Under Nutrition - Malnutrition

Occurs when a person is not getting enough food or not getting the proper amounts of micronutrients to meed daily nutritional requirments

Prevention

Improve water supply, sanitation and hygiene

Ensure nutrition food security foor poor households in quantity and quality

Provide adequate nutrition for mothers and children

Promote early initiation and exclusive breastfeeding through to 6 months

Stunting, underweight and wasting is caused by long term undernutrition

The most undernourished children are in Asia (India) and SSA (Nigeria)

Who is most at risk?

Children <2

Foetus

Pregnant and lactating women

Poverty / emergency situations

Elderly

Chronic infections

Hospitalised

Low birth weight babies un 2.5kg are more likely to suffer malnutrition, contract infection and die from illness

Under 5 mortality is declining

2010 64% child death due to infectious diseases. 2017 <60%

40% deaths during neonatal period. under nutrition contributes to over 1/3 child deaths. Complication of preterm birth, sepsis, meningitis. Leading cause of death in older children is pneumonia and diarrhoea

Acute undernutrition (wasting) – a multi-deficiency state that includes a range of
conditions.

The most severe types are

  1. Marasmus
  1. Kwashiorkhor
  1. Marasmic kwashiorkhor

Case fatality rates of 20-30% are typical for severely malnourished <5s

Hypoglycaemia

Hypothermia

Dehydration

Septic shock

Infections

Kawashiorkor - treated with low protein diet. Common post weaning. Kwash more common in areas with high cassava, plantain, yam, rice consumption. Cause largely unknown - but NOT protein deficiency

No difference in diet of children that develop
marasmus or kwash. Children with marasmic kwash ‘recover’ to become
marasmic

Chronic is long term (growth failure) and acute is short term (weight loss)