Study of the Prevalence of Rickets among Infants Attending Primary Health Care Centers in Cairo

Abstract

Rickets is a disease of growing bones due to mineralization defect, it has several types but the most common and persistent one is nutritional vitamin D rickets in which the defect is in vitamin D amount or in calcium either related to low vitamin D or low calcium intake. The present study was a cross-sectional conducted on 800 infants (385 at 9 months old), (415 at 18 months old) from different primary health care units all over Cairo and from different socio-economic standards. The study sample were subjected to Physical assessment included calculation of the weight for age and the weight for length standard deviation scores, calculation of the length for age and BMIstandard deviation scoresaccording to WHO, 2010,screened by measuring serum calcium, phosphorous and ALP, normal ranges were defined according to the reference ranges of the used kits of Stainbio Company with exclusion of hepatic and renal causes of rickets. In the present study the mean calcium level among the infants aged 9 months old was 8.53±0.842 mg/dL while in the 18 months old group, the mean calcium level was 9 ±1.014 mg/dl, the difference between them was highly significant, p-value was (0.000), while phosphorus levels had no significant difference between the two groups, we were dependent on levels of serum Alkaline Phosphatase to diagnose rickets, our cutoff point was 350 iu/l. The screening showed 9 rachitic cases among the study sample whom subjected to:detailed maternal questionnaire, detailed history including age, sex, order of birth, number of siblings, living place, history of sun exposure, clinical evaluation of rickets,dietary assessment of calcium and vitamin D status,assessment of the adequacy of Vitamin D,and epidemiologicquestionnaire to assess the socioeconomic statusaccording to the criteria of (El-Bohy, 1983),