Kwashiorkor and Marasmus

Challenges to clear

• Sort every sign.
• Fill the Marasmus column — the deficiency of energy itself, not just protein.

The task

Both are protein-energy malnutrition, but they are not the same. Sort each sign.

What this lesson covers

• Kwashiorkor — Protein lacking: Enough calories, but far too little protein (Typically a child weaned onto a starchy diet with no pulses, milk or egg.); Swollen belly, feet and face from fluid retention (Too little blood protein, so fluid leaks into the tissues. It masks the weight loss.); Some fat is retained under the skin (Calorie intake was adequate, so fat stores are not fully used up.); Usually seen in children aged one to three, after weaning (It appears when breast milk — the protein source — is withdrawn.); Hair turns thin, pale and brittle; skin patchy (Hair and skin pigment both need protein.)
• Marasmus — Everything lacking: Too little of everything — protein and calories both (Severe general starvation.); No swelling — the child looks visibly wasted (There is no fluid retention to hide the loss.); Almost no fat or muscle left; ribs clearly visible (The body has consumed its own tissue for energy.); Usually seen in infants under one year (Often from very early weaning or severe feeding failure.); Shrunken, wrinkled face, often described as old-looking (The loss of the fat pads in the cheeks.)

Hint

The single most useful discriminator is oedema. Swelling means kwashiorkor; visible wasting without swelling means marasmus.