Pass God no more? Kwashiorkor among patients admitted in a Therapeutic Feeding Programme in Sierra Leone : why do certain children develop oedema, where others don’t?
Document type: mthesis
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Abstract:
BACKGROUND: Severe Acute Malnutrition can present as kwashiorkor (oedema) or marasmus (wasting). The prognosis of kwashiorkor is considered to be worse and its pathogenesis is not fully understood. Proposed causative factors in literature are: social circumstances, breastfeeding practices, diet and infection. OBJECTIVES: Identification of potential risk factors for kwashiorkor by comparing two groups of patients (kwashiorkor versus marasmus). METHODS: A treatment facility based observational study consisting of three components: analysis of archived patient charts; in depth interviews; a questionnaire. RESULTS: Kwashiorkor children were on average older, equally stunted and less wasted than marasmus children. Adverse social circumstances, poor breastfeeding practices and food insecurity seemed to be more common in the marasmus group. Inadequate diets, frequent illnesses and unsafe drinking water were problems equally present in both groups. Median duration between being weaned and admission for malnutrition was 4 to 5 months for both groups. Kwashiorkor did not have a worse prognosis than marasmus in this programme; mortality and cure rates were equal and defaulter rate was worse in the marasmus group (10.8% vs. 18.3%, p = 0.003). LIMITATIONS: The objectives of the study were exploratory and descriptive in nature and data collection was not meant to find statistically significant associations. Sample sizes were opportunistic and not based on power-calculations. CONCLUSIONS: The marasmus patients were younger, more socio-economical disadvantaged and subjected to poorer breastfeeding practices compared to the kwashiorkor patients. Also they defaulted more often.
Authors:
Hugen, C.
Country:
Sierra Leone
Category:
Research
Department:
Development Policy & Practice
Institute:
KIT (Royal Tropical Institute)
Keywords:
nutrition
,
health
Language:
eng
Organization:
KIT - Royal Tropical Institute
PAGE:
vii, 80
Year:
2010
Region:
West Africa
Right:
© 2010 Hugen
Subject:
Health and Nutrition
Title:
Pass God no more? Kwashiorkor among patients admitted in a Therapeutic Feeding Programme in Sierra Leone : why do certain children develop oedema, where others don’t?
Training:
Master in International Health (MIH)