Incidence and Risk Factors of Rachitic Genu Varus in Preschool Children in a Paediatric Health Institute in Egypt as One of the Developing Countries

Abstract

Background:Rachitic genu varus is one of the common conditions among the Egyptian children, despite the shinning sun of Egypt all the year.Purpose:The aim of the study was to estimate the incidence of rachitic genu varus among the Egyptian children, and to assess the risk factors contributing to it.Patients and Methods:This prospective study recruited a total of 250 consecutive children, being 130 males and 120 females, with rachitic bow legs or genu varus, between 2 - 4 years of age, together with 250 controls of the same age group, out of a total number of 1900 children with other types of rickets, and other children's orthopaedic diseases, who presented to the National Institute of Neuromotor System in Egypt between September 2014 to September 2015. The cases and the controls were subjected to clinical, laboratory biochemical, and plain radiographic examinations. Their parents were subjected to epidemiological, maternal, and nutritional questionnaires.Results:The calculations revealed high incidence (13.1%) of rachitic genu varus. The risk factors were low socioeconomic status, insufficient family income, poor housing conditions, lack of exposure to sunlight due to cultural practices, sole breast feeding, and inadequate supplementation of vitamin D to the children and the pregnant women. The p value was <0.05.Conclusion:Vitamin D deficiency rachitic genu varus is a multifactorial condition in Egypt. Raising the standard of living, level of education, housings, and dietary supplementation of vitamin D to the pregnant women and infants are the solution.

Nutritional Rickets and Osteomalacia in the Twenty-first Century: Revised Concepts, Public Health, and Prevention Strategies

“…In developing countries populated by high-risk ethnic groups, the failure, or non-existence, of vitamin D supplementation policies are main contributors to the rise in NR despite abundant sunshine [ 18 •, 45 – 47 ]. A recent study from Egypt reported a high incidence (13.1%) of rachitic genu varum in children aged 2–4 years [ 48 ]. The study reported the following risk factors to be associated with the development of NR: low socioeconomic status, insufficient family income, poor housing conditions, lack of sunlight exposure due to cultural practices, sole breast feeding and inadequate supplementation of vitamin D in children and pregnant women [ 48 ].…”

“…A recent study from Egypt reported a high incidence (13.1%) of rachitic genu varum in children aged 2–4 years [ 48 ]. The study reported the following risk factors to be associated with the development of NR: low socioeconomic status, insufficient family income, poor housing conditions, lack of sunlight exposure due to cultural practices, sole breast feeding and inadequate supplementation of vitamin D in children and pregnant women [ 48 ].…”

A Case of Rickets and Pediatric Iron Deficiency Anemia in Alabama

“…Infancy is crucial for physical and cognitive development, and consequences can be avoided with attention to detail and awareness. Socioeconomic status and ability to obtain nutrients should also be considered during follow-up visits with infants, as nutritional rickets are more prevalent in lower-income environments [ 15 ]. In similar cases, multidisciplinary teams that include pediatricians, social workers, developmental and behavioral professionals, dietitians, hematologists, and endocrinologists should be included to ensure that the patient receives well-rounded care and that all aspects of the patient’s condition are managed appropriately.…”

Risk Factors of Nutritional Rickets among Children Under-five Years of Age

“…5 Some studies have reported other causes of nutritional rickets as well which include exclusive breastfeeding, no intake of supplements, use of cow's milk, mothers' poor nutritional status, and low socioeconomic status. 2,6,7 Although many studies have been conducted around the world to assess the risk factors of the nutritional rickets. 5,6,7 However, the risk factors of the nutritional rickets are under-studied in the Pakistan especially in the region of Rawalpindi.…”

“…2,6,7 Although many studies have been conducted around the world to assess the risk factors of the nutritional rickets. 5,6,7 However, the risk factors of the nutritional rickets are under-studied in the Pakistan especially in the region of Rawalpindi. Therefore, this study aims to determine the risk factors of the nutritional rickets among the children in Holy Family Hospital of Rawalpindi.…”