BAB 1 Busung lapar

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Busung lapar/kwashiorkor

Salah satu dari banyak anak penderita busung lapar di pengungsian

selama Perang Biafra

Klasifikasi dan rujukan luar

Spesialisasi Pediatri

ICD-10 E40., E42.

ICD-9-CM 260

DiseasesDB 7211

MedlinePlus 001604
 MeSH D007732

[sunting di Wikidata]

Busung lapar atau honger oedema disebabkan cara bersama atau salah satu
dari simtoma marasmus dan kwashiorkor adalah sebuah fenomena penyakit di Indonesia bisa
diakibatkan karena kekurangan protein kronis pada anak-anak yang sering disebabkan beberapa
hal, antara lain anak tidak cukup mendapat makanan bergizi, anak tidak mendapat asuhan gizi yang
memadai dan anak mungkin menderita infeksi penyakit.
Istilah kwashiorkor sendiri berasal dari bahasa salah satu suku di Afrika yang berarti "kekurangan
kasih sayang ibu". Tanda yang khas adalah adanya edema (bengkak) pada seluruh tubuh sehingga
tampak gemuk, wajah anak membulat dan sembab (moon face) terutama pada bagian wajah,
bengkak terutama pada punggung kaki dan bila ditekan akan meninggalkan bekas seperti lubang,
otot mengecil dan menyebabkan lengan atas kurus sehingga ukuran LIngkar Lengan Atas LILA-nya
kurang dari 14 cm, timbulnya ruam berwarna merah muda yang meluas dan berubah warna menjadi
coklat kehitaman dan terkelupas, tidak bernafsu makan atau kurang, rambutnya menipis berwarna
merah seperti rambut jagung dan mudah dicabut tanpa menimbulkan rasa sakit, sering disertai
infeksi, anemia dan diare, anak menjadi rewel dan apatis perut yang membesar juga sering
ditemukan akibat dari timbunan cairan pada rongga perut salah salah gejala kemungkinan
menderita "busung lapar".[1]
Penyebab langsung tersebut bisa dikarenakan adanya bencana alam, daya beli masyarakat,
tingkat pendidikan, kondisi lingkungan dan pelayanan kesehatan.
Cara mendeteksi penderita busung lapar pada anak yaitu dengan cara menimbang berat badan
secara teratur bila perbandingan berat badan dengan umurnya dibawah 60% (standar WHO-NCHS)
maka anak tersebut dapat dikatakan terindikasi busung lapar atau dengan cara mengukur tinggi
badan dan LIngkar Lengan Atas (LILA) bila tidak sesuai dengan standar anak yang normal kurang
dari 14 cm (standar WHO-NCHS) waspadai akan terjadi busung lapar.
Dampak runtutan dari adanya busung lapar berakibatkan pada penurunan tingkat kecerdasan anak,
rabun senja serta rentan terhadap penyakit terutama penyakit infeksi. Menurut ketentuan WHO bila
angka telah mencapai 30 % dinyatakan tinggi dan perlu tindakan lebih lanjut.
Pencegahan dapat dilakukan dengan memberikan makanan yang bergizi pada anak berupa sayur
mayur, buah-buahan, makanan yang mengandung karbohidrat (seperti nasi, kentang, jagung),
makanan yang mengandung protein (telur, ikan,daging) dll, kemudian dianjurkan pemberian air susu
ibu (ASI) bagi anak berusia dari 0 bulan sampai dengan 24 bulan.

BAB 2 What Is
Kwashiorkor?
 Causes
 Symptoms

 Diagnosis

 Treatment

 Complications

 Prevention

2.1. Understanding
kwashiorkor
Kwashiorkor, also known as “edematous malnutrition” because
of its association with edema(fluid retention), is a nutritional
disorder most often seen in regions experiencing famine. It is a
form of malnutrition caused by a lack of protein in the diet.
People who have kwashiorkor typically have an extremely
emaciated appearance in all body parts except their ankles,
feet, and belly, which swell with fluid.

Kwashiorkor is rarely found in the United States and other

countries with a generally steady food supply. It’s most
common in sub-Saharan Africa and other countries where
people routinely have a limited supply of food.

Most people who are affected by kwashiorkor recover fully if

they are treated early. Treatment involves introducing extra
calories and protein into the diet. Children who develop
kwashiorkor may not grow or develop properly and may remain
stunted for the rest of their lives. There can be serious
complications when treatment is delayed,
including coma, shock, and permanent mental and physical
disabilities. Kwashiorkor can be life-threatening if it’s left
untreated. It can cause major organ failure and eventually
death.

2.2. What causes

kwashiorkor?
Kwashiorkor is caused by a lack of protein in the diet. Every
cell in your body contains protein. You need protein in your diet
for your body to repair cells and make new cells. A healthy
human body regenerates cells in this way
constantly. Protein is also especially important for growth
during childhood and pregnancy. If the body lacks protein,
growth and normal body functions will begin to shut down, and
kwashiorkor may develop.

Kwashiorkor is most common in countries where there is a

limited supply or lack of food. It is mostly found in children and
infants in sub-Saharan Africa, Southeast Asia, and Central
AmericaTrusted Source. A limited supply or lack of food is
common in these countries during times of famine caused by
natural disasters — such as droughts or floods — or political
unrest. A lack of nutritional knowledge and regional
dependence on low-protein diets, such the maize-based diets
of many South American countries, can also cause people to
develop this condition.

This condition is rare in countries where most people have

access to enough food and are able to eat adequate amounts
of protein. If kwashiorkor does occur in the United States, it
can be a sign of abuse, neglect, or fad diets, and it’s found
mostly in children or older adults. It can also be a sign of an
underlying condition, such as HIV.

2.3. What are the symptoms

of kwashiorkor?
The symptoms of kwashiorkor include:

 change in skin and hair color (to a rust color) and texture
 fatigue

 diarrhea

 loss of muscle mass

 failure to grow or gain weight

 edema (swelling) of the ankles, feet, and belly

 damaged immune system, which can lead to more

frequent and severe infections

 irritability

 flaky rash

 shock
 2.4. How is kwashiorkor
diagnosed?
If kwashiorkor is suspected, your doctor will first examine you
to check for an enlarged liver (hepatomegaly) and swelling.
Next, blood and urine tests may be ordered to measure the
level of protein and sugar in your blood.

Other tests may be performed on your blood and urine to

measure signs of malnutrition and lack of protein. These tests
may look for muscle breakdown and assess kidney function,
overall health, and growth. These tests include:

 arterial blood gas

 blood urea nitrogen (BUN)

 blood levels of creatinine

 blood levels of potassium

 urinalysis

 complete blood count (CBC)

2.5. How is kwashiorkor

treated?
Kwashiorkor can be corrected by eating more protein and more
calories overall, especially if treatment is started early.
You may first be given more calories in the form of
carbohydrates, sugars, and fats. Once these calories provide
energy, you will be given foods with proteins. Foods must be
introduced and calories should be increased slowly because
you have been without proper nutrition for a long period. Your
body may need to adjust to the increased intake.

Your doctor will also recommend long-term vitamin and mineral

supplementation to your diet.

2.6. What are the

complications of
kwashiorkor?
Even with treatment, children who have had kwashiorkor may
never reach their full growth and height potential. If treatment
comes too late, a child may have permanent physical and
mental disabilities.

If left untreated, the condition can lead to coma, shock, or

death.

2.7. Eating right and knowing

the signs
Kwashiorkor can be prevented by making sure you eat enough
calories and protein-rich foods. Dietary guidelines from
the Institute of MedicineTrusted Source recommend that 10 to
35 percent of adults’ daily calories come from protein. Five to
20 percent of young children’s and 10 to 30 percent of older
children and teenagers’ daily calories should come from
protein.

Protein can be found in foods like:

 seafood
 eggs

 lean meat

 beans

 peas

 nuts

 seeds

Children and older adults, the two groups who most commonly
experience kwashiorkor as a result of abuse or neglect, will
display typical symptoms of the condition. The most visible
symptoms are swelling of the ankles, feet, and belly. In some
cases of abuse or neglect, these symptoms may also
accompany other signs of mistreatment, such as bruising and
broken bones.

If you suspect a person is in immediate danger because of

abuse or neglect, call 911 right away. Cases of abuse and
neglect that don’t appear immediately life-threatening should
be reported to your state’s abuse hotline. Child abuse cases
may also be reported to the Childhelp National Child Abuse
Hotline at 800-4-A-CHILD