CHAPTER 1

INTRODUCTION
Malnutrition is the result of deficiency of protein, energy, minerals as well
as vitamins leading to loss of body fats and muscle tissues. Malnutrition is a
significant public health problem which is often neglected. (2). The World Health
Organization estimates that by the year 2015, the prevalence of malnutrition will
have decreased to 17.6% globally, with 113.4 million children younger than 5
years affected as measured by low weight for age. The overwhelming majority of
these children, 112.8 million, will live in developing countries with 70% of these
children in Asia, particularly the southcentral region, and 26% in Africa. An
additional 165 million (29.0%) children will have stunted length/height secondary
to poor nutrition.

(3)

Malnutrition is directly responsible for 300,000 deaths per

year in children younger than 5 years in developing countries and contributes

indirectly to more than half of all deaths in children worldwide. (6)
Protein-energy undernutrition (PEU), previously called protein-energy
malnutrition, is an energy deficit due to deficiency of all macronutrients. It
commonly includes deficiencies of many micronutrients. In children, chronic
primary PEU has 2 common forms: marasmus and kwashiorkor. The form
depends on the balance of nonprotein and protein sources of energy. (7)
Kwashiorkor is one of the serious forms of PEM. Kwashiorkor is almost
never seen in the developed world. Widespread in sub-Saharan Africa and
common in Southeast Asia and Central America, kwashiorkor occurs in young
children living in areas with endemic food insecurity or famine; prevalence varies
by geographic area, with reported levels ranging up to 6% in some chronic
foodinsecure communities and occasionally to one quarter of young children in
areas facing famine. (10)