Rapid assessment of the prevalence of lower limb clinical rickets in Bangladesh

Karim, Farhana; Chowdhury, A Mushtaque R; Gani, M.S.

doi:10.1016/s0033-3506(02)00017-3

Cited by 14 publications

(11 citation statements)

References 6 publications

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“…In recent years, rickets has been reported in at least 21 countries including Bangladesh where it appears to be most prevalent in Cox's Bazar District of southeastern Bangladesh [18][19][20]. The Bangladesh Institute of Mother and Child Health reported that 9% of children examined in Chakaria sub-district presented with one or more rachitic signs including varus and valgus deformities of the knees, sabre tibiae, swollen wrists and joints, pectus carinum, and difficulty walking, with 11% of that number also showing active rickets elevated serum alkaline phosphatase (AP) activities [18].…”

Section: Introductionmentioning

confidence: 99%

“…They also reported that 22% of apparently asymptomatic children also showed elevated serum AP activities suggesting that, for every child presenting with the disease, another two may be at risk of developing it. Karim et al [19] conducted a community-based, rapid assessment of the prevalence of rachitic leg signs among children in Cox's Bazar District, finding an average prevalence of leg signs of nearly 1.9%. Because leg signs are seen in only about 47% of cases [18], these results suggest an overall rickets prevalence approaching 4%.…”

Section: Introductionmentioning

confidence: 99%

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Apparent Efficacy of Food-Based Calcium Supplementation in Preventing Rickets in Bangladesh

Combs

Hassan

Dellagana

et al. 2008

Biol Trace Elem Res

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To determine whether increased Ca intakes can prevent rickets in a susceptible group of children living in a rickets-endemic area of Bangladesh, we conducted a 13-month long, double-blind, clinical trial with 1-to 5-year-old children who did not present with rickets but ranked in the upper decile of plasma alkaline phosphatase (AP) activity of a screening cohort of 1,749 children. A total of 158 children were randomized to a milk-powder-based dietary supplement given daily, 6 days/week, and providing either 50, 250, or 500 mg Ca, or 500 mg Ca plus multivitamins, iron, and zinc. Upon initial screening, 194 healthy children presented with no rachitic leg signs and had serum AP in the upper decile (>260 u/dl) of the cohort. When 183 of those subjects were re-screened after a 7-month pre-trial period, 23 (12.6%) had developed rachitic leg signs, suggesting an annual risk of 21.5% in this cohort. Of those still not presenting with leg signs and completing 13 months of dietary intervention, none showed rachitic leg signs, none showed significant radiological evidence of active rickets, and all showed carpal ossification normal for age after that intervention. These results are consistent with even the lowest amount of supplemental Ca (50 mg/day) being useful in supporting normal bone development in this high-risk population.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Apparent Efficacy of Food-Based Calcium Supplementation in Preventing Rickets in Bangladesh

Combs

Hassan

Dellagana

et al. 2008

Biol Trace Elem Res

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“…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%

“…Those results also indicated that in some villages rickets affected as many as four in every 10 households. Karim et al (2001) implemented a communitybased, rapid assessment of the prevalence of rachitic leg signs among children in Cox's Bazar District. Their results indicated a district-average prevalence of leg signs of nearly 1.9%.…”

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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“…Например, отчеты из Йемена [17], Иордании [18], Катара [19], Саудовской Аравии [20,21] и Турции [22] показывают, что алиментарный рахит является проблемой среди детей из стран Ближнего Востока. Рахит распро-странен в странах Африки к югу от Сахары -в Нигерии [23], Эфиопии [24] и Гамбии [25], в странах Южной Азии -Индии [26] и Бангладеше [27,28]. Тем не менее рахит встречается у детей не только в этих странах [29].…”

Section: новые рекомендации заметно уменьшают число детей с риском деunclassified

Nutritional Rickets – Revisited

Плудовски¹,

Захарова²

2016

Med. sov.

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Rapid assessment of the prevalence of lower limb clinical rickets in Bangladesh

Cited by 14 publications

References 6 publications

Apparent Efficacy of Food-Based Calcium Supplementation in Preventing Rickets in Bangladesh

Apparent Efficacy of Food-Based Calcium Supplementation in Preventing Rickets in Bangladesh

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

Nutritional Rickets – Revisited

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