Risk factors for nutritional vitamin D deficiency rickets in children under 5 years of age

Objective: to identify possible risk factors for the development of vitamin d deficiency rickets in children under 5 years of age. methods: this case - control study was conducted in the department of pediatric medicine,national institute of child health,karachi. fifty cases and fifty controls were taken. children,under 5 years of age,presenting with signs and symptoms of rickets were included and information regarding the predisposing factors and investigations were recorded on a pre-structured proforma. results: fifty children with rickets were compared with age - matched control subjects. fifty six percent were male children and sixty six percent were between 6 months and 2 years. maternal sun - exposure of > 60 minutes per week was noted in forty two percent of the mothers compared to seventy two percent of control mothers. thirty percent of mothers of children with rickets exposed only their hands to the sun compared to ten percent of controls. twenty six percent of the rachitic children had no exposure to the sun during the day compared to ten percent of the controls. biochemical disturbances were present in all children with rickets. radiological bone changes were present in all rachitic children with forty eight percent showing widening and cupping. conclusion: it was noted that almost all children with rickets had poor exposure to sun along with a diet deficient in vitamin d,that is green leafy vegetables and egg-yolks.