Kwashiokor- A Common Disease Amongst African Kids.

I am sure I must have mentioned it here before that, I lived in an extremely local region for around a year in my life, thanks to NYSC, and that's one part of my life that I would never forget and cannot stop talking about, because the experiences are basically unforgettable. There was this sweet little baby I meet during my service year, bless her soul because she is late now, she had this disturbing big stomach that was bigger than her body.
I was always worried about the size of her stomach, but the villagers said she would outgrow it, the first time I saw her, the first thing that came to my mind was Kwashiorkor, which is a disease common in Africa by the way, since we have a serious high rate of poverty over here.

Kwashiorkor is a serious disease caused by intense malnutrition of protein, it often affects children and infants who live in poverty-stricken regions and places where starvation is paramount. In the early days of advanced medical practice, It was not so easy to identify Kwashiorkor as a disease, as most of the recorded childhood death were attached to infectious etiology, or disease of the digestive system, but in the 1950s, the World Health Organization (WHO), were able to identify it as a public health crises. Several scientific research made experts come to the conclusion that Kwashiorkor is a secondary cause of death amongst children, since research proved that, a great number of Kwashiorkor cases would not have developed without the intense stress of dehydration, diarrhea and other infectious diseases like even measles and HIV.

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The children who have Kwashiorkor were found to have peripheral edema, which is a common symptom amongst those suffering from starvation, edema come on as a result of fluid balance between hydrostatic and oncotic pressures found across the existing capillary blood vessel walls. The concentration of albumin serves as a great contribution to the oncotic pressure, this makes it possible for the body to maintain fluids within the vasculature. It was also discovered that children with Kwashiorkor had a serious low level of albumin and, of course, this would lead to having them become intravascular depleted. Over time, antidiuretic hormone (ADH), increases as a response to hypovolemia, leading to edema. Great oxidants levels are very common during starvation, and are even more common in the case of chronic inflammation.

Primary associated factors of Kwashiorkor are;

Consuming mostly carbohydrate-based food: It is no news that, carbohydrate based meals are very common in Africa and only, comfortable people can afford protein rich food, these carbohydrates rich food are very cheap and easily accessible, most times even farmed by these local farmers. Mothers, who are protein deficient, could pass on the deficiency to their children as well.

Inadequate food replacement after weaning: Often times, as a result of inadequate food resources or ignorance, the weaning toddler does not get the required diet replacement, and of course, the nutritional level of the child greatly deteriorates.

• Life stress like natural disaster, famine and stress could also trigger the presence of Kwashiorkor.

• Absence of dietary antioxidants.

Kwashiorkor is distinguished from other forms of malnutrition, as those with Kwashiorkor may have emaciated limbs, but also experience swelling in their feet, belly and on their faces.

Marasmus, is another existing type of deficiency recognized worldwide, but the difference between marasmus and kwashiokor is that, Kwashiorkor is a deficiency in protein while marasmus describes the deficiency of different forms of macronutrients like; carbohydrates, fats and protein, those with marasmus, generally, are deprived of calories, this may be because of them eating too little or eating too much, while Kwashiorkor patients, may not necessarily be deprived of calories, but they are basically deprived of meals rich in protein.

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Unlike, the popular belief that Kwashiorkor is only identified with a protruding stomach in kids, there are also clinical manifestation of Kwashiorkor, and they include;

• The presence of a dry, full, hypopigmented hair that falls out on its own or could easily be plucked out.

• Retardation of growth.

• Skin lesions.

• Edema, the swelling with fluid, especially in regions like the feet and the ankles.

• Subcutaneous fat retention characterized with a loose inner inguinal skin folds.

• Psychic changes.

• Round face, the cheeks become more pronounced.

• Marked muscle atrophy.

• A thin, dry, peeling skin characterized with scaling and hyperpigmentation.

*Enlarged liver.

• Fatigue and irritability.

• Hepatomegaly. 1

Kwashiorkor can cause some other serious complications;

• Hypoglycemia- Low blood sugar.
• Hypothermia- Low blood temperature.
• Hypovolemia- Low blood volume.
• Electrolyte- Existing imbalance as a result of dehydration.
• Developmental delay experienced in kids.
• Failure in immune system, creating room for infection and inability for wound to heal fast.
• Untimely death.

Diagnosing Kwashiorkor is definitely not by just seeing the sign of a protruding stomach in a child, medical experts, diagnose the disease by physically examining the child, and observing the telltale physical signs, asking questions related to the diet of the child as well as possible presence of history of infections and illness. Furthermore, the child's weight is measured relatively to the height ratio, height measured against age and recorded across different charts. The result obtained from the calculated weight-height chart, will help the medical team identify how serious the child's medical condition is, the result obtained from the height-age chart on its own as well makes it possible to determine the severity of malnutrition in the child.

Kwashiorkor can be fatal and, most likely, death could be the reward when it is not treated on time. The complications of Kwashiorkor could be really severe, and some children may never be able to recover fully from the created complication, of course, early medical intervention would lead to greater result.

If you are as curious as I am, I am sure at this point, you are also wondering if there is a treatment for this terrible disease, the good news is, the World Health Organization (WHO), has come out with 10 unique steps to help treat the case of serious undernutrition. 2

Treatment procedure for Kwashiorkor.

Prevent/treat hypoglycemia: When calories are not provided in sufficient amount in the human body, hypoglycemia can occur, the formula for rehydration in malnourished people, is the introduction of glucose, this will help maintain balance first, during the first instance of treatment, this is administered.

Prevent/treat hypothermia: When a body is malnourished, the body is unable to regulate its own temperature, the next stage of treatment is to ensure the body is kept warm.

Prevent/treat dehydration: The next stage of treatment is to treat dehydration with the use of a special formula called RESOMAL (Rehydration Solution for Malnutrition), this treatment option is designed to help restore and maintain body fluid as well as, maintain sodium balance, this treatment option can be given either orally or through the aid of a tube.

Treat electrolyte imbalances: When a malnourished person begins the process of re-feeding, electrolyte imbalances can produce a very serious life-threatening effect. That's the reason why medical experts try to address this condition first.

Treat present infection: With an already existing diminished immune system of course, caused by Kwashiorkor, infections are present, and they poise a serious threat to recovery, these infections are treated with antibiotics.

Correct deficiencies: The deficiencies of some form of vitamins and minerals in the human body, the correction of these important minerals and vitamins, need to be done first, before re-feeding is carried out.

Begin to feed cautiously: The bodies that are undernourished have their metabolism altered, the process of re-feeding the bodies will certainly create changes in the metabolism again, but if this process happens too fast, certain life-threatening complications would have been created.

Catching up with growth process: Once a child has become stabilized and has gotten to the point of feeding appropriately again, the calories can increase to up to a level of 140% of recommended age value, there is a liquid formula provided by the WHO to serve this purpose, the liquid formula can be given to the child either through tube or orally. The nutritional rehabilitation stage, may take up to six weeks.

Providing emotional support and sensory stimulation: Children who have, Kwashiorkor, may have been subjected to a state of apathy for a while, the stage of malnutrition also has the ability to have stunted their intellectual, neurological as well as social development. A part of the treatment plan, is to stimulate the developmental aspect of the child.

Prepare for a follow-up plan: Just before the child gets discharged from the health care facility center, education and counselling is provided to the mother/caregiver regarding appropriate breastfeeding, nutrition, disease prevention, as well as food and water hygiene. 3

References.

https://www.ncbi.nlm.nih.gov/books/NBK507876/

https://www.physio-pedia.com/Kwashiorkor

https://my.clevelandclinic.org/health/diseases/23099-kwashiorkor

https://www.medicalnewstoday.com/articles/322453

https://www.healthline.com/health/kwashiorkor

Hi, I am Tobi a writer, speaker, relationship blogger, and lover of good music. I love making friends and learning from people. Want to hear me speak on relationships and general life issues, you can find my youtube channel where you can watch any episode for free, do not forget to subscribe and share with friends. I sincerely appreciate every love I get from members of the community and do well to keep them coming.