DOI: http://dx.doi.org/10.18203/2349-3291.ijcp20192045

Social dilemma and vitamin D deficiency: a cross-sectional study of nutritional rickets in children ages 6 months to 24 months

Sajid S., Irfan Khan, Khalid K., Khalil A., Zahid I. Marwat, Shah N.

Abstract


Background: In developing countries, malnutrition's is one of the challenges that still need to be addressed. Undernutrition is usually a result of the unavailability of food and/or repeated infections in children. Countries with comparatively lower per-capita incomes as well as those with middle per-capita income have its increased prevalence in younger age. Social dilemma of mothers, like exclusively breastfeeding, heavy clothing’s and practice of keeping babies inside the doors, lead vitamin D deficiency and ultimately into nutritional rickets. The objective of this study was to determine the frequency of factors leading to nutritional rickets in children ages 6 months to 24 months.

Methods: This cross-sectional study was conducted at Department of Pediatrics, Ayub Teaching Hospital, Abbottabad, Pakistan from March to December 2017. After inclusion/exclusion criteria, total 160 patients of rickets were observed. Detailed history followed by vitamin D level (<15 ng/ml) was measure. Data was analyzed by SPSS-22 and all documents were locked with principal author.

Results: Present study showed that 62% children were in age ranged 6-12 months and 38% children were in age range 13-24 months. Mean age was 12 months with SD±2.16. Seventy nine percent children were male, and 21% children were females. More over 52% children had exclusive breast feeding, and 48% children did not have exclusive breast feeding. Similarly, 15% children had limited sun-light exposure and 85% children did not have limited sun-light exposure.

Conclusions: Present study concluded that a lack of health education and sunlight exposure and exclusive breastfeeding were the significant risk factors contributed to nutritional rickets among children of Abbottabad, Pakistan.


Keywords


Children, Lower respiratory tract infections, Nutritional rickets

Full Text:

PDF

References


Wagner CL, Greer FR. Prevention of rickets and vitamin D deficiency in infants, children, and adolescents. Pediatrics. 2008;122(5):1142-52.

Du X, Greenfield H, Fraser DR, Ge K, Trube A, Wang Y. Vitamin D deficiency and associated factors in adolescent girls in Beijing. Am J Clin Nutr. 2001;74:494-500.

Harris NS, Crawford PB, Yangzom Y, Pinzo L, Gyaltsen P, Hudes M. Nutritional and health status of Tibetan children living at high altitudes. N Engl J Med. 2001;344:341-7.

Hag AI, Karrar ZA. Nutritional vitamin D deficiency rickets in Sudanese children. Ann Trop Paediatr. 1995;15:69-76.

Oginni LM, Worsfold M, Oyelami OA, Sharp CA, Powell DE, Davie MW. Etiology of rickets in Nigerian children. J Pediatr. 1996;128:692-4.

Muhe L, Luiseged S, Mason KE, Simoes EAF. Case-control study of the role of nutritional rickets in the risk of developing pneumonia in Ethiopian children. Lancet. 1997;349:1801-4.

Siddiqui, TS, Rai MI. Presentation and predisposing factors of nutritional rickets in children of Hazara Division. J Ayub Med. 2005;17;29-32.

Pugliese MT, Blumberg DL, Hludzinski J, Kay S. Nutritional rickets in suburbia. J Am Nutrition. 2003;17:637-41.

Thacher TD, Fischer PR, Strand MA. Pettifor JM. Nutritional rickets around the world: causes and future directions. Ann Trop Pediatrics. 2005;26:1-16.

Molla M, Badawi M, Al-Yaish S, Sharma P, El-Salam R, Molla A. Risk factors for nutritional rickets among children in Kuwait. Pediatrics Int. 2000;42:280-4.

Matsuo K, Mukai T, Suzuki S, Fujieda K. Prevalence and risk factors of vitamin D deficiency rickets in Hokkaido, Japan. Pedia Int. 2000;51:559-62.

Lawrence M, Gartner MD, Frank R, Greer MD. Prevention of rickets and vitamin D deficiency: new guidelines for vitamin D intake. Pediatrics. 2003;111:908-10.

Rajakumar M. Vitamin D, Cod-Liver Oil, Sunlight, and Rickets: a historical perspective. Pediatrics 2003;112:el32-35.

Gartner LM, Greer FR. Section on breast feeding medicine and committee on nutrition. American academy of pediatrics. prevention of rickets and vitamin D deficiency: new guidelines for vitamin D intake. Pediatrics. 2003;111:908-10.

Cesur Y, Çaksen H, Gündem A, Kırimi E, Odabaş D. Comparison of low and high dose of vitamin D treatment in Nutritional vitamin D deficiency rickets. JPEM. 2003;16:1105-09.

Hatun Ş, Bereket B, Çalıkoğlu AS, Özkan B. Vitamin D deficiency and nutritional rickets today. J Child Heal Dis. 2003;46:224-41.

Bhakhri BK, Debata PK. Nutritional rickets presenting with myelofibrosis. Ind J Pediatrics. 2010;77:1437-9.

Unuvar T, Buyukgebiz A. Nutritional rickets and vitamin D deficiency infants, children and adolescents. Pediatric Endocrinol Rev. 2010;7:283-91.

Özkan B, Büyükavcı M, Aksoy H, Tan H, Akdağ R. Incidence of rickets among 0-3-year-old children in Erzurum. J Child Heal Dis. 1999;42:389-96.

Misra M, Pacaud D, Petryk A, Solberg FC, Kappy M. Vitamin D deficiency in children and its management: Review of current knowledge and recommendations. Pediatrics. 2008;122:398-417.