Prevalence and clinical characteristics of rickets in infants and children attending the outpatient clinic at Damietta University hospital

Abstract

Background: Rickets is a common health problem in Egypt and leads to frequent morbidities. There is insufficient information about its prevalence and risk factors. Objective: Studying the prevalence and clinical characteristics of rickets in the age group (6-36 months) in New Damietta city using a clinical score with x-ray as a gold standard. Materials and Methods: About 300 children, aged from 3-36 months, selected from the pediatric outpatient clinic at Damietta University hospital by systematic random sample (every 3rd child) on a day work (3 days/week) in the period from April, 2011 till December, 2012. Each child enrolled in the study was submitted to history taking, thorough clinical examination and radiographic examination. The studied cases were classified into two groups according to the presence of rickets by x-ray: Rachitic group and non-rachitic group. Results: Rickets was present radiologically in 35 cases (11.7%) out of 300 children. Rachitic group was younger than the non-rachitic group with the mean age (9.9±4.3, 16.5±7.4) respectively, p = 0.00. Most of rachitic children had spent little time under the sun and living in overcrowded houses. Most rachitic children had motor developmental delay (74.3%) with high statistical significant difference, p = 0.00. The most frequent sign was rachitic rosaries 74.3%, followed by thickened epiphysis and delayed closure of fontanel 62.9 and 60%, respectively. The most sensitive clinical signs were Harrison's sulcus and parietal bossing 100%. Conclusion: Rickets is a major health problem in Damietta governorate, as its prevalence is 11.7%, especially with young age, overcrowding and low social class.