Severe rickets in a children's hospital in Addis Ababa

A retrospective, case-controlled study of rachitic patients admitted to Ethio-Swedish Children's Hospital (ESCH), Addis Ababa, Ethiopia, over a ten-year period (1979-1988) is presented. Clinical records of 131 patients with clinical and radiological evidence of rickets and an equal number of randomly selected, age and sex matched controls with no rickets were analysed. Rickets was found to be more common in males (2:1) and at 6 to 18 months of age (79%). Associated findings were infectious diseases (90%), protein-energy malnutrition (75%), anaemia (39%), and congestive heart failure (16). Mortality was much higher in rachitic patients. The admission rates show a progressive increase over the study period. The need for early diagnosis and treatment, continued nutrition and health education, and further study to elucidate the relation between protein-energy malnutrition (PEM) and rickets is suggested.