ASSESSMENT OF NUTRITIONAL STATUS AND RISK FACTORS IN UNDER FIVE YEARS CHILDREN WITH NUTRITIONAL RICKETS ATTENDING A TERTIARY CARE CENTRE IN BANGLADESH

Bodhrun Naher*, Sharmistha Ghosal, Khan Lamia Nahid and Md. Rukunuzzaman

ABSTRACT

Background: Nutritional rickets (NR) or vitamin D deficiency rickets remain prevalent in developing regions of the world and rank among the 5 most common diseases in children. In Bangladesh, it is the second most common micronutrient deficiency. Objective: This study was conducted to assess nutritional status of urban and rural Bangladeshi children associated with Nutrional rickets and the risk factors are also evaluated. Materials and Methods: This cross- sectional study was conducted at BSMMU, Bangladesh, in which 50 children aged <5 years with nutritional rickets were included. Results: Mean age of children were 15.16±11.18 months. All children were having one or more clinical signs and symptoms of nutritional rickets including rachitic rosary (14%), widely open anterior fontanel (22%), widening of wrist (14%), bowing of legs (14%), chest infection (22%), diarrhea (10%), delayed eruption of teeth (24%), failure to thrive (10%), seizure (4%), sweating (26%) and irritability (20%). The mean values of weight-for-age z-score (WAZ), height-for-age z-score (HAZ), weight-for height z-score (WHZ) and head circumference-for-age z-score (HCAZ) were -1.78 ± 0.95, -3.28 ± 0.56, -2.55 ± 0.92 and 0.79 ± 0.95, respectively. Majority of cases came from urban area (60%). 60% had no or little exposure to sunshine. Significant associations were detected with exclusive breast feeding for more than 4 months, exposure of children to sunlight for less than 30 minutes daily, dark skin color, urban slum residence, deficit monthly income, and father and mother’s education in years. Conclusion: Nutritional rickets is prevalent among Bangladeshi children, urban children being more vulnerable. Adoption of a screening programme for children of all age group and implementation of preventive strategies through public health policies are strongly recommended.

Keywords: Radiographic findings; Nutritional rickets; Delayed eruption.