"Children and adults with marasmus neither have enough protein in their diets nor do they take in enough calories. Marasmus affects mostly children below the age of one in poor countries. Body weights of children with marasmus may be up to 80 percent less than that of a normal child of the same age. Marasmus is a Greek word meaning “starvation.” The syndrome affects more than fifty million children under age five worldwide. It is characterized by an extremely emaciated appearance, poor skin health, and growth retardation. Symptoms include acute fatigue, hunger, and diarrhea. Kwashiorkor and marasmus often coexist as a combined syndrome termed marasmic kwashiorkor. Children with the combined syndrome have variable amounts of edema and the characteristics and symptoms of marasmus. Although organ system function is compromised by undernutrition, the ultimate cause of death is usually infection. Undernutrition is intricately linked with suppression of the immune system at multiple levels, so undernourished children commonly die from severe diarrhea and/or pneumonia resulting from bacterial or viral infection. The United Nations Children’s Fund reports that undernutrition causes at least one-third of deaths of young children. As of 2008, the prevalence of children under age five who were underweight was 26 percent."