Black Sudanese children 350X more likely to have rickets than other Australians

Highlights

• 75% of rickets cases were those were refugee children,

• 63 % were born in Africa

• 47% Sudanese.

• 85 %were dark-skinned,

• 13 % categorised as intermediate

• 2 % were fair skinned

• mothers who were veiled for cultural and religious reasons, contributed to low vitamin D levels

Incidence of vitamin D deficiency rickets among Australian children: an Australian Paediatric Surveillance Unit study

Craig F Munns craigm2@chw.edu.au , Peter J Simm, Christine P Rodda, Sarah P Garnett, Margaret R Zacharin, Leanne M Ward, Janet Geddes, Sarah Cherian, Yvonne Zurynski and Christopher T Cowell, on behalf of the APSU Vitamin D Study Group

Med J Aust 2012; 196 (7): 466-468.

Objective: To determine the incidence of and factors associated with vitamin D deficiency rickets in Australian children.

Design: 18-month questionnaire-based prospective observational study, using Australian Paediatric Surveillance Unit (APSU) data.

Setting: Australian paediatricians and child health workers, January 2006 – July 2007.

Participants: Children aged ? 15 years with vitamin D deficiency rickets (25-hydroxyvitamin D [25OHD] ? 50 nmol/L, and elevated alkaline phosphatase levels [> 229 IU/L] and/or radiological rickets).

Main outcome measures: Incidence of vitamin D deficiency rickets. Description of demographics, clinical presentation, identification and further analysis of overrepresented groups, and treatment regimens compared with best-practice guidelines.

Results: We identified 398 children with vitamin D deficiency (55% male; median age, 6.3 years [range, 0.2–15 years]).

The overall incidence in children ? 15 years of age in Australia was 4.9/100 000/year. All had a low 25OHD level (median, 28 nmol/L [range, 5–50 nmol]) and an elevated alkaline phosphatase level (median, 407 IU/L [range, 229–5443 IU/L]), and 48 (12%) were hypocalcaemic.

Ninety-five children had wrist x-rays, of whom 67 (71%) had rachitic changes.

Most (98%) had dark or intermediate skin colour and 18% of girls were partially or completely veiled.

Most children were born in Africa (252; 63%) and 75% of children were refugees.

Duration of exclusive breastfeeding was inversely related to serum vitamin D levels in children < 3 years of age.

Empirical vitamin D treatment was given to 4% of children before diagnosis.

Conclusions: Vitamin D deficiency rickets is a significant problem in Australia among known high-risk groups. Public health campaigns to prevent, identify and treat vitamin D deficiency, especially in high-risk groups, are essential.

Image from PDF attached at the bottom of this page

See also VitaminDWiki

• Overview of Rickets and Vitamin D

• Africa category listing has items along with related searches

• Rickets in Denmark especially among immigrant children- Feb 2012

• Rickets in 30 % of infants in India who had low vitamin D – March 2011

• Vitamin D Levels in Kids are So Low that Rickets is Back with a Vengeance - by Knox

• Somali did not have a word for autism before getting to Canada Vitamin D Council 2010

• Death of Babies in UK due to vitamin D deficiency – Jan 2012

• All items in category Rickets and vitamin D items

• 73 % of Australians had too little vitamin D – Dec 2011

• Vitamin D insufficiency in UK youths – 37X more likely if dark skin – July 2011

• Striking ethnic health disparity – blacks dying due to lack of vitamin D – Nov 2011

• Do blacks have a 5 year life penalty due to low vitamin D

• Turkey gave 400 IU vitamin D to needy infants and reduced Rickets by 60X - 2011

• Giving vitamin D to ALL children and pregnant women reduced symptoms by 60 percent – Aug 2012

  • Seems like Australia could eliminate a huge cost of rickets by giving 400 IU of vitamin D to all the dark skinned children
• However, the Australian govt still says just 200 IU is enough thru middle age,
  • which is probably not enough to stop rickets (see Turkey, above)