Kwashiorkor – ‘revisiting the evidence’

Author(s): South Sudan Medical Journal

Kwashiorkor – ‘revisiting the evidence’

Kwashiorkor malnutrition affects hundreds of thousands of children and kills tens of thousands each year. Although recognized as a unique form of malnutrition since the 1930s, its etiology is still unclear. 

A series of webinars was held in 2020 and 2021 to discuss the following topics: 1) the basic characterisation and treatment of kwashiorkor, 2) observable signs of kwashiorkor and 3) metabolic and biochemical characterisation of kwashiorkor.

The full recordings of the webinar series can be found at 

Although a causal association remains to be fully demonstrated, there is general agreement that there is an association between kwashiorkor and low serum albumin; nevertheless, many children with low serum albumin concentration do not develop oedema and some adults with ascites and oedema have normal albumin concentrations. 

Most of the reports on kwashiorkor rely on cross-sectional observations that attempt to explain a snapshot of a highly dynamic process. Therefore, capturing this dynamic process, either by observing determinants of kwashiorkor before it occurs or by subjecting children with kwashiorkor to a metabolic nudge and monitoring their response, may provide deeper insights into the pathophysiology, or perhaps aetiology, of kwashiorkor. In conclusion, there is still much more we do not know about kwashiorkor and more research, especially targeting mechanistic pathways, is necessary to elucidate the aetiology of this disease.

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