Kwashiorkor

It is estimated by the World Health Organization that over 2 million children in Nigeria suffer from undernutrition. Kwashiorkor is a type of undernutrition that is caused by the deficiency of proteins and usually presents with a swollen abdomen.

It affects children majorly, especially in regions where there is famine, natural disasters such as drought, or reduction in the food supply. In kwashiorkor, the liver is swollen and every other part of the body can be seen to depreciate in size; the hands and feet become lean, making the enlarged abdomen more visible.

With near intervention, affected people may recover fully; however, owing to the fact that kwashiorkor takes a period of time before it appears, haling may take some time as well.

If treatment is delayed, however, kwashiorkor can be life-threatening and in most cases when the children survive, they may remain stunted for a greater period of their lives.

What causes kwashiorkor?

Kwashiorkor is caused by a persistent lack of protein in the diet. Proteins are a very essential part of the diet; some of the functions of proteins include

• Growth and body maintenance
  Many parts of the body are made up of proteins; muscles, bones, skin, and even nails. Hence proteins are very important especially in growing children to enable them to form tissues and structures in the body. Keratin found in nails is a protein, elastin which helps the body tissues remain flexible is also a protein.
• Formation of hormones
  Some hormones in the body like insulin and glucagon are made up of proteins. Hormones are important in regulating the different functions of the body; for example, insulin and glucagon regulate the glucose concentration of the blood.
• Act as enzymes
  Enzymes are also proteins, and they aid in speeding up the rate at which chemical reactions occur in the body. Enzymes are very important as they assist functions such as blood clotting, synthesis of substances, digestion of food, contraction of muscles, etc.
• Homeostasis
  General regulation of the body’s functions is carried out by haemoglobin which consists of a protein and other components. Globulin and albumin are responsible for maintaining the fluid balance of the body.
• Immunity
  Antibodies (which are proteins) are responsible for fighting invading microorganisms in the body, they prevent the body from infections.
• Source of energy
  The body majorly uses carbohydrates and fats to produce energy. However, in cases where both of these sources are highly depleted or unavailable, the body has mechanisms that can break down proteins in order to release energy for use. Whenever it gets to this point, the muscles begin to atrophy (reduce in size) and several other symptoms are seen.

Symptoms of Kwashiorkor

Based on the functions of proteins highlighted above, some symptoms of kwashiorkor will include:

• Swelling of the ankles, feet and belly.
  This happens due to accumulation of fluid in these regions and an enlarged liver.
• Loss of weight.
  Proteins are essential for proper growth and development, therefore with a prolonged lack of protein intake, there will be a corresponding decrease in the weight of the child.
• Hair loss
  Hair is lost because hair is made of protein.
• Change in skin and hair colour
• Irritability and apathy
  The child begins to lose interest in social activities and is easily irritated by little happenings.
• Atrophy of muscles
  In most cases, kwashiorkor is just a side effect of very poor nutrition. This implies that carbohydrates and fats may not be present in adequate amounts to ‘spare’ the proteins from being used, therefore the body begins to break down the muscle which is a major store of proteins to produce energy.
• Diarrhoea and fatigue
  Constant stooling will usually be accompanied by tiredness and weakness. As the muscles even atrophy, weakness follows suit.
• Weakened immune system
  When the immune system is weak, the patient continues to suffer from more and more infections and ailments that could ordinarily be avoided.

Treatment of Kwashiorkor

The major type of treatment offered is the increase in protein content of the diet; protein supplements are also given over a period of time. In addition, other foods that contain carbohydrates and fats may be added to the meal to increase the amount of substrate available for the production of energy.

It is easier to prevent kwashiorkor than to treat it; because in severe cases, it may lead to mental retardation, shock, coma, and even death.