Protein Energy Malnutrition Flashcards
► ——— is the deficiency of macronutrients or energy and protein in the diet.
► Protein Energy Malnutrition (PEM) is the deficiency of macronutrients or energy and protein in the diet.
The causes of PEM can either be —— or ——.
The causes of PEM can either be direct or indirect.
Direct causes of PEM are
Direct causes
The direct factors, which are commonly referred to as immediate factors include:
(i) Inadequate food intake
Inadequate food intake is the result of limited access to food in terms of quality and quantity.
(ii) Diseases
Diseases notably malaria and measles lead to loss of appetite, increased rate of metabolism due to fevers thereby increasing the body’s nutrient demands. Diarrhoea reduces the absorption of food nutrients, whereas vomiting decreases food intake. Intestinal parasites compete for nutrients
Indirect causes of PEM are
Indirect causes
(i) Food insecurity and limited access to foodstuffs
• Families cannot acquire or produce enough food to cater for energy needs.
• Lack of or limited access to land or agriculture inputs, marketing and distribution of foods.
• Loss of food through destruction by pests, fungi, rodents, birds and wild animals. Soil erosion, often resulting from overstocking, deforestation and discriminate burning.
• Poor farming practices often due to lack of knowledge, money, time or equipment.
• Poor weather conditions like failure of rains, floods etc.
• Lack of time to gather food, prepare it properly and provide special dishes for young children. Among the time consuming and energy – expending activities of the rural African housewife are the fetching of water from long distances.
(ii) Poor water / sanitation and inadequate health services.
• Health services may be of low quality, expensive, non-existent or unfriendly. • Lack of pre-natal and child health care.
• Inadequate management of sick children.
• Inadequate water and sanitation facilities.
(iii) Inadequate maternal and childcare practice.
• Families do not give adequate time and resources for women and children’s health, dietary and emotional needs.
• Poor caring practices, including the inappropriate care of sick children.
• Not utilizing health care facilities for special needs of pregnant mothers or adolescent girls.
• Not supporting mothers to breastfeed adequately.
Protein-Energy-Malnutrition takes different forms which include:
Clinical form
Subclinical form
What are the clinical forms of PEM
Clinical forms
o Kwashiorkor
o Marasmus
o Marasmic kwashiorkor
What are the subclinical forms of PEM
Sub-clinical forms
Underweight
Wasting
Stunting
Which of the subclinical PEM are mild or moderate
Underweight- mild
Wasting and stunting- mild or moderate
Which measurement is are used in determining wasting and stunting?.
Anthropometric measurements
Clinical signs of kwashiorkor
Odema
Poor growth
Mental changes
Hair changes
Skin changes
Moon face
Micronutrient deficiencies: Almost all the children manifest anaemia (due to iron deficiency) of some degree.
► Eye signs of vitamin A’ deficiency are also common.
► Manifestations of vitamin B complex deficiency are also noted in many cases.
Kwashiorkor Mostly occur in children between the ages of —— and —- years, when they are completely weaned (taken off the breast).
1 and 3 years
Marasmus is common in children below the age of — years.
2
Signs and Symptoms of Marasmus
Signs and Symptoms of Marasmus
Extreme muscle wasting - “skin and bones”
Loose and hanging skin folds
Old man’s or monkey faces
Absolute weakness
Signs and symptoms of Marasmic Kwashiorkor
Signs and symptoms of Marasmic Kwashiorkor
► Extreme muscle wasting - “skin and bones”
► Loose and hanging skin folds
► Old man’s or monkey’s face
► Absolute weakness
► Oedema
List the Effects of PEM in children
.
Effects of PEM in children
The effects of under nutrition on children are potentially serious, depending on how severe it is, how long it lasts, and the age the child.
Children with severe kwashiorkor and marasmus:
• Often die. Kwashiorkor is particularly difficult to treat.
• Have poor growth and development.
• Are often anaemic and suffer from xerophthalmia, an eye condition that can eventually end in blindness.
• Have poor academic performance and attendances of children at school.
