Uncovering the Root Causes of Nutritional Rickets in Children - An Observational Study in a Bangladeshi Hospital

Abstract

Introduction: Nutritional rickets (NR), commonly known as vitamin D deficient rickets, are still frequent in underdeveloped nations and is among the top 5 pediatric illnesses. It is the second most typical micronutrient deficit in Bangladesh. Despite the abundance of sun exposure, an increase in rickets causes people to look into the risk factors that go along with it. Hence, the study's goal was to assess the risk factors for nutritional rickets in children aged 0 to 5 in Bangladesh. Aim of the study: The study aimed to uncover the root causes of nutritional rickets in children. Methods: The study was an observational cross-sectional study that took place over three years from November 2014 to December 2017 conducted at Bangladesh Shishu Hospital and Institute, Dhaka, Bangladesh. A total of 120 children aged 0-5 years were selected for the study based on predetermined selection criteria. Results: The study population consisted of 120 subjects, with a mean age of 29.40 years (SD=11.65). The majority of the subjects were male (85%). 36.7% of the subjects resided in rural areas, 23.3% in urban areas, and 40% in urban slums. Most of the fathers had either no education (38.3%) or 1-5 years of education (36.7%), while most of the mothers had either no education (45%) or 1-5 years of education (38.3%). The largest group of family heads had farmers as their occupation (25%), followed by day laborers (26.7%) and rickshaw pullers (16.7%). 68.3% of the families had insufficient monthly income. Exclusive breastfeeding for 4 to 6 months has the highest odds ratio of 3.59, indicating that infants who are exclusively breastfed for this period are more likely to develop rickets. Inadequate sunlight exposure of fewer than 30 minutes and dark skin color also have positive associations with rickets, with odds ratios of 2.25 and 2.76, respectively. Conclusion: Exclusive breastfeeding for >4 months, sunlight exposure <30 minutes/day, dark skin color, urban slum residence, deficit monthly income, and parent's education are the risk factors for NR in Bangladeshi children.