Echocardiographic features of children presenting with rickets at Kenyatta National Hospital
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Date
2009Author
Odhiambo, Grace NA
Type
ThesisLanguage
enMetadata
Show full item recordAbstract
Background: The prevalence of rickets has remained high in our setup probably due to
inadequate nutrition and insufficient exposure to sunlight. Rachitic children have
significant morbidity and mortality, often due to severe pneumonia and heart failure.
Objective: To determine the prevalence, pattern and biochemical correlates of
echocardiographic abnormalities in children with rickets at KNH.
Methodology: This was a Descriptive Cross sectional study conducted at KNH
paediatrics wards. Children aged between 3 months and 36 months admitted with rickets
were recruited to the study. All the study patients had serum calcium, phosphorus and
alkaline phosphatase levels measured and Echocardiography done to determine the
presence of cardiac abnormalities.
Results: A total of one hundred and seventy five patients were evaluated. There were 87
/
males (50%) and 88 females (50%). Their age range was 3 months to 18 months with a
median of7 months. Abnormal echocardiographic findings were present in 103 (59%)
patients. Of these, left ventricular systolic dysfunction was found in 78 (45%), pulmonary
hypertension in 35 (20%), diastolic dysfunction in 33 (19%) and pericardial effusion in 8
(4.5%) patients. Left ventricular systolic dysfunction was significantly correlated with
low calcium levels, p-value <0.001, odds ratio 4.1 and 95% confidence interval (2.2-
7.8). There was no difference between children with pneumonia and those without
pneumonia with regards to echocardiographic abnormalities.
Conclusion: The study revealed a high prevalence of echocardiographic abnormalities in
children with rickets (59%). Left ventricular systolic dysfunction was the most common
finding (45%); it was significantly associated with severe rickets and hypocalcaemia.
Recommendations: Echocardiographic evaluation should be done on patients with
rickets, particularly those with severe rickets and severe hypocalcaemia so that
appropriate treatment can be instituted for cardiac dysfunction if present