Summary about Disease
Marasmus is a severe form of malnutrition characterized by energy deficiency. It primarily affects infants and young children and results in wasting, stunted growth, and significantly reduced muscle mass and subcutaneous fat. It is a serious condition that can be life-threatening if left untreated.
Symptoms
Severe weight loss and wasting of muscles and tissues.
Stunted growth and development.
Dry, thin, and wrinkled skin.
Prominent bones with little or no subcutaneous fat.
Thin, sparse hair.
Irritability and apathy.
Chronic diarrhea.
Weakened immune system, leading to increased susceptibility to infections.
Bradycardia (slow heart rate).
Hypothermia (low body temperature).
Causes
Severe calorie and nutrient deficiency, often due to inadequate food intake.
Poverty and food insecurity.
Lack of access to nutritious foods.
Improper feeding practices, such as early weaning or diluted formula.
Chronic infections, such as diarrhea or respiratory infections, which increase nutrient requirements and decrease absorption.
Underlying medical conditions that interfere with nutrient absorption or metabolism.
Medicine Used
There is no specific "medicine" for marasmus. Treatment focuses on nutritional rehabilitation, which involves:
Rehydration: Addressing any dehydration with oral rehydration solutions or, in severe cases, intravenous fluids.
Nutritional Support: This is a stepwise process:
Initial Phase (Stabilization): Carefully reintroducing nutrients with specialized formulas like F-75 (a therapeutic milk formula) to prevent refeeding syndrome.
Transition Phase: Gradually increasing caloric intake with formulas like F-100, while monitoring for complications.
Rehabilitation Phase: Continued feeding with nutrient-dense foods to promote weight gain and catch-up growth.
Treatment of Infections: Addressing any underlying infections with appropriate antibiotics or other medications.
Vitamin and Mineral Supplementation: Providing essential vitamins and minerals to correct deficiencies.
Is Communicable
No, marasmus is not communicable. It is a nutritional deficiency disease, not an infectious disease.
Precautions
Promote breastfeeding: Encourage exclusive breastfeeding for the first six months of life.
Ensure adequate nutrition: Provide infants and young children with a balanced diet that meets their nutritional needs.
Improve food security: Address poverty and food insecurity through social programs and economic development.
Educate caregivers: Educate caregivers on proper feeding practices and the importance of nutrition.
Prevent and treat infections: Implement measures to prevent and treat common childhood infections, such as diarrhea and respiratory infections.
Monitor growth: Regularly monitor children's growth and development to identify early signs of malnutrition.
How long does an outbreak last?
Marasmus doesn't occur in "outbreaks" like infectious diseases. Its prevalence is related to chronic factors like poverty and food insecurity. The duration of an episode in an individual depends on the severity of the malnutrition and the effectiveness of the treatment plan. Nutritional rehabilitation can take several weeks or months.
How is it diagnosed?
Diagnosis is based on:
Clinical Assessment: Physical examination revealing severe wasting, muscle loss, and other characteristic symptoms.
Anthropometric Measurements: Assessing weight, height, and mid-upper arm circumference (MUAC) to determine the degree of malnutrition. Weight-for-age is often significantly below the normal range.
Medical History: Gathering information about the child's dietary intake, feeding practices, and any underlying medical conditions.
Laboratory Tests: Blood tests to assess for electrolyte imbalances, anemia, and other nutritional deficiencies, as well as to rule out underlying medical conditions.
Timeline of Symptoms
The timeline of symptoms varies depending on the severity of the malnutrition and the child's overall health. Generally:
Early Stage: Gradual weight loss, slowing of growth, and decreased activity levels.
Progressive Stage: Continued weight loss, muscle wasting becomes more apparent, skin becomes dry and wrinkled, and the child may become irritable.
Severe Stage: Severe wasting, prominent bones, loss of subcutaneous fat, increased susceptibility to infections, and potentially life-threatening complications.
Important Considerations
Refeeding Syndrome: A potentially fatal complication that can occur when severely malnourished individuals are rapidly refed. It involves electrolyte imbalances and fluid shifts. Careful monitoring and gradual reintroduction of nutrients are crucial to prevent this.
Psychosocial Support: Malnutrition can have significant psychological and developmental effects. Providing psychosocial support to the child and family is essential for recovery.
Long-term Follow-up: Children who have recovered from marasmus require long-term follow-up to monitor their growth and development and to prevent relapse.
Prevention is Key: Addressing the underlying causes of malnutrition, such as poverty and food insecurity, is essential for preventing marasmus.