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A prospective 15-year follow-up study of kwashiorkor patients. Part I. Physical growth and development
Insights
Kwashiorkor survivors showed no growth differences compared to siblings. Malnutrition
Area of Science:
- Pediatrics
- Nutritional Science
- Public Health
Background:
- Kwashiorkor is a severe form of malnutrition.
- Early childhood malnutrition has long-term health implications.
Purpose of the Study:
- To assess the long-term physical growth and development of children who survived kwashiorkor.
- To compare survivors' development with their unaffected siblings.
Main Methods:
- A 15-year follow-up study of 221 infants hospitalized with kwashiorkor.
- Comparison of physical growth and development between survivors and siblings.
Main Results:
- 32% of infants died from malnutrition during or shortly after admission.
- No significant differences in physical growth and development were observed between kwashiorkor survivors and their siblings.
- The combined group exhibited retarded growth and delayed development, suggesting an adaptive survival mechanism.
Conclusions:
- Malnutrition's primary impact is on early-life morbidity and mortality.
- Short-term interventions like food subsidies are crucial for young children.
- Long-term solutions require socioeconomic advancement and improved health practices for sustained growth and development.
Abstract:
A series of 221 infants admitted to hospital with kwashiorkor between 1958 and 1960 has been followed up for 15 years. Seventy-two (32%) died of malnutrition either at the time of first admission or shortly thereafter. The subsequent physical growth and development of the survivors remaining in Cape Town has been compared with that of 89 of their siblings who had never had kwashiorkor, but grew up in the same environment. No differences were noted between the two groups, but considered together they demonstrated a pattern of retarded growth and delayed development. This suggests an adaptive mechanism suited to survival in poor socio-economic circumstances. The years of poor growth in childhood and early adult life are not associated with an undue mortality, and malnutrition exacts its toll of morbidity and mortality in the early years of life. It is to this age group that intervention with short-term solutions (food subsidization and supplementation) should be applied with the expectation of demonstrable benefit. The long-term solution depends on advancing socio-economic conditions, bringing better nutrition and enlightened health practices; this will eventually lead to improved standards of growth and development.