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NUTRITIONAL RICKETS IN YOUNG NIGERIAN CHJLDREN IN THE SAHEL SAVANNA
Abstract
Objectives: To determine the prevalence of clinical and biochemical rickets in an under-five
out-patient population, relate the prevalence of biochemical ricliets (BR) to the sociocultural
characteristics of families and determine the response af nutritional rickets to
vitamin D therapy.
Design: Prospective cross-sectional and retrospective case-series SI lrveys.
Setting: Paediatric general out-patient and consultant clinics.
Subjects: One hundred and ninety eight out-patients and twenty two patients aged >1 to 60
months treated for nutritional rickets.
Interventions: Clinical examination, interview with mothersand dete~ mination of biochemical
abnormalities of under-fives and management of patients with riclrets using stosstherapy.
Main outcome measures: Prevalence of BR and response to stosstherapy.
Results: Eight (4%) patients in the survey had clinical and biocbernic al rickets while 33 (17%)
had biochemical rickets only; 92 (47%) other patients had isolate11 hypocalcaemia and/or
hypophosphataemia. The prevalence of BR was higher in males (p d).05), and increased with
age (p <0.001). The prevalence was lower in families who were indigel lous to the area (p <0.05),
children of Moslem families (p <0.05) and children whose mothers w ere full-time housewives,
unskilled or traders (p <0.01), and who lacked any formal western ed~ lcation (p = 0.157). Three
of the seven evaluable patients who received stosstherapy responde 3 late.
Conclusion: The results support the hypothesis that deficiency 01. reduced availability of
dietary calcium may be of at least equal importance with vitamin D d eficiency in the aetiology
of nutritional rickets in the Sahel savanna.
out-patient population, relate the prevalence of biochemical ricliets (BR) to the sociocultural
characteristics of families and determine the response af nutritional rickets to
vitamin D therapy.
Design: Prospective cross-sectional and retrospective case-series SI lrveys.
Setting: Paediatric general out-patient and consultant clinics.
Subjects: One hundred and ninety eight out-patients and twenty two patients aged >1 to 60
months treated for nutritional rickets.
Interventions: Clinical examination, interview with mothersand dete~ mination of biochemical
abnormalities of under-fives and management of patients with riclrets using stosstherapy.
Main outcome measures: Prevalence of BR and response to stosstherapy.
Results: Eight (4%) patients in the survey had clinical and biocbernic al rickets while 33 (17%)
had biochemical rickets only; 92 (47%) other patients had isolate11 hypocalcaemia and/or
hypophosphataemia. The prevalence of BR was higher in males (p d).05), and increased with
age (p <0.001). The prevalence was lower in families who were indigel lous to the area (p <0.05),
children of Moslem families (p <0.05) and children whose mothers w ere full-time housewives,
unskilled or traders (p <0.01), and who lacked any formal western ed~ lcation (p = 0.157). Three
of the seven evaluable patients who received stosstherapy responde 3 late.
Conclusion: The results support the hypothesis that deficiency 01. reduced availability of
dietary calcium may be of at least equal importance with vitamin D d eficiency in the aetiology
of nutritional rickets in the Sahel savanna.
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