Nutritional rickets in Calabar, Nigeria

The features of 20 cases of nutritional rickets who presented at the University of Calabar Teaching Hospital, Calabar in south-eastern Nigeria over a 9-year period (January 1985-December 1993) are presented. The aim is to compare them with those in the only other reports from Nigeria between 18 and 42 years ago from Ibadan in the west of the country. The ages at presentation ranged between 6 months and 5 years with no sex preponderance. Most of the children were well nourished with the major features being delay in walking, swollen wrists and ankles and genu varum. The majority of cases in the present study occurred among children of elite and middle class parents who deprived their children of sunshine by keeping them indoors most of the day while they were at work. Reasons for the comparatively low prevalence of rickets in Calabar are social and cultural factors which enhance the exposure of children to sunlight. In addition, the relative availability of seafood and vegetables in this coastal city enhances rickets prevention.