Look and feel for Kwashiorkor - utilizing IMMCU5

• Main Author: Kamaruzaman, Nor Azam
• Format: Conference or Workshop Item
• Language: English; English
• Published: 2019
• Subjects: RJ101 Child Health. Child health services
• Online Access: http://irep.iium.edu.my/70873/1/Look%20and%20feel%20for%20kwashiorkor%20-%20oral%20presentation.pdf; http://irep.iium.edu.my/70873/13/70873%20%20Kwashiorkor.pdf; http://irep.iium.edu.my/70873/

Introduction / Background: Malnutrition is an important contributory factor for mortality and morbidity among infant and young children globally and locally with prevalence among Orang Asli (OA) remains high. Pahang which has the highest number of OA population recorded more than two thousand recipients for food basket in 2015 with nearly half were OA. The state had developed a comprehensive manual on assessment and management of malnourished children called The Integrated Management of Malnutrition in Children under 5 (IMMCU5). It emphasizes on detection of severe malnutrition by three simple steps: take weight for age, look for visible severe wasting and feel for oedema of both feet. Case description / Clinical experience: A 5 months old OA boy was brought to a clinic in Pekan, Pahang after defaulted last follow-up. He is the first child to a 23 year old mother who are mentally challenged and living in poverty, on an isolated hill. During the visit, the infant was asymptomatic. He appeared chubby with noticeably shiny skin on limbs but his weight was only 4.5kg with Very Low Weight for Age, WFA (< -3SD). Baffled by the incongruous findings, referral was made to Family Medicine Specialist who promptly recognized Kwashiorkor by eliciting the sign of pitting oedema on both feet. The mother had been feeding her baby with condensed milk after breastfeeding was stopped for the past three months. Inpatient care and then nutritional rehabilitation were instituted according to IMMCU5 manual. The infant recovered well with WFA later returned to normal. Conclusion: This case highlighted the importance of using the correct method in detecting subtle sign of Kwarshiorkor that might be missed by an untrained personnel.