Coulter J B, Omer M I, Suliman G I, Moody J B, Macfarlane S B, Hendrickse R G
Department of Tropical Paediatrics, School of Tropical Medicine, Liverpool, U.K.
Ann Trop Paediatr. 1988 Jun;8(2):96-102. doi: 10.1080/02724936.1988.11748548.
The socio-economic and family background and the nutrition of 145 children with kwashiorkor admitted to hospital in Khartoum over a 2-year period were compared with 113 marasmic kwashiorkor, 158 marasmic, and 186 nutritionally normal controls of similar age. Peak admissions for kwashiorkor were in the wet and post-wet season and the mean (SD) age was 1.6 (0.6) months. Mothers of malnourished children were more likely to be pregnant, and had poorer housing, sanitation and water supply, a lower income and food expenditure and less education than controls. Mothers of controls breastfed their children longer, introduced mixed feeding earlier, offered a wider variety of foods, and were more likely to have had their infants immunized. Neither family instability nor cultural practices which result in separation of children from their mothers appear to have an important role in protein-energy malnutrition in the Sudan. Families of kwashiorkor children had a higher food expenditure and better maternal education than marasmic children. There was no significant difference between the two groups in duration of breastfeeding or in the age of introduction of mixed diet. However, kwashiorkor children appeared to be offered more meat. Differences in food availability could account for the relative retardation of growth and lack of subcutaneous fat in marasmus compared to kwashiorkor.
在两年时间里，对喀土穆收治的145名夸希奥科病儿童的社会经济和家庭背景以及营养状况，与113名消瘦型夸希奥科病儿童、158名消瘦儿童以及186名年龄相仿的营养正常儿童进行了比较。夸希奥科病的入院高峰出现在雨季和雨季后，平均（标准差）年龄为1.6（0.6）个月。与对照组相比，营养不良儿童的母亲更有可能怀孕，住房、卫生和供水条件较差，收入和食品支出较低，受教育程度也较低。对照组儿童的母亲母乳喂养时间更长，更早引入混合喂养，提供的食物种类更多，并且其婴儿更有可能接种过疫苗。在苏丹，家庭不稳定以及导致儿童与母亲分离的文化习俗似乎在蛋白质 - 能量营养不良中并不起重要作用。夸希奥科病儿童的家庭食品支出高于消瘦儿童，母亲受教育程度也更高。两组在母乳喂养持续时间或引入混合饮食的年龄方面没有显著差异。然而，夸希奥科病儿童似乎摄入了更多的肉类。食物供应的差异可能解释了与夸希奥科病相比，消瘦症中生长相对迟缓以及皮下脂肪缺乏的原因。
