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Published on: January 29, 2018
A case-control study on determinants of rickets
D Chali1, F Enquselassie, M Gesese
1Yekatit 12 Hospital, P.O. Box 257, Addis Ababa.
Insights
Rickets risk factors include being a twin, abnormal birth weight, malnutrition, and non-maternal caretakers. Increased sun exposure significantly protects against rickets in children.
Area of Science:
- Pediatrics
- Nutritional Science
- Public Health
Background:
- Rickets, a condition causing bone softening in children, is a significant public health concern.
- Identifying risk factors is crucial for effective prevention and intervention strategies.
Purpose of the Study:
- To investigate the factors associated with rickets diagnosis in a pediatric population.
- To identify both risk and protective factors for rickets.
Main Methods:
- A case-control study was conducted with 156 rickets cases and 307 controls.
- Univariate and multivariate analyses were employed to determine independent associations.
Main Results:
- Independent risk factors identified: being a twin, high birth weight, moderate to severe malnutrition, and having a grandmother as caretaker.
- Protective factors: increased frequency and duration of sun exposure, and exposure while unclothed.
Conclusions:
- Rickets is associated with specific demographic, socioeconomic, and environmental factors.
- Sun exposure emerges as a key protective factor, highlighting the importance of sunlight for bone health in children.
Abstract:
A case-control study on rickets was performed on 156 cases and 307 controls admitted to Birla pediatric wards, Yekatit 12 Hospital. The following factors were significantly (p < 0.05) associated with diagnosis of rickets in univariate analysis: male gender, being a twin, abnormal birth weight, malnutrition, higher birth order, higher number of siblings, having a caretaker who is not the mother, lower education of the caretaker, having a caretaker who is not housewife, and with protective effect, exposure to sunshine (in number of days per week, duration of daily exposure in minutes, and not wearing clothes during exposure). In multivariate analysis, the following factors remained independently associated with diagnosis of rickets in children: being a twin (OR = 5.86, 95% CI = 1.40-24.50), history of high birth weight (OR = 8.94, 95% CI = 2.30-34.70), moderate and severe malnutrition (OR = 5.64, 95% CI = 2.30-13.80 for severe malnutrition when compared to normal weight), having the grand mother as caretaker (OR = 19.80, 95% CI = 3.70-104.70), and with protective effect, exposure to sunshine (OR associated with an increase of one day of exposure per week = 0.65, 95% CI 0.55-0.77; OR associated with daily exposure of more than 30 minutes, when compared to less than 15 minutes = 0.24, 95% CI = 0.09-0.64; and OR associated with being nude while exposed to sunshine = 0.32, 95% CI = 0.14-0.73). There was no significant difference between cases and controls in marital status or religion of the caretakers.
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