Malnutrition is the cellular imbalance between the supply
of nutrients and energy and the body's demand for them
to ensure growth, maintenance, and specific functions
(WHO). The term protein energy malnutrition (PEM)
includes marasmus, kwashiorkor, and intermediate states
of marasmic-kwashiorkor. Children may present with a
mixed picture of marasmus and kwashiorkor, or milder
forms of malnutrition (Scheinfeld et al., 2012).
In 2000, world health organization (WHO) estimated
that malnourished children were 181.9 million (32%) in
developing countries. In addition, an estimated 149.6
million children under 5 years are malnourished when
measured in terms of weight for age. The same report
indicated that in South Central Asia and Eastern Africa,
about half of the children have growth retardation due to
PEM (WHO/Nutrition for Health and Development (NHD),
2000).
PEM has been identified as the most lethal form of
malnutrition indirectly or directly causing annual death of
at least 5 million children worldwide. Estimates indicate