Rickets is a disease that results in softening of bones in children potentially leading to fractures and deformity and it is among the most frequent childhood diseases in many developing countries. The predominant cause of rickets is vitamin D deficiency, but lack of adequate calcium intake can also lead to rickets.
On 26th January, 2010 a Dissemination of National Rickets Survey in Bangladesh was held at BRAC INN Centre, Dhaka. The survey was conducted by Rickets Interest Group (RIG) with the leadership of Dr. S K Roy, Senior Scientist, ICDDR, B and in collaboration with SARPV, UNICEF, CARE Bangladesh, National Nutrition Programme, BRAC and Plan Bangladesh. The aim of the National Rickets Survey was to determine the prevalence of the disease in Bangladesh in children 1 to 15 years of age and to determine the association with their nutritional status and dietary intake of calcium and other nutrients.
The aim of the survey was to determine the prevalence of the disease in Bangladesh in children 1 to 14 years of age and to determine the association with their nutritional status and dietary intake of calcium and other nutrients.
16,000 children in rural areas and 4000 children in urban areas irrespective of their sex and socio-economic status from six divisions were randomly selected. After enrolment they were examined for the presence of features of rickets and their parents /guardians were interviewed to record their age, sex and socio-economic data. With the presence of rickets featuresparent/guardians were asked about the feeding practice of the child and representative food was sampled to assess calcium content. Qualitative and quantitative data were collected through anthropometrical measurement (weight, height) and in-depth interviews.
In clinically suspected cases, radiological examination was done to identify radiological signs of active rickets and blood was taken for biochemical tests. This survey included both current patients and new cases were identified through case-finding strategy among their family members. The results were analyzed to determine the relationship of Rickets with nutritional status of the children and their dietary (calcium, phosphorus, protein) deficiencies, and dietary and environmental inhibitors (phytates, oxalates).
The result of the survey showed high prevalence of rickets in 1% children aged 1-15 years of which 76.6% were from Chittagong Division. Districts like Cox’s Bazar, Chokoria, Maheshkhali and other upazilas of Chittagong reported for high endemic rickets. About 47.4% children were deficient in calcium and vitamin D. In these areas UNICEF is supporting SARPV to identify rickets and have undertaken community based programs for its prevention.
The session was Chaired by Professor Dr. Shah Monir Hossain, Director General, Directorate General of Health Services, MOHFW, who said that over the next 5 years starting in July 2011 the Government should take initiative to merge Health and Nutrition programme to resolve these problems, which at present runs individually. He suggested to investigate the causes of differences of incidence of rickets in different geographical areas and ethnic groups and stressed on awareness building to reduce the chances of those children being physically disabled and finally becoming burden of their families as well as in the society Dr. Shah Monir Hossain also mentioned that complementary feeding for children after six months of age should be focused and communicated to the parents to avoid chances of rickets. He also mentioned that, Rickets can be prevented just with nutritional advice if detected early and must be taught at the primary level. Behavior change is very important and with appropriate communication and dissemination of information it is possible to make Bangladesh a ricket free country.
Source: icddrb.org
