| dc.description.abstract | Rickets is a metabolic bone disease and is caused by low calcification of bones. It is a nutrient deficiency manifestation particularly for calcium and vitamin D from sunlight. Rickets among children in Kiambu District Hospital as reported by doctors is high with about 100 cases per month. The causative factors for the seemingly high cases of rickets are not clearly understood. Low socio-economic conditions lead to low education status and empowerment. At the same time, the purchasing power of foods rich in calcium and vitamin D that prevent rickets may be affected. Insufficient dietary intake of vitamin D and calcium, inhibitors of calcium absorption, covered dressing, remaining indoors for long periods and living in urban flats are some of the common causes of rickets.
The purpose of the study was to establish the factors associated with rickets among children aged 6- 59 months at Kiambu District Hospital. More specifically, the objectives of the study were to determine the socio-economic and demographic characteristics of households with children suffering from rickets and their feeding and care practices as likely underlying and immediate determinants of rickets status among children attending Kiambu District Hospital.
A controlled case study design was used involving 200 children with rickets and a similar number without rickets, all who were attending Kiambu District Hospital for' health care services. Children with rickets were exhaustively selected for the study while the children without rickets were selected systematically after every case was selected. Data collection was from August 2011 to September 2011, and was done using structured questionnaires with mothers as respondents. The specific data collected was on the socio-economic and demographic characteristics, feeding and child care practices.
Statistical data analysis was carried out using SPSS version 16 and Nutrisurvey 2007 and descriptive statistics, t test, Chi squares and logistic regression were performed. Food adequacy for the children was determined using a 24 hour dietary recall and a food frequency questionnaire on various foods rich in vitamin D, calcium and phosphorus. The prevalence of rickets in Kiambu District Hospital is 3.4%. Males were slightly more (58%) than the females (42%). Children of unemployed mothers were 0.8 times at risk of developing rickets.
Children who were not breast feeding were 0.3 times more likely to develop rickets compared to the ones who were breast feeding. The likelihood of developing rickets was significantly higher for children who started complementary feeding before six months of age (p<0.01). A higher percentage of the non rickets children (99%) were sun bathed every day compared to 63% of the rickets cases. These figures were highly significant (p<0.01).
The prevalence of rickets in Kiambu District Hospital is high as raised by the medics and worrying and the age most vulnerable to rickets was 6-12 months. Children of employed mothers were at a lower risk of developing rickets. Early introduction of complementary foods, short period of breast feeding, inadequate complementary practices and lack of exposure to the sunlight are the risk factors associated with rickets in Kiambu District Hospital.
The government and other development partners should design interventions to curb the upsurge of rickets in Kiambu District Hospital. These interventions should target parents and caregivers of children below one year as they are more vulnerable to rickets. The government and other development partners should design interventions to promote exclusive breast feeding and increasing the intake of calcium and phosphorus rich foods among children. The caregivers should be educated on the need to sunbathe the children with more emphasis on alternative care givers. | en_US |
