Clinical and radiographic improvement of rickets in Bangladeshi children as a result of nutritional advice.
BACKGROUND
Calcium-deficiency rickets is common in south-east Bangladesh and responds to calcium supplementation.


OBJECTIVE
To evaluate the healing effect on active rickets of a five-component nutritional advice programme aimed at doubling dietary calcium intakes.


METHODS
Forty-nine children aged <10 years with mild lower limb deformities and active rickets were followed over a period of 12 months. All were provided with a five-component nutritional advice programme advocating (i) the routine addition of 1 g limestone/kg rice, (ii) consuming small fish (including bones) instead of large ones, and (iii) daily consumption of 5 g ground sesame seeds, (iv) 100 g leafy vegetables and, if possible, (v) 100 ml of milk.


RESULTS
Radiographic scores improved in 90% of children. The response was positively associated with age (r=0.34, n=48, p=0.01) and severity of radiographic score at baseline (r=0.85, n=49, p<0.0001).


CONCLUSIONS
Despite the lack of a statistically significant association between radiographic improvement and compliance with nutritional advice, in mild calcium-deficiency active rickets, nutritional advice may be a cost-effective treatment and possibly a valuable long-term solution to the problem.
Arnaud
J
J
Department of Integrated Biology, Clinical Biology Unit, University Hospital Grenoble, Grenoble, France. jarnaud@chu-grenoble.fr
Pettifor
J M
JM
Cimma
J P
JP
Fischer
P R
PR
Craviari
T
T
Meisner
C
C
Haque
S
S
D000886:Anthropometry / Q000379:methods; D001459:Bangladesh; D002136:Calcium, Dietary / Q000008:administration & dosage / Q000627:therapeutic use*; D002648:Child; D002664:Child Nutritional Physiological Phenomena; D002675:Child, Preschool; D003906:Developing Countries; D004032:Diet; D006801:Humans; D010290:Parents / Q000193:education; D010349:Patient Compliance; D015397:Program Evaluation; D011859:Radiography; D012279:Rickets / Q000000981:diagnostic imaging / Q000178:diet therapy*; D016896:Treatment Outcome
D002136:Calcium, Dietary