Oedema is seen as swollen feet, legs, hands, arms and face. Children with oedema are sometimes described as having kwashiorkor, and those with severe wasting and no oedema as having marasmus. A child with a combination of severe wasting and oedema may be described as having marasmic-kwashiorkor. These terms, however, have largely been replaced by the general term ‘severe acute malnutrition’. Oedema is graded into three levels, based on its severity:

• Grade + (mild) is oedema of both feet;
• Grade ++ (moderate) is oedema of the feet plus lower legs, hands or lower arms;
• Grade +++ (severe) is generalised oedema including feet, legs, hands, arms and face.