition characterized by inadequate protein intake with reasonable caloric (energy) intake; it tends to occur after weaning, when children change from breast milk to a diet consisting mainly of carbohydrates

DESNUTRICION MARASMO PDF

Kwashiorkor is a form of protein-energy malnutrition (PEM) that occurs when there is not enough protein in the diet. 1,2. The World Health Organization (WHO) defines malnutrition as a cellular imbalance between supply of nutrients and energy and the body's demand for them to ensure growth, maintenance, and specific functions. 1 Postby first» Tue Aug 28, am. Please, help me to find this fisiopatologia de marasmo y kwashiorkor pdf. I'll be really very grateful. fisiopatología tema lesion celular cuando la célula se altera, se altera el órgano el sistema. la célula normal se encuentra en un equilibrio, estado normal

KWASHIORKOR PATHOPHYSIOLOGY PDF. There are close pathophysiological parallels between kwashiorkor and when it is associated with shock, as if they shared precisely the same pathophysiology. Kwashiorkor results from relative protein deficiency in the setting of adequate energy intake and is characterized by hypoproteinemia, pitting Pathophysiology A NOTE OF THE TREATMENT OF KWASHIORKOR, Journal of Tropical Pediatrics, Volume 2, Issue 4, 1 March 1957, Pages We use cookies to enhance your experience on our website.By continuing to use our website, you are agreeing to our use of cookies Kwashiorkor (kwah-shee-awr-kawr or -ker, IPA: / k w ɑː ʃ i ˈ ɔːr k ɔːr /, / k w ɑː ʃ i ˈ ɔːr k ər /) is a form of severe protein malnutrition characterized by edema and an enlarged liver with fatty infiltrates. It is thought to be caused by sufficient calorie intake, but with insufficient protein consumption (or good quality protein), which distinguishes it from. marasmic kwashiorkor are often severely ill and have a higher risk of mortality. Management of the three categories of acute malnutrition should be approached in the same manner by following inte-grative management protocols to ensure that mortality and morbidity are kept as low as possible.[3,4,6,8,9] Treatmen

Protein Energy Malnutrition

The treatment and management of severe protein-energy

Management of Severe Malnutrition: A Manual for Physicians

Kwashiorkor is the edematous form of protein- energy malnutrition; it is due to total deprivation of protein. Marasmus is a form of PEM which is characterized by muscle wasting and shrunken appearance of the child discharge patients upon recovery needs harmonization. MUAC misdiagnose Kwashiorkor children due to fluid retention but remains a reliable tool. Ready to Use Therapeutic Food (RUTF) used for management of SAM. The study aimed to evaluate the effectiveness of screening tools, therapeutic interventions and shed light on the risk factors associated. The contribution of severe acute malnutrition to the overall burden of childhood morbidity and mortality is enormous, with more than 20 million children with severe wasting worldwide, 1 an untold.

IMAM stands for Integrated Management of Acute Malnutrition.; It is an integrated program to fight back against acute malnutrition. It is a nutritional program designed especially for children of 6-59 months of age and is a very important concept for management of malnutrition Severe acute malnutrition is defined in these guidelines as the presence of oedema of both feet or severe wasting (weight-for-height/length <-3SD or mid-upper arm circumference < 115 mm). No distinction is made between the clinical conditions of kwashiorkor or severe wasting because their treatment is similar

INCAP studies of kwashiorkor and marasmu

  1. Kwashiorkor is due to inadequate protein in the diet despite an adequate caloric intake. Symptoms may include irritability and fatigue followed by slowed growth, weight loss, muscle wasting, generalized swelling, skin changes, enlargement of the liver and abdomen, and weakening of the immune system, leading to frequent infections
  2. Kwashiorkor is most common in rural areas, especially in the sub-urban regions and areas with low food supply are more prone to this disease. Read more Kwashiorkor . Marasmus is a type of nutrition deficiency disorder, which usually occurs in children. It can be life-threatening if not diagnosed at an early stage
  3. The management of kwashiorkor improved considerably after decades of research and mortality decreased dramatically first in a few pilot centres and then more generally after the publication of a standardised protocol by WHO in 1999. 30,31 Still, mortality remains high in referral treatment centres
  4. Kwashiorkor is a severe form of malnutrition known as protein energy malnutrition or protein calorie malnutrition that is caused mainly by insufficient amount of protein needed by the body with conservation of subcutaneous fat. Kwashiorkor is seen mostly in children of 1 year to 3 years and affects mostly children in Africa, Latin America and Asia
  5. g countries of southern and eastern Africa, kwashiorkor is arguably the predo
  6. eralization are obscure. Full Text Available Abstract Objective: This.

Case management of kwashiorkor: an intervention project at

kwashiorkor pathophysiology pdf There are close pathophysiological parallels between kwashiorkor and when it is associated with shock, as if they shared precisely the same pathophysiology. Kwashiorkor results from relative protein deficiency in the setting of adequate energy intake and is characterized by hypoproteinemia, pitting Pathophysiology With this dismal prognosis in mind, it is interesting to review the contemporary treat- ment of kwashiorkor and to note the consid- erable differences in management. Much of this can perhaps be explained by local vari- ations in etiology and in clinical patterns, nevertheless there do appear to be major as- pects of therapy where divergence of. KWASHIORKORPresenters: Kasturi Mahalinggam ( 060100293)Siti Raihana (060100246)Supervisor: dr. Oke Rina Ramayani Sp. The focus of assessment in children with marasmic - Kwashiorkor is anthropometric measurements (weight, height, upper arm circles and thick folds of skin). Signs and symptoms that may be obtained are: Decrease the size of the anthropometric. Hair changes (depigmentation, dull, dry, smooth, sparse and easily removed)

Kwashiorkor - Management Approach BMJ Best Practic

Abstract: In the dietary management of severe acute malnutrition in children, there is evidence to support the WHO Manual's protocol of cautious feeding of a low energy and protein formula with small frequent feeds in the initial phase of treatment, particularly in kwashiorkor. However, this initial milk diet (WHO F‐75) might benefit from increasing the sulphur amino acid, phosphorus and. Kwashiorkor needs immediate diagnosis and treatment, as it can quickly become life-threatening. Marasmic kwashiorkor. Marasmic kwashiorkor is the third form of protein-energy malnutrition that. SUMMARY. Detailed suggestions for the treatment of children with severe protein malnutrition (kwashiorkor) are given. These include attention to the fluid and electrolyte imbalances which are likely to characterize the acute case due to secondary complications and instructions for beginning treatment with frequent feedings of milk diluted to half strength case management of marasmus by standard protocolized management with or without complication can reduces case fatality and improves health status marasmic children. INTRODUCTION Marasmus is one form of sever protein energy malnutrition (PEM). It is an important cause of under 5 deaths in developing countries The treatment and case management of kwashiorkor suggested in this chapter are consistent with its recommendation.) Severe malnutrition: report of a consultation to review current literature. 2004. (This is the report of an informal consultation convened by WHO in Geneva in 2004. Temporary advisers for this meeting included representatives from.

The Management of Nutrition in Major Emergencies: Chapter

  1. Kwashiorkor is a disease marked by severe protein malnutrition and bilateral extremity swelling 1). Kwashiorkor is most common in some developing regions of the world where babies and children have a diet that lacks protein and other essential nutrients. The main sign of kwashiorkor is too much fluid in the body's tissues, which causes.
  2. DOI: 10.1016/S0140-6736(08)60752-7 Corpus ID: 31374480. Kwashiorkor and severe acute malnutrition in childhood @article{Ndekha2008KwashiorkorAS, title={Kwashiorkor and severe acute malnutrition in childhood}, author={M. Ndekha}, journal={The Lancet}, year={2008}, volume={371}
  3. Malnutrition is directly responsible for 300,000 deaths per year in children younger than 5 years in developing countries and contributes indirectly to more than half of all deaths in children worldwide. See the image below
(PDF) Management of severe acute malnutrition by cow milk

Kwashiorkor: Causes, symptoms, and treatmen

  1. In this condition, features of marasmus and kwashiorkor are present simultaneously. The body weight is less than 60% of the normal. Dependent edema is present. Mental changes, skin and hair changes and hepatomegaly are evident. Secondary infection is very common in protein energy malnutrition. This is due to the fact that both humoral and.
  2. Marasmus - Complications, Treatment and Prevention. Marasmus is a disorder of malnutrition that is a result of total calorie starvation, especially protein and energy. It is often seen in infants under 1-5 year of age most commonly in developing countries. The decreased nutrition is usually secondary to weaning problems resulting from disease.
  3. Acute malnutrition is a nutritional deficiency resulting from either inadequate energy or protein intake. Children with primary acute malnutrition are common in developing countries as a result of inadequate food supply caused by social, economic, and environmental factors. Secondary acute malnutrit
  4. Kwashiorkor results from relative protein deficiency in the setting of adequate energy intake and is characterized by hypoproteinemia, pitting Pathophysiology. Kwashiorkor is a serious form of malnutrition caused by a lack of protein. Learn how to spot this condition and how to prevent it. This allows oxygen delivery and perfusion of the organs.
  5. Management of acute moderate and severe childhood malnutrition. Correspondence to: M J Manary manary@kids.wustl.edu. Acute childhood malnutrition affects about a tenth of the world's children under 5 years of age, particularly those living in circumstances of extreme poverty in the developing world. 1 2 Malnutrition is typically the result of.
  6. e. It is a result of insufficient protein intake in the context of adequate caloric intake. Case report: We report a case of a 13-year-old male with trisomy 21 in Southwestern Ontario, Canada wh
  7. Kwashiorkor (kwah-shee-awr-kawr or -ker, IPA: / k w ɑː ʃ i ˈ ɔːr k ɔːr /, / k w ɑː ʃ i ˈ ɔːr k ər /) is a form of severe protein malnutrition characterized by edema and an enlarged liver with fatty infiltrates. It is caused by sufficient calorie intake, but with insufficient protein consumption, which distinguishes it from marasmus.Kwashiorkor cases occur primarily.

Kwashiorkor: Treatment, Prognosis, Causes, Symptom

  1. Kwashiorkor could be serious if it's unattended. It can certainly result in major organ failure and finally the loss of life. A malnutrition disorder, mainly in children and kids, caused by serious protein insufficiency which often takes place whenever the child is weaned from the breast
  2. Kwashiorkor, or edematous malnutrition, affects children, and is characterized by bilateral pitting edema, in the absence of another medical cause of edema. Other clinical signs include a poor appetite, ulcerating dermatosis, and apathy. Etiology remains ill defined, but is not entirely because o..
  3. The effective management of severe acute malnutrition (SAM) is a huge challenge in lowresource healthcare settings. More effective preven-tion and treatment of malnutrition is needed urgently. Keywords kwashiorkor; malnutrition; nutrition disorder; wasting Nutrition disorders: a leading cause of ill health in the worl
  4. oedema, kwashiorkor or oedematous malnutrition, is a sign bilateral pitting oedema of the feet, verified when thumb pressure applied on top of both feet for 3 seconds leaves a pit (indentation) Management of Childhood Illness (IMCI) guidelines, treatment should begin ONLY after 14 days in th
  5. Kwashiorkor is defined by the presence of symmetrical edema (edematous malnutrition). Marasmus and Kwashiorkor commonly coexist and a simple unified approach to clinical management can be applied to both [1, 2]. Table 2. Nutritional Status Assessment . Method No malnutrition Mild malnutrition Moderate malnutrition Sever
  6. and the potential dangers of its use, but argues that
  7. KWASHIORKOR & MARASMUS 13. IAP UG Teaching slides 2015-16 MARASMIC KWASHIORKOR 14. IAP UG Teaching slides 2015-16 15 POOR PROGNOSTIC CRITERIA IN PEM • Age: infants • Wt/Ht >70%/ 3 SD • MUAC < 11.5 cm • Stupor or coma MANAGEMENT 23. IAP UG Teaching slides 2015-16 2

Kwashiorkor or marasmus Anorexia nervosa Chronic malnutrition, e.g., from carcinoma or in the elderly Chronic alcoholism Prolonged fasting Duodenal switch operation for obesity Hunger strikers Oncology patients Postoperative patients FIG. 1. Schematic diagram of some of the metabolic consequences of starvation and the refeeding syndrome.9 The principles of management of severe acute malnutrition, whatever the programme setting, are based on 3 phases. -Phase 1. Patients without an adequate appetite and/or a major medical complication are initially admitted to an in-patient facility for phase 1 treatment. The formula used during this phase (F75) promotes recovery of normal metaboli

Kwashiorkor - Causes Diagnosis, Treatment and Complication

Management of Acute Malnutrition in Infants (MAMI) Project. 8.1 Psychosocial stimulation in the treatment of malnutrition 8.1.2 Scientific basis for the WHO recommendations Relevant studies and experiences are few and often dated. For studies prior to 1990, we will use th behavior and weight management. Eating disorders are more common in affluent societies where food is plentiful. Women are much more commonly affected than men. Anorexia ner-vosa is characterized by a body weight less than 85% of ex-pected for age and height, and an intense fear of gaining weight. Anorexia nervosa affects about 0.5% to 1% of wome

2/20/2018 3 DM&A Nutrition Division Malnutrition Education and Training Program •Onsite Nutrition Focused Physical Assessment Hands On Training •Dietitian Driven Program •Education, Training and Coaching : Dietitians, Providers & Physicians, Coding, CDI, Revenue Integrity, Decision Support, Food Service, Social Work, Case Management each type of malnutrition and nutritional management. The evolution is given at D1, D3, D5, D7, D14 and D21. The results for patients with Kwashiorkor are showed in Table 2 with its graph in Fig. 1; the ones for patients with marasmus in the Table 3 and Fig. 2 and for the pa-tients with mixed malnutrition in the Table 4 and Fig. 3 home management is recommended for patients without complications. As for nutritional rehabilitation, WHO in 2000 set out guidelines for the hospital management of these children, which are updated periodically. Key words: Severe malnutrition, Kwashiorkor, Marasmus, Diagnosis, Treatment, Childre

lines for the management of children with severe malnutrition,3 and where standardized management protocols havebeenfollowed,mortalityhasbeen kwashiorkor,wealsoevaluatedtheposi-tive and negative likelihood ratios for deathforeachofMUAC,WHZ,andvis-ibleseverewastingcombinedwith(and/ or) kwashiorkor. These were calcu and 2) and kwashiorkor cases (r = - 0.412 and 0.233 for groups 1 and 2). Conclusion. The incidence of kwashiorkor has fallen in Ilesa, Nigeria. Given the relatively low HIV prevalence rate in the country during the study period, better management of diar-rhoeal diseases, including measles, may have accounted for this drastic fall Kwashiorkor: Severe malnutrition characterised by protein deficiency, oedema and distended abdomen. 10% weight loss or < 80% ideal body weight 5 days IV fluids only or poor intake for >7 days Chronic diseases causing under-nutrition e.g. cancer and Inflammatory Bowel Disease Anorexia nervosa Hypoalbuminemia 2 Lancet 1967)to 25 marasmic children, 23 marasmic-kwashiorkor and 10 kwashiorkor cases. Two ofthe marasmic scored zero and would have been considered normal, onescored 4and would havebeen considered marasmic kwashiorkor but 22scored between 1-3. Allthe marasmic-kwashiorkor and kwashiorkor scored above 4but the seperation into the two categories di

KWASHIORKOR PATHOPHYSIOLOGY PDF - Pinards PD

kwashiorkor (a mix of the two; note 1).1,2 Kwashiorkor was first documented as a specific syndrome in the 1930s,3-5 yet despite more than 80 years of research, the specific causes and mechanisms leading to the onset and progression ofkwashiorkorremainelusive.6-10 Theepidemio-logic distribution of kwashiorkor cases at a loca to have HIV than those with kwashiorkor or marasmic kwashiorkor (83% vs 33%, OR 9.7, 95% CI 3.5- Specific guidelines for the management of severe malnutrition in HIV positive children and improved tuberculosis, growth monitoring and growth promotion programmes could reduce this impact Management of a child with marasmic-kwashiorkor Since a child with marasmic-kwashiorkor has both marasmus and kwashiorkor, the treatment is the same as for marasmus and kwashiorkor. However, each patient should in any case be treated as an individual according to the clinical and other findings Kwashiorkor Survey Prevalence and pattern of hypothermia.-21 (47%) of the 45 children had a rectal temperature of less than 96[deg]F (36-5[deg]C) on at least one occasion. Fig. 1 shows the fre- quency of hypothermia, its severity, and relation to admission and death in these 21 [quot] cold [quot] children The Hospital Incorrectly Billed Medicare Inpatient Claims With Kwashiorkor (A-03-13-00031) i EXECUTIVE SUMMARY University Hospitals Case Medical Center incorrectly billed Medicare inpatient claims with Kwashiorkor, resulting in overpayments of $118,000 over 3 years. WHY WE DID THIS REVIEW Kwashiorkor is a form of severe protein malnutrition

condition was consistent with kwashiorkor, a complication to malnutrition rarely seen in AN. BACKGROUND Kwashiorkor is a nutritional syndrome caused by protein deficiency in the diet, meaning 'the disease of the displaced child'. Kwashiorkor is seen almost exclusively in the non-industrialised world, an Marasmus and kwashiorkor are two types of PEM (protein energy malnutrition). A third type of PEM is called marasmic kwashiorkor, which is the most severe form of PEM in children, with weight-for-height less than 60% of that expected, and with edema and other symptoms of kwashiorkor INTRODUCTION. Undernutrition is a critical determinant of mortality and morbidity in young children worldwide: It is associated with 45 percent of all deaths in children under five years of age [].In this topic review, we use the term malnutrition in its traditional sense, referring to undernutrition (wasting, stunting, or micronutrient deficiencies), although some authors use the term more.

ENFERMEDAD DE KORSAKOFF PDF

Schafer, H. and Werner, E. —Contribution to the problems of adding protein or aminoacids to infant food II. Addition of aminoacid mixture in treatment of acute dyspepsia. Mschr. Kinderheilk. 98: 289, 1950. CAS Google Scholar. 16. Smellie, J. M. —Symposium on etiology and treatment of marasmus. Brit. Med Washingto

Effects of protein deficiency: Protein Energy Malnutrition

Management of the child with a serious infection or severe malnutrition : guidelines for care at the first-referral level in developing countries. 1.Child 2.Communicable diseases-in infancy and childhood-diagnosis-therapy 3.Disease management 4.Child nutrition disorders 5.Delivery of health care, Integrated 6.Commu PROTEIN ENERGY MALNUTRITION (PEM) The term protein energy malnutrition covers a wide spectrum of clinical stages ranging from the severe forms like kwashiorkar and marasmus to the milder forces in which the main detectable manifestation is growth retardation.It is widely prevalent among weaned infants and pre-school children in India and other developing countries asmic kwashiorkor (severe wasting and bilateral pitting oedema)Mar Divide participants into working groups and ask them to name the characteristics of clinical manifestations of acute malnutrition: marasmus, kwashiorkor and marasmic kwashiorkor. Have one group present their answers and the other groups add additional points. Fill in any gaps MacDonald Ndkeha and Tido von Schoen-Angerer and colleagues express surprise at that the Lancet undernutrition Series did not mention kwashiorkor. Estimates of the number of children affected by severe acute malnutrition were based on an anthropometric definition (weight-for-height Z score below −3), as have previous reviews.1 Although the oedema that occurs in kwashiorkor might push some. Wasting, kwashiorkor and stunting are not usually due to either protein or energy deficiency. Treatment based upon this concept results in high mortality rates, and failure of treated children to return physiologically to normal. They become relatively obese with insufficient lean tissue. Preventive strategies have also failed. Wasting and stunting are primarily due to deficiency of type II.

Indian Journal of Dermatology: Table of Contents

Causes of malnutrition may range from individual and household level to country, regional and global level. To note down, some major causes of Malnutrition are: poverty, food insecurity, poor maternal nutrition, poor sanitation and hygiene, low birth weight, lower rate of exclusive breast feeding, frequent illnesses, environmental enteropathy. A treatment algorithm is provided to guide management of children with severe acute malnutrition and systemic complications who require inpatient therapy and for those with uncomplicated severe or. A child is said to have Marasmus when the weight for age is less than 60% without body swelling (i.e no edema). When the weight for age is less than 60% with body swelling, then the child is said to have Marasmic-Kwashiorkor, which is a combination of the features of Marasmus and Kwashiorkor. Laboratory investigations in the management of Marasmu Kwashiorkor was produced in 1954 by JF Brock. This was done at a time when the diagnostic criteria were vague and oedema was not always present. Putting Kwashiorkor on the Map: a call for sharing data to complete the picture of prevalence and raise the profile of Kwashiorkor, was released in October 2013 by the Community-Based Management of Acut Kwashiorkor starts with symptoms of irritability, fatigue, lethargy, decreased muscle mass and growth retardation. Over time, the physical appearance changes to include a protruded stomach, edema, discolored hair, pigmented skin, rash and a round face

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