© 1981 by Oxford University Press
research-article |
Severe Protein-Energy Malnutrition in Kuala Lumpur
*Department of Paediatrics, General Hospital Kuala Lumpur
Division of Nutrition, Institute for Medical Research (I.M.R.) Kuala Lumpur
Except for the description of one case of severe PEM by Chen (1974), there has been little documentation of severe PEM from Malaysian Hospitals for the past decade or so. This report complements available information on the prevalence of PEM in field situations and indicates that despite the rapid pace of development occuring around the urban city of Kuala Lumpur, PEM can still be found in its midst. This is hardly surprising. since the well recognized contributory factors to PEM, such, as, poor socio-economic status, poor housing, large families, parental neglect and low educational status were all observed in the present series.
The Straits Times of Malaysia (May 13, 1977-Editorial) estimated that there were about 200,000 squatters around the city of Kuala Lumpur. The size of this disadvantaged group of urban dwellers suggests that there may be many other urban children who are potentially vulnerable to the development of PEM. Thus PEM need not necessarily be confined to rural Malaysia; the disadvantaged urban poor seem equally susceptible.
The Wellcome Classification for severe PEM was found to be most valuable in the hospital diagnosis of PEM. This was particularly so, especially when none of the PEM cases observed presented with all the clinical features usually attributed to this nutritional disorder. Nutritional biochemistry and anthropometric indices of "wasting" and "stunting" seem to support the validity of diagnosis.
We hope that this report would stimulate further study and documentation of severe PEM in Malaysian Hospitals. Such data if available on a regular basis should be of considerable interest and value to health and economic planners especially when taken into consideration with data obtained during community nutritional assessment.