When a diet is nutritionally inadequate but the sanitation is good & infections are minimal, the onset of deficiency symptoms is gradual. Likewise, when a well-nourished child succumbs to an infection the period of illness is usually short and the mortality rate is low. Conversely, the coexistence of malnutrition and infection vastly increases the severity of both. 

KWASHIORKOR :-

It's a high mortality deficiency disease known as kwashiorkor meaning red boy. The name comes from the odd reddish orange color of the hair, as well as from the skin rash, characteristic of the disease. Moderate to severe growth failure is present kwashiorkor.

For the 1^st few months of life, the breast fed infant in the developing countries grows at a rate that is comparable to that of well fed infants, but thereafter symptoms starts occurring of a kwashiorkor child if the nutrition is not adequate.

What are the symptoms?

• The increase in stature & in tissue development is increasingly retarded.



• The muscles are poorly developed & lack tone.



• Edema is usually severe.



• Potbelly (protruding of the stomach)



• Swollen legs & face.



• Anorexia & diarrhea are common . Poor sanitation is cause of diarrhea.



• Whimpering , but does not cry or scream.



• The child is not interested in or curious about his surrounding, but remains seated whenever he is put down.

Pathologic & biochemical changes :-

• Fatty infiltration of the liver.Serum levels of triglycerides, phospholipids, & cholesterol are reduced.Amylase, lipase and trypsin are reduced.Serum proteins and albumin fractions are markedly reduced.Hb. levels are low, especially if parasite infestation is also present.



• Vitamin A levels are usually reduced. This could be a serious complication leading to blindness & death in some children.