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Long-term follow-up of severe protein-energy malnutrition in Eastern Zaïre.

In an area in Eastern Zaire where protein-energy malnutrition is highly endemic 171 children who had been treated for severe protein-energy malnutrition (PEM) wer traced after discharge from hospital for 5 years. Their nutritional status on admission was as follows: kwashiorkor 5% marasmus 1% marasmic kwashiorkor 93% nutritional dwarfism 1%. The average age on admission was 46 months. The proportion surviving to the end of 5th year was 0.816. This proportion surviving was lowest for the year following discharge from hospital especially for the youngest children. Follow-up included a clinical examination the measurement of height and weight and the determination of serum albumin by paper electrophoresis. No catch-up for weight and for height was observed and the serum albumin concentrations decreased after the 1st year. Neither weight for age nor height for age are associated in this study with increased frequency of death either at 1 year or at 5 years after discharge. There is no significant acceleration in growth for height or weight among survivors during the 5 years after discharge. Serum albumin concentrations at the end of the 1st year remain simiar to those observed on discharge but they decrease markedly thereafter. Children who suffer from PEM before the age of 2 have a decreased chance of survival the risk of death being particularly high during the 1st year of discharge.