Etiology of rickets in Nigerian children

Oginni, LM; Worsfold, M.; Oyelami, Oyeku Akibu; Sharp, Christopher; Powell, Diane; Davie, M. W. J.

doi:10.1016/s0022-3476(96)80137-5

Cited by 94 publications

(55 citation statements)

References 9 publications

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“…A low calcium intake has been associated with rickets in some children in Africa (Oginni et al, 1996). Milk is considered to be an important food in most Asian diets and very few children received little or no milk.…”

Section: Discussionmentioning

confidence: 99%

Dietary and lifestyle factors affecting plasma vitamin D levels in Asian children living in England

1999

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Objective: To determine the vitamin D status of a sample of young Asian children living in England by measurement of plasma 25-hydroxycholecalciferol levels; to relate biochemical measurements with parameters of diet, lifestyle and iron status in this population. Design: The`Infant Feeding in Asian Families' survey covered infants born to mothers of Bangladeshi, Indian or Pakistani origin, plus a sample of children born to White mothers in 41 local authority areas. The current study describes vitamin D values in a sub sample of Asian children from that survey. Setting: Forty-one local authority areas which covered 95% of the Asian population at the time of the 1991 Census and include areas with the highest and lowest density of Asians. Subjects: Seventy-one percent (2382) of mothers who were originally eligible were interviewed on four occasions up to the time their infant was 15 months. One thousand, seven hundred and thirty-eight of these children were followed up for this current study. Of these 618 had a blood sample analysed for vitamin D.

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Section: Discussionmentioning

confidence: 99%

Dietary and lifestyle factors affecting plasma vitamin D levels in Asian children living in England

1999

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“…The methodology used does not support any determination of whether these associations may have been causal. Rickets in Chakaria appears to be of the Ca deficiency type that has been documented in South Africa (Pettifor et al, 1978) and Nigeria (Okonofua et al, 1991;Oginni et al, 1996;Thacher et al, 1997Thacher et al, , 1999Thacher et al, , 2000a. It is significant that Chakaria is not regarded as among the poorest areas of Bangladesh, and that the level of malnutrition, including Ca undernutrition, among at-risk children in Chakaria is not substantially different from that of children living elsewhere in Bangladesh where rickets is not endemic.…”

Section: A Priori Hypothesesmentioning

confidence: 94%

“…It tends to be thought of in historic terms, without the recognition in many quarters that it continues to be a source of disability in the developing world. In recent years, rickets has been reported in some 21 countries (Bishop, 2001), including Tibet (Harris et al, 2001), Kuwait (Majid Molla et al, 2000), Ethiopia (Muhe et al, 1997), Yemen, (Banajeh et al, 1997), Mongolia (Fraser & Tserendolgor, 2001), the United Kingdom (Mughal et al, 1999), the United States (Eugster et al, 1996;Pugliese et al, 1998;Kreiter et al, 2000;Shah et al, 2000), South Africa (Pettifor et al, 1978), Nigeria (Okonofua et al, 1991;Oginni et al, 1996;Thacher et al, 1997Thacher et al, , 1999Thacher et al, , 2000a, and Bangladesh (Snedecor & Cochran, 1967;Anonymous, 1998;Fischer et al, 1999;Staab et al, 1999;Karim et al, 2001). While some of these reports describe sporadic occurrences of the disease in association with lifestyle and the lack of solar exposure sufficient to support adequate vitamin D biosynthesis, studies in South Africa (Pettifor et al, 1978) and Nigeria (Okonofua et al, 1991;Oginni et al, 1996;Thacher et al, 1997Thacher et al, , 1999Thacher et al, , 2000a have shown the disease to be caused by primary dietary deficiencies of calcium (Ca).…”

Section: Introductionmentioning

confidence: 99%

The Chakaria food system study: household-level, case–control study to identify risk factor for rickets in Bangladesh

Combs

Hassan

2005

Eur J Clin Nutr

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Objective: A comprehensive, multiround survey of local food systems in a rickets-endemic area of Bangladesh was conducted to identify household-level risk factors for rickets. Design: A household-level, case-control study was conducted in a rickets-endemic area, Chakaria, with planned comparisons between households with one or more rachitic child and neighboring households with no affected children. Setting: A rickets-endemic area of southeastern Bangladesh, Chakaria. Subjects and methods: An interview-based survey was conducted in six villages in Chakaria with 199 households with at least one child showing physical signs consistent with rickets and 281 households with no affected children. Results: Households with rachitic children in Chakaria had more children, more pregnant or lactating women, and fewer adults than unaffected households in that community. Affected households tended to rely on farming for their livelihood and tended to have less economic activity as indicated by less outstanding debt than their neighbors. Households with rickets were at significantly greater risk of pneumonia than were other households. Calcium undernutrition was severe and widespread in Chakaria due to a food system that offered very little of the element in accessible forms. Household diets were based on cereals and starchy vegetables. Rice and fish constituted the major source of calcium for most households, although dairy products, when used, were very important calcium sources, particularly for young children. In fact, the use of dairy products was the only household choice that led to substantial increases in the calcium intakes of children, and households that used dairy products tended to show increased calcium intakes for all of their members. Conclusions: The risk of a Chakarian household having a child with rickets appeared to be related to its economic status. Although this might be expected to be manifest as limitations in food access and/or use, rickets households failed to show a dietary pattern associated with rickets. Calcium undernutrition was prevalent and, thus, would appear to be a predisposing factor for rickets; however, calcium undernutrition was prevalent in Chakarian households with and without rickets. Therefore, it is probable that another precipitating factor(s) play a role(s) in the etiology of rickets in Chakaria.

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“…The most probable alternative explanation for the lack of association between rickets and exposure to sunlight is reduced dietary intake of calcium as a major factor in the causation of rickets. Several studies and reports have documented the fact that calcium deficiency could lead to rickets (11)(12)(13)(14)(15)(16). The deficiency of calcium may increase the requirement for vitamin D, and therefore calcium deficiency may aggravate a borderline vitamin D status.…”

Section: Introductionmentioning

confidence: 99%

“…Studies conducted in Nigeria suggest that rickets is largely the result of lack of calcium deficiency (14,15). Calcium deficiency as a cause of rickets is also reported from rural South Africa (16). The evidence for the role of calcium deficiency in the causation of rickets comes from dietary surveys, biochemical studies, and the response to calcium therapy alone.…”

Section: Introductionmentioning

confidence: 99%

Calcium deficiency and causation of rickets in Ethiopian children

et al. 2005

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Objective: To assess the role of calcium in the development of clinical rickets among Ethiopian children coming to Jimma Specialised Hospital outpatient, department. Design: Case control study. Settings: Jimma Specialised Teaching Hospital and surrounding urban and rural community in the catchment area. Subjects: One hundred and thirty five under five year old children (30 cases of rickets and 104 non-rachitic cases) who came for paediatric service in Jimma hospital. Results: The mean (±SD) level of calcium intake for cases and controls was 664.5 (± 102.7) mg and 645.8(± 144.4) mg, respectively. There was no statistically significance difference between the two groups in the mean level of calcium intake (t=0.659, P>0.05). Generally, in both cases and controls the majority of the study participants were taking calcium below the recommended daily calcium requirement of 800 mg for age group according to Food and Nutrition Board of the National Research Council. When adjusted for different co-variates including age, sex, breast feeding history, history of diarrhoea lasting longer than 14 days and 24 hours calcium intake children and religion, occupation, educational status and residence the mothers/care givers using logistic regression model, frequency of exposure to sunlight ( OR=1.55, 95%CI: 1.2, 2.0), being from rural areas(OR= 5.0, 95% CI: 1.1, 23.3) and age 12-23 months (OR= 4.5, 95%CI: 1.2, 16.5) were significantly associated with rickets( P<0.05). Conclusion: It was found that Ethiopian children with rickets and without had a low calcium intake as compared to the recommended daily allowance. The fact that there was no difference in the dietary calcium intake between cases and controls and the significant difference observed between case and controls in terms of frequency of exposure to sunlight per week reflects that vitamin D deficiency emanating from poor exposure to radiant energy is the main cause of rickets in Ethiopian children. This study also documented the fact that rural children are at a higher risk of developing rickets as compared to their urban counterparts which could be mainly due to the traditional beliefs and practices more prevalent in the rural areas. Enhancing behaviour change communication about the benefits of exposing children to sunlight is very important in preventing the prevalence of rickets.

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Etiology of rickets in Nigerian children

Cited by 94 publications

References 9 publications

Dietary and lifestyle factors affecting plasma vitamin D levels in Asian children living in England

Dietary and lifestyle factors affecting plasma vitamin D levels in Asian children living in England

The Chakaria food system study: household-level, case–control study to identify risk factor for rickets in Bangladesh

Calcium deficiency and causation of rickets in Ethiopian children

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