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Factors affecting the morbidity of vitamin D deficiency rickets and primary protection
1Department of Public Health, School of Medicine, Karadeniz Technical University, Trazbon, Turkey.
Insights
This study found that 9.8% of children aged 3-36 months in Turkey had rickets, a condition preventable with vitamin D. Rickets was linked to poor diet, young maternal age, and lack of sun exposure, and increased risks of respiratory infections and enteritis.
Area of Science:
- Pediatrics
- Nutritional Science
- Public Health
Background:
- Rickets is a significant health concern in children, particularly in developing regions.
- Understanding the prevalence and risk factors of rickets is crucial for targeted interventions.
Purpose of the Study:
- To determine the prevalence and incidence of rickets in children aged 3-36 months in northeastern Turkey.
- To identify risk factors associated with rickets.
- To assess the impact of vitamin D supplementation on rickets prevention.
Main Methods:
- Cross-sectional study of 860 children aged 3-36 months.
- Biochemical analysis (calcium, phosphorus, alkaline phosphatase) and wrist X-rays for diagnosis.
- Cohort study to determine incidence and evaluate vitamin D intervention.
Main Results:
- Rickets prevalence was 9.8%, with higher rates in infants (3-6 months), those with limited sun exposure, low fish consumption, young mothers (<18 years), and mothers not using contraception.
- Children with rickets had significantly higher rates of acute respiratory infections (47.62%) and enteritis (29.76%).
- No rickets cases were observed in the group receiving 400 IU of vitamin D daily; incidence was 3.8% in the untreated group over 12 months.
Conclusions:
- Rickets is prevalent in the studied population and associated with significant morbidity from infections.
- Vitamin D supplementation (400 IU/day) appears effective in preventing rickets.
- Public health strategies should focus on vitamin D supplementation and addressing identified risk factors to combat rickets in developing countries.
Abstract:
Rickets was investigated in 860 children in the 3 to 36 month age group in 21 villages attached to Sinik Health Centre, in northeastern Turkey. The blood calcium, phosphorus and alkaline phosphatase levels of suspect cases were determined following examination and wrist x-rays taken. The prevalence of cross-sectional rickets was determined, in the cohort group formed by removing the rickets cases (to the first group, advice was not given; to the second, 400 IU of vitamin D) and its incidence determined. The prevalence of rickets was calculated as 9.8% with no distinction observed between males and females (P > 0.05). It is higher in children in the 3-6 month group (23.97%) (P < 0.05); exposed rarely to the sun (P < 0.001); without fish in diet (P < 0.01); born to mother under 18 years old (P < 0.001); with a mother not using contraception (P < 0.01). The prevalence of acute respiratory infections (ARI) was calculated as 47.62% and 35.70% (P < 0.05) in children with and without rickets, respectively. The prevalence of enteritis was calculated as 29.76% and 18.43% (P < 0.05) in children with rickets and without rickets, respectively. Rickets was not seen where 400 IU of vitamin D was administered, while incidence for the twelve-month period was calculated as 3.8% in the other group. Combatting rickets is important in developing countries where deaths under five years are largely due to ARI and enteritis.