Viewpoint: part 2:Wasting disease in African children: the challenges ahead

Abstract

Malnutrition is an important contributing factor in 5.6 million children who die annually. Severe acute malnutrition (SAM) is a direct cause in 2.7 million deaths . While the clinical syndrome kwashiorkor has impressed clinician and journalist alike, it are stunting, wasting disease and micronutrient diseases like anaemia, vitamin A and iodine deficiency which contribute most to the large global burden of malnutrition (-related) disease . As discussed in part I of this trilogy, 6 decades of understanding of the pathophysiology of severe malnutrition in children has enabled the world community and WHO to develop evidence-based therapeutic guidelines curing most malnourished children . We tend to have become less dogmatic and in anticipation of the many different, often adverse, environments realise why and how children become malnourished. Jackson and Golden defined the varied
clinical presentations of malnutrition as determined by the severity, duration and complexity of interactions of specific macro- and micronutrient deficiencies. Both the impact of the nutrient deficits and susceptibility for infection decrease with age, the young being most vulnerable.