The present day epidemiology of severe protein-energy malnutrition in Nigeria.

Eighty-eight patients with severe protein-energy malnutrition (PEM) admitted into the Wesley Guild Hospital, Ilesa, Nigeria over a 9-month period were studied to define the patterns and factors encountered currently in PEM. Severe PEM now occurs predominantly in the 6- to 18-month age group, which is earlier than was reported previously. The majority of the parents were Yoruba Christians and were low-income workers or unemployed. Poverty was a factor in 54.5 percent. Most of the parents were literate. About half of the families were polygamous. The prevalence of social problems was high, with 72.7 percent of the parents living apart. Attacks of measles and recurrent or prolonged gastroenteritis were preceding precipitating factors in 30.7 percent and 33 percent of the patients, respectively. Failure or cessation of breast-feeding or bottle-feeding with cow's milk from the first month of life preceded the development of PEM in a large percentage of patients. The implications of these findings are discussed.