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Grow Healthy Pakistan

Learn about the current situation, epidemiology, clinical features, and biochemical changes of kwashiorkor and marasmus. Discover prevention strategies and a way forward to address stunted growth in children.

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Grow Healthy Pakistan

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  1. Grow Healthy Pakistan • Prof Dr SairaAfzal • Dean of Public Health and Preventive Medicine, KEMU

  2. Grow Healthy Pakistan • Current Situation • Epidemiology • Clinical features of kwashiorkor and Marasmus and their Differences • Biochemical and Metabolic Changes • Prevention • A way forward

  3. Stunted Growth • Children are defined as stunted if their height-for-age is more than two standard deviations below the WHO Child Growth Standards median.

  4. Stunting is the impaired growth and development that children experience from: • poor nutrition, repeated infection, and poor sanitation condition.

  5. Among Children 6-23 months of age, only 12% are fed according to the criteria of minimum acceptable diet

  6. More than one in every three children born in Pakistan today is stunted. • 240 Million Children have growth retardation (https://www.thenews.com.pk/print/361890-number-of-stunted-and-wasted-children-in-pakistan)

  7. Types of PEM Weight for age less than60% Weight for age less than 80% Weight for age less than 60% with edema

  8. Epidemiology of Malnutrition • Global Burden- Starts In Womb And Ends In Tomb • Affects every 4th Child worldwide • More than 50% deaths are associated with Malnutrition • Median Case fatality rate is 23.5% in severe malnutrition and 50% in edematous Malnutrition

  9. Pathogenesis Of Marasmus Muscle wasting

  10. Pathogenesis of Kwashiorkor Hypoalbuminemia Decreased Oncotic Pressure Hepatomegaly Fluid Imbalance Edema

  11. Kwashiorkor Condition of Protein Malnutrition Moon Face with little interest in surroundings Edema of legs Swollen Abdomen Protein Intake deficient Generalised Muscle Wasting Hyponatremia

  12. Marasmus Severe Growth Retardation Total Caloric Malnutrition Fat wasting Oedema Mental Changes Weight for Height Low

  13. Differential Diagnosis of Malnutrition

  14. Biochemical and Metabolic Changes • Hypoalbuminemia (10-25g/l) • Plasma Cortisol and Growth levels are high • Percentage of body water increased • Electrolytes especially K are depleted • Decreased Urinary Excretion of Urea • Iron Deficiency Anemia and Metabolic Acidosis

  15. Prevention • Provision of Adequate Nutrition • Provision of Protein • High Energy Food during Pregnancy • Education • Food Supplements • Better School Health Services • Better Feeding Practices • Awareness Campaigns

  16. First two years of life • Maternal Nutrition and Literacy • Better Feeding Practices • Educational and Policy Reforms • School Health Services

  17. Thank You

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