发达国家/地区几乎从未出现恶性营养不良。 恶性营养不良在撒哈拉以南非洲地区较为普遍，常见于东南亚和中美洲地区，发病者为居住于粮食不安全状况严重或饥荒盛行地区的幼儿。 患病率因地理区域而异，报告的幼儿重度急性营养不良患病率从长期粮食得不到保障社区的 6% 到面临饥荒地区的 25% 不等。[3]Valid International. Community-based therapeutic care (CTC): a field manual. 2006. [internet publication].http://www.fantaproject.org/sites/default/files/resources/CTC-Field-Manual-Oct2006-508.pdf[4]Davis LE. Epidemiology of famine in the Nigerian crisis: rapid evaluation of malnutrition by height and arm circumference in large populations. Am J Clin Nutr. 1971 Mar;24(3):358-64.http://www.ncbi.nlm.nih.gov/pubmed/5548743?tool=bestpractice.com[5]Scrimshaw NS, Behar M, Viteri F, et al. Epidemiology and prevention of severe malnutrition (kwashiorkor) in Central America. Am J Public Health. 1957 Jan;47(1):53-62.http://ajph.aphapublications.org/doi/pdf/10.2105/AJPH.47.1.53http://www.ncbi.nlm.nih.gov/pubmed/13381843?tool=bestpractice.com 与其他地区的儿童相比，农村地区（特别是以非畜牧业为生的无家畜农耕地区）的儿童罹患恶性营养不良的可能性更大。[6]Saloojee H, De Maayer T, Garenne ML, et al. What's new? Investigating risk factors for severe childhood malnutrition in a high HIV prevalence South African setting. Scand J Public Health Suppl. 2007 Aug;69:96-106.http://journals.sagepub.com/doi/pdf/10.1080/14034950701356435http://www.ncbi.nlm.nih.gov/pubmed/17676510?tool=bestpractice.com 恶性营养不良的发病年龄通常为 1 至 3 岁，且男女患病几率相当。 恶性营养不良一直是粮食不安全地区面临的主要问题。[7]Latham MC. Protein-energy malnutrition - its epidemiology and control. J Environ Pathol Toxicol Oncol. 1990 Jul-Oct;10(4-5):168-80.http://www.ncbi.nlm.nih.gov/pubmed/2124617?tool=bestpractice.com[8]Oyedeji GA. The present day epidemiology of severe protein-energy malnutrition in Nigeria. Clin Pediatr (Phila). 1984 Nov;23(11):623-8.http://www.ncbi.nlm.nih.gov/pubmed/6435922?tool=bestpractice.com
