The use of epidemiological tools in conflict-affected populations: open-access educational resources for policy-makers

Table of Contents

1. Welcome
2. Introduction: Epidemiology in crises
3. Ethical issues in data collection
4. Need for epidemiologic competence
5. Surveys - Introduction
6. Surveys - Description of sampling methods
7. Surveys - Sampling error, bias, accuracy, precision, & sample size
8. Surveys - Resources required for surveys
9. Surveys - Critiquing survey reports
10. Surveillance - When to do surveillance
11. Surveillance - Methods
12. Surveillance - Common problems
13. Programme data
14. Rapid assessment
15. Mortality - Indicators and their measurement
16. Mortality - Data sources
17. Mortality - Interpretation and action
18. Nutrition - Introduction and background
    1. Types of malnutrition
    2. Kwashiorkor and marasmus
    3. Malnutrition in adults
    4. Micronutrient deficiencies
19. Nutrition - Indicators and their measurement
20. Nutrition - Data sources
21. Nutrition - Interpretation and action
22. Health services
23. Vaccination programmes
24. Water supply, sanitation, and shelter
25. Violence
26. Presentation of results
27. Formulating conclusions and recommendations
28. Dissemination and action

Kwashiorkor and marasmus

(go to Outline)

Kwashiorkor

Some children with acute protein-energy malnutrition develop oedema. Oedema is an accumulation of fluid in the tissue, especially the feet and legs. Such children may not lose weight when developing acute protein-energy malnutrition because the weight of this excess oedema fluid counterbalances the weight of lost fat and muscle tissue. These children may look fat or swollen. Such children have kwashiorkor.

Click here for photo of child with kwashiorkor

Kwashiorkor is very important to distinguish because the risk of death for children with kwashiorkor is higher than it is in children with just wasting or thinness.

Marasmus

Other children, for reasons not entirely understood, develop thinness without oedema. This condition is called marasmus.

Click here for photo of child with marasmus

Some children have signs of both kwashiorkor and marasmus. They have marasmic-kwashiorkor.

Both kwashiorkor and marasmus are life-threatening medical emergencies which need to be treated by sophisticated feeding programmes. Such programmes must be run by medical professionals with experience in refeeding children with severe protein-energy malnutrition.