Rickets in Children Aged 6-59 Months at Mbagathi Hospital Nairobi County, Kenya

Abstract

Rickets is a disease associated with bone deformity that is caused by inadequate mineralization in growing bones. Despite the high declines in the prevalence of nutritional rickets since the discovery of vitamin D and role of ultra violet light in prevention of the disease, the condition is still a concern in many affluent and developing countries. Rickets affects bone growth and mineral homeostasis that is associated with high infant and childhood deaths especially when accompanied with lower respiratory tract infections. In Kenya, there is scanty data on the predisposing factors associated with the re-emergence of rickets, yet recent research shows increasing numbers of cases of rickets being reported at health facilities. The broad objective of this study was to establish the predisposing factors that influence the occurrence of rickets in children aged 6-59 months at Mbagathi Hospital, Nairobi County, Kenya. A case- control study, of the children with rickets (cases) and those without rickets (controls). Mbagathi Hospital, is a level four public Hospital located on the outskirts of Kibera, in Nairobi County, which serves people from various informal settlements. The study population consisted of children aged 6-59 months and their mothers or caregivers who sought health care services at the Hospital during the month of April 2019. The cases (53) and controls (104) were picked alternatively in the ratio of 1:2 until the sample size of 157 respondents. Data was collected using semi-structured questionnaires that were uploaded on ODK and analyzed using SPSS. The results of the study show that large household size (p=0.04), low birth weight (p=0.000), birth order (p=0.03), use of family planning methods(p=0.000), malnutrition (wasting & underweight) (p=0.000), exclusive breastfeeding (p=0.008), lack of sun bathing (0.000), positioning children under the shade during sunbathing and attending day care (0.037) were significantly associated with the occurrence of rickets. In conclusion the following factors; household size, income expenditure on medical expenses, birth order, birth weight, underweight, wasting, sunbathing, position during sunbathing, attending daycare and practice of family planning are the predisposing factors of rickets. The study recommends that caregivers should adopt sunbathing their children under direct sunlight, that further studies be conducted on the following factors household size, birth weight, birth order and attending day care. It also recommended that the Government of Kenya through the Ministry of Health and relevant bodies should formulate an elaborate policy on rickets.