Food and Nutrition Surveillance

and Response in Emergencies

Session 7
Overview of malnutrition in
emergencies
Session overview
Overview of malnutrition
Types of malnutrition
Strategies of addressing macro and micronutrient
deficiencies (supplementation, fortification, dietary
diversification and food preparation).
Definitions
Malnutrition
Any condition caused by excess or deficient food energy or
nutrient intake or by an imbalance of nutrients.
Protein energy malnutrition
A range of pathological conditions arising from coincident
lack of varying proportion of protein and calories accruing
most frequently in infant and young children and commonly
associated with infections.
Types of malnutrition
Kwashiorkor:
A condition resulting due to protein deficient
characterized by the oedema, skin and hair
changes and usually low body weight for age
(<60% weight for age)
Marasmus:
A condition of starvation to which a child has
adjusted by reduces growth.
Marasmic kwashiorkor:
A condition that develops when the child diet is
low in total calories and protein.
CLINICAL SIGNS OF P.E.M.
Marasmus
Extreme low weight
hunger
Extreme wasting
pot belly
an old persons face
irritability
Fretfulness
Marasmic-kwashiorkor
extremely low weight
oedema
other signs of marasmus
and kwashiorkor
Kwashiorkor
edema of legs, arms and
face
wasted weak muscles
enlarged liver
moon face
poor appetite
pale, sparse hair with weak
roots
pale and thin peeling skin

Micronutrient deficiencies
common in emergency
Micronutrient deficiency disorders:
Iron deficiency (defined as low heamogblobin
levels): the most prevalent in refugee camps the
world-over due to lack of iron.
Vitamin A deficiency is almost as widespread as
anaemia, particularly among populations that depend
of food aid.
Zinc Deficiency is increasingly suspected in
populations that live mainly on bulk grains for long
periods.
Overview of malnutrition cont..
Vitamin C deficiency or scurvy:
is even more localized than beriberi. Almost all outbreaks of
scurvy in emergencies have been reported among Ethiopian and
Somalis population, principally those who have been cut off for
months from camel milk markets.
Indicators of Nutritional status
Indicators of nutritional status:
a) Height for age
Measures degree of stunting or chronic
malnutrition
b) Weight for height
Degree of wasting-estimates acute malnutrition
and need for immediate action
c) Weight for age:
Reflects both stunting and wasting.