BWACYE

**Kwashiorkor** KWOSH  CYANGWA KWOSH   Bikekwa ko biterwa no gufata kalori ihagije, ariko hamwe no gukoresha proteine idahagije (cyangwa kubura proteine nziza), itandukanya na marasmus . Ubushakashatsi buherutse gukorwa bwerekanye ko kubura mikorobe ya antioxydeant nka β-karotene, lycopene, izindi karotenoide, na vitamine C kimwe no kuba aflatoxine ishobora kugira uruhare mu iterambere ry’indwara.  Ariko, impamvu nyayo itera kwashiorkor ntiramenyekana. Ibiribwa bidahagije bifitanye isano no kwashiorkor; kugaragara mubihugu byinjiza amafaranga menshi ntibisanzwe.  Bibaho hagati yonsa abana bafite imyaka igera kuri itanu.  

Ibintu bisa na kwashiorkor byanditswe neza kwisi yose mumateka.  Icyakora, umuganga w’abana w’abana bo muri Jamayike, Cicely Williams, yatangije iryo jambo mu 1935, nyuma yimyaka ibiri atangaje ibisobanuro by’indwara ya mbere. Williams niwe wambere wakoze ubushakashatsi kuri kwashiorkor no kuyitandukanya nubundi buke bwimirire. Niwe wambere watanze igitekerezo ko ibyo bishobora kuba bike bya poroteyine.   Iri zina ryakomotse ku rurimi rwa Ga rwo ku nkombe za Gana, bisobanurwa ngo "indwara umwana agira iyo umwana mushya aje" cyangwa "indwara y'umwana wimuwe", kandi ikagaragaza iterambere ry'uburwayi ku mwana mukuru wabaye konsa kuva mu ibere iyo murumunawe aje.  Amata yonsa arimo aside amine ingirakamaro mumikurire yumwana. Mu baturage bafite ibyago, kwashiorkor irashobora gukura nyuma yuko abana bonsa amata yonsa bagatangira kurya indyo yuzuye karubone, harimo ibigori, imyumbati cyangwa umuceri.  

## Ibyiciro

Abana bafite imirire mibi ikabije bafite ibyago byinshi byo kurwara no gupfa.

Kwashiorkor ni bumwe mu buryo nyamukuru bw’imirire mibi yo mu bwana iba mu bihugu bikennye kandi byinjiza amafaranga make. Kwashiorkor ni kenshi byitwa imirire mibi ikabije (SAM). Ubwoko bukabije bwimirire mibi buramenyekana, harimo stunting, marasmus, na kwashiorkor.  Kwashiorkor na marasmus byombi bigwa munsi yumutungo muto witwa protein - imirire mibi (PEM).  Izi ndwara zikunze kuganirwaho hamwe, ariko zishobora gutandukanywa. Kwashiorkor ishyirwa mubikorwa na proteine idahagije mugihe marasmus ifitanye isano no kubura ingufu rusange no guta imitsi bikabije. Kwashiorkor nayo itandukanijwe na marasmus kuberako hari edema. Hariho na marasmic kwashiorkor aribwo kubura karori no muri proteyine.   Nubwo byombi ari ubwoko butandukanye bwimirire mibi ikabije, habayeho kunywa cyane antioxydants, vitamine, namabuye y'agaciro bigaragara kubafite kwashiorkor ugereranije nabafite marasmus. 

## Ibyiciro bya Wellcome
Ibyiciro bya Wellcome  ni uburyo bwo gushyira mu byiciro imirire mibi ya protein-ingufu mu bana ukurikije uburemere bwimyaka yabo kandi bishingiye ku kuba hari indurwe. Ibindi byiciro birimo Gomez ishyirwa mubikorwa na Waterlow.  

## Ibimenyetso n'ibimenyetso
Ikimenyetso gisobanura kwashiorkor mu mwana ufite imirire mibi ni ugutera edema (cyane cyane kubyimba amaboko n'ibirenge). Bitandukanye na marasmus, aho umwijima nizindi ngingo zingenzi zigabanuka mubunini, kwashiorkor irangwa n "umwijima munini wumwijima, fibrosis, hamwe nudukorwa twingingo nyinshi (nk'umwijima, impyiko, na sisitemu y'imitsi)".  Ibindi bimenyetso birimo inda yagutse, kunanuka umusatsi, gutakaza amenyo, uruhu cyangwa umusatsi, hamwe na dermatite . Abana bafite kwashiorkor bakunze kurakara no kubura anorexia . Mubisanzwe, indwara irashobora kuvurwa hongerwamo proteine mumirire; icyakora, irashobora kugira ingaruka ndende kumikurire yumubiri no mubitekerezo byumwana, kandi mubihe bikomeye bishobora kuviramo urupfu. 

Mu bihe byumye, marasmus nindwara zikunze kugaragara zijyanye nimirire mibi. Indi syndrome yimirire mibi irimo cachexia, nubwo akenshi iterwa nindwara zishingiye. Ibi nibitekerezo byingenzi mukuvura abantu bafite kwashiorkor. 

## icyibitera
Etiologiya isobanutse ya kwashiorkor ntisobanutse neza.     Hatanzwe ibitekerezo byinshi bifitanye isano no gusobanura bimwe, ariko ntabwo aribintu byose bigize pathophysiologiya ya kwashiorkor. Harimo, ariko ntibigarukira gusa kubura protein itera hypoalbuminemia, kubura aside amine, guhagarika umutima, no guhindura mikorobe yo mu nda.   

### Referances