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Black Sudanese children 350X more likely to have rickets than other Australians – April 2012

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 at 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.

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See also VitaminDWiki

see for example wikipage: http://www.vitamindwiki.com/tiki-index.php?page_id=2322

Attached files

ID Name Comment Uploaded Size Downloads
1246 Rickets Australia April 2012.pdf PDF admin 16 Apr, 2012 13:59 247.68 Kb 836
1245 Rickets dark skin Australia.jpg admin 16 Apr, 2012 13:57 35.60 Kb 5471
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