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Assessing Working Memory in Children: The Comprehensive Assessment Battery for Children – Working Memory (CABC-WM)

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Nutritional rickets in immigrant and refugee children.

Tom D Thacher¹, Pawel Pludowski², Nick J Shaw³

¹1Department of Family Medicine, Mayo Clinic, 200 First Street SW, Rochester, MN 55905 USA.

Public Health Reviews

|February 17, 2018

Summary

Nutritional rickets, a vitamin D deficiency bone disease, is rising in immigrant children. Early screening and universal vitamin D supplementation are crucial for prevention in vulnerable populations.

Keywords:

Calcium Metabolic bone Nutrition Pediatric Vitamin D

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Area of Science:

Pediatrics
Public Health
Nutritional Science

Background:

Immigrant and refugee children face unique public health challenges, including increased prevalence of diseases rare in host nations.
Nutritional rickets, a condition caused by vitamin D and/or calcium deficiency, is increasingly observed in high-income countries, particularly among immigrant children.
Risk factors include dark skin pigmentation, sun avoidance, cultural practices, and dietary habits common in specific ethnic groups.

Purpose of the Study:

To highlight the rising incidence of nutritional rickets in immigrant and refugee children in high-income countries.
To emphasize the preventable nature of nutritional rickets and advocate for public health interventions.
To recommend screening and supplementation strategies for at-risk pediatric populations.

Main Methods:

Review of the prevalence and risk factors associated with nutritional rickets in immigrant children.
Clinical assessment and radiographic confirmation of nutritional rickets in children under 5 years.
Analysis of vitamin D and calcium requirements for prevention.

Main Results:

Nutritional rickets is increasingly prevalent in children from the Middle East, Africa, and South Asia residing in high-income countries.
Key risk factors include vitamin D deficiency, inadequate calcium intake, dark skin, sun avoidance, and prolonged breastfeeding without supplementation.
The condition can lead to severe consequences including stunted growth, bone deformities, seizures, and even death.

Conclusions:

Screening immigrant and refugee children under 5 from specific ethnic groups for nutritional rickets is recommended.
Universal vitamin D supplementation (400 IU/d for infants, 600 IU/d thereafter) and adequate calcium intake (500 mg/d) are effective preventive measures.
Public health policies should incorporate screening for micronutrient deficiencies and vitamin D supplementation for all refugee children upon arrival.