Nutritional rickets in Almadinah Almunawwarah: Presentation and associated factors

ObjectivesTo study vitamin D deficiency rickets and associated factors in the Almadinah Almunawwarah region, where this problem has not been studied previously, despite reports from other parts of Kingdom of Saudi Arabia.MethodsWe conducted a prospective hospital-based study of cases of rickets or hypocalcaemia seen in the outpatient clinic or admitted to the main referral hospital between October 2008 and March 2009. Socioeconomic, clinical and biochemical data were collected and analyzed to determine the factors associated with rickets include environmental, nutritional and maternal in Almadinah Almunawwarah region.ResultsThe presenting features of the 136 cases of rickets seen were diarrhoea and vomiting or cough and fever in 48, convulsions in 11 infants (8.1% of the total and 33.3% of those aged less than 1 year), bow legs in 78, delayed dentition in 33, delayed standing in 38, hypotonia in 25, abnormal gait in 54 and sweating in 33. The factors associated with rickets were multiple.ConclusionRickets is prevalent in the Medina region. The main factor associated with its prevalence was environmental and cultural avoidance of exposure to the sun, which shines all the year round. As rickets is a preventable disease, vitamin D supplementation should be given. All breastfed infants should be given the recommended 400 IU daily, and the mothers during pregnancy and lactation should be supplemented with 1000 units of vitamin D3, to prevent rickets in their infants and avoid diseases in themselves.