The distribution of kwashiorkor in the southern region of Malawi.

Using existing nutritional survey data collected over an 11-month period during the recent drought, we sought to determine the distribution of kwashiorkor in the ten districts of the Southern Region of Malawi. Sampling and survey methods were identical and considerable efforts were made to ensure comparability. In 23 surveys, 25,824 children were weighed and measured and oedema was recorded. The district-adjusted prevalence of kwashiorkor was 18/1000. The northernmost districts of the Southern Region had rates five to ten times higher than the southernmost districts. Prevalence peaked at 18-23 months and was similar in boys and girls. Dysentery was associated with the presence of kwashiorkor while diarrhoea was not. The distinctive pattern of kwashiorkor in the region suggests that there are characteristics specific to the northern districts that place children in these areas at greater risk of kwashiorkor.