Prevalence of Rickets and Certain Associated Risk Factors Among Children Under Five Years of Age Attending the Outpatient Clinic of Maternity and Children Teaching Hospital in Ramadi City
Al- Anbar Medical Journal,
2011, Volume 9, Issue 1, Pages 1-13
AbstractObjective: this study is an attempt to search for prevalence, risk factors and diagnostic criteria of rickets among children under 5 years of age, attending the outpatient clinic of Maternity and Children Hospital in Ramadi city.Subject and Methods: Four hundred children under 5 years of age, attending the outpatient clinic of Maternity and Children Hospital in Ramadi city over a period of 2 months(1st of December 2001 to the end of January 2002), were selected randomly and studied for the prevalence of rickets and certain associated risk factors. Diagnosis of rickets was based on clinical, biochemical and radiological findings of active disease. One hundred twenty six children matched for age and sex who had no evidence of rickets, were used as control.Results: The prevalence of rickets for children attending the outpatient clinic was 10.5% and its 95% confidence interval was 7.8 -13.8%. The majority of cases (97.6%) were within the age range from 3-24 months. The exclusive breast feeding, small houses, apartments and urban areas were found as a significant risk factors for developing rickets ( p< 0.001, p=0.04, p=0.01 and p=0.02 respectively). Widening of the wrist at all age groups was detected in 69% of rachitic subjects. The mean of serum alkaline phosphatase significantly increased while the mean of serum calcium and phosphorus significantly declined by increasing radiological severity of rickets ( p <0.001).Conclusion: vitamin D deficiency rickets still represents an important health problem in our area. It is mostly seen in children under the age of 2 years. The exclusively breast fed infants or those living in apartments or small houses in urban areas are more prone to develop rickets. Widening of the wrist seems to be a good clinical sign for the diagnosis of rickets, and serum alkaline phosphatase appears as the best available indicator for the diagnosis of rickets and its severity.Key words: Rickets. Under 5 years. Ramadi. Iraq.
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