Frequency of nutritional rickets, its clinicobiochemical profile and its relationship to the lower respiratory tract infections in indoor patients from 2 to 60 months of age
DOI:
https://doi.org/10.18203/2349-3291.ijcp20203646Keywords:
Acute lower respiratory tract infections, Rickets, Vitamin-DAbstract
Background: Frequency of nutritional rickets, its clinicobiochemical profile and its relationship to the lower respiratory tract infections in indoor patients from 2 to 60 months of age.
Methods: Children aged 2 to 60 months admitted for the first time were included in the study and divided into two groups i.e. with and without clinical signs of rickets. Disease profile was studied in both groups. Incidence of lower respiratory tract infection was compared between two groups. Children with clinicoradiological signs of rickets were also investigated for biochemical abnormalities.
Results: During the one year study period a total of 393 children were admitted, 65 were found to have rickets constituted as study group and 328 were without rickets were included the controls. Rickets incidence was 16.5% of which majority (74.6%) were males and most rachitic children (64.6%) were below six months of age. Acute lower respiratory tract infection (64.6%) was commonest in study group and acute gastroenteritis (24.4%) in the controls. The rate of ALRTI was nearly three times in study group. Frontal bossing (67.7%) was most common sign of rickets and increased alkaline phosphatase (93.8%) was the commonest biochemical abnormality.
Conclusions: Nutritional rickets, a multifactorial disease, is easily preventable. The present study has revealed the high incidence of rickets i. e., 16.5% and also show the strong statistically significant association of nutritional rickets with acute lower respiratory tract infections.
References
Hochberg Z. Vitamin-D and rickets. First Edition Basel: S. Karger AG. 2003:1-13.
Pettifer JM. The Epidemiology of Vitamin D and Calcium Deficiency. In: Pettifer JM, Zlotin S. (eds). Micronutrient Deficiencies during Weaning Period and First Year of Life. Vevey, Switzerland: Nestec Ltd. 2004:21-35.
Tomashek KM, Nesby S, Scalon KS, Cogswell ME, PowellK E, Parasher VD, et al. Commentry: Nutritional Rickets in Georgia. Pediatrics. 2001;107:45-50.
Ladhani S, Srinivasan L, Buchanan C, Allogrove J. Presentation of Vitamin D Deficiency. Arch Dis Child. 2004;80:1725-9.
Pettifer JM. Nutritional Rickets: Deficiency of Vitamin- D, Calcium, or Both? Am J Clin Tehran. Study of 200 Cases. Arch Dis Child. 1975;47:89-92.
Zitterman A. Vitamin D in Preventive Medicine: Are we Ignoring the Evidence. B J Nutr. 2003;89:552-72.
Thacher TD, Fischer PR, Pettifor JM, Lawson JO, Ischei CO, Reading JC, et al. A Comparison of Calcium, Vitamin D, or Both for Nutritional Rickets in Nigerian children. N Engl J Med. 1999;341:563-8.
Tsendolger U, Mawson JT, Macdonald AE, Oyunbileg M. Prevalence of rickets in Monglia. Asia Pacific J Clin Nutr. 1998;7(3):325-8.
Muhe L, Lulseged S, Mason KE, Simos EA. Case control study of nutritional rickets in the risk of developing pneumonia in Ethiopian children. Lancet. 1997;349:1801-4.
Bahl L, Dattal MS, Parmar V, Sarin NK, Shukla PS. Profile of rickets in hilly area of Himanchal Pradesh. Indian J Pediatr. 1980;47:89-92.
El-Radhi AS, Majeed M, Mansor N, Ibrahim M. High incidence of rickets in children with wheezy bronchitis in developing countries. J R Soc Med. 1982;75:884-7.
Rafi M. Rickets in Breastfed Infants Below Six Months of Life Without Vitamin-D supplementation in Trehan. Arch Irn Med. 2001;4(2)93-95.
Lapatsanis P, Makaronis G, Vretos C, Doxiadis S. Two types of nutritional rickets in infants. Am J Nutr. 1976;29:1222-6.
Najada AS, Habasnen MS, Khader M. The frequency of nutritional rickets among hospitalised infants and its relationship to respiratory disease. J Trop Pediatr. 2004;50:564-8.
