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Nutritional rickets around the world: causes and future directions
Tom D Thacher1, Philip R Fischer, Mark A Strand
1Department of Family Medicine, Jos University Teaching Hospital, Nigeria.
Annals of Tropical Paediatrics
|February 24, 2006
Summary
Nutritional rickets is caused by a spectrum of vitamin D and calcium deficiencies, varying by region. Addressing both deficiencies is crucial, as vitamin D alone may not suffice where calcium intake is limited.
Area of Science:
- Nutritional Science
- Pediatrics
- Public Health
Background:
- Nutritional rickets is a global health concern, reported in at least 59 countries over the past two decades.
- The etiological factors contributing to rickets exhibit significant geographical variation.
Purpose of the Study:
- To systematically review the prevalence and causes of nutritional rickets worldwide.
- To analyze the geographical differences in rickets etiology over the last 20 years.
Main Methods:
- Systematic review of published articles on nutritional rickets.
- Extraction of data on rickets prevalence and causative factors from diverse geographical regions.
Main Results:
- Calcium deficiency is a primary cause in Africa and parts of Asia, with increasing recognition globally.
- Vitamin D deficiency rickets is resurging in North America and Europe, typically presenting earlier in infancy than calcium deficiency rickets.
- Distinguishing between vitamin D and calcium deficiency rickets is challenging in many developing countries due to limited reporting of 25-hydroxyvitamin D levels.
Conclusions:
- Nutritional rickets presents as a spectrum, from isolated vitamin D deficiency to isolated calcium deficiency.
- Interactions between calcium and vitamin D deficiencies, influenced by genetic and environmental factors, likely contribute to rickets development.
- Vitamin D supplementation may be insufficient for treating rickets in populations with inadequate calcium intake.