Conference abstract

Widening our understanding on kwashiorkor through an exploratory approach with key informants

Pan African Medical Journal - Conference Proceedings. 2018:9(45).22 Sep 2018.
doi: 10.11604/pamj-cp.2018.9.45.773
Archived on: 22 Sep 2018
Contact the corresponding author
Keywords: Kwashiorkor, mixed methodology, gut microbiota, splanchnic disorder
Oral presentation

Widening our understanding on kwashiorkor through an exploratory approach with key informants

Huerta Uribe Nidia1,&, Kovach Colleen2, Martínez García Daniel3, Rakotoambinina Benjamin4

1University of Westminster, Westminster, United Kingdom, 2Médecins Sans Frontières, Switzerland, 3Médecins Sans Frontières, Medical Department, Geneva, 4University of Antananarivo, Antananarivo, Madagascar

&Corresponding author
Huerta Uribe Nidia, University of Westminster, United Kingdom


Introduction: kwashiorkor is a clinical syndrome characterized by bilateral pitting oedema, fatty liver, skin and hair alterations and poor prognosis. Although it was recognized more than 150 years ago, its pathogenesis is still obscure. The aim of this study was to gather a further understanding of the aetiology, pathophysiology and risk factors associated with kwashiorkor.

Methods: a mixed methodology including a literature review and interviews with key informants was performed. Published and unpublished materials were reviewed during the first phase. Key issues and gaps identified during the literature review were used to formulate the questionnaire, which was then applied in the second phase. A deductive and inductive thematic analysis of the information gathered was performed for both phases.

Results: there is lack of strong evidence supporting any of the theories proposed in the literature as a single causal factor, which was consistent with the uncertainty found in the study's qualitative phase. Kwashiorkor is more likely to be the expression of a combination of factors, among which diet, gut microbiota, metabolism and environmental factors are involved. The most important risk factor identified was infection. Both literature and participants agree on a remarkable geographical variation in the incidence of Kwashiorkor, however the pattern's cause is unknown. The social and environmental aspects are neglected from research, however, almost all informants agree these are part of the context in which Kwashiorkor develops.

Conclusion: after 150 years, we are still missing a lot of knowledge about this syndrome. A “dysadaptation of the gut microbiota” may be the link between environment, diet and metabolism in Kwashiorkor, which potentially explains the clinical features and the geographical variations reported. Extensive research is still needed in order to understand this entity and to improve the prognosis of children with Kwashiorkor.