Local Resource
Mineral Status in Relation to Rickets in Chakaria, Bangladesh

Authors: RM Welch, CA Meisner, N Hassan, JM Duxbury, M Rutzke, PR Fischer, A Rahman, JP Cimma, TO Kyaw-Myint, AL Kabir, K Talukder, DB Staab, S Haque, GF Combs, Jr.


Objective:Explore the aetiology of rickets in Chakaria and identify opportunities within the local food system to prevent the disease. The rickets prevalent among children of the Chakaria region of Bangladesh is not usually associated with vitamin D deficiency. Therefore, Ca-deficiency would appear to be at least a predisposing factor in its aetiology. That rickets has emerged as a public health problem in Chakaria within the last two decades suggests that changes in...

Apparent efficacy of food-based calcium supplementation in preventing rickets in Bangladesh.

To determine whether increased Ca intakes can prevent rickets in a susceptible group of children living in a rickets-endemic area of Bangladesh, we conducted a 13-month long, double-blind, clinical trial with 1-to 5-year-old children who did not present with rickets but ranked in the upper decile of plasma alkaline phosphatase (AP) activity of a screening cohort of 1,749 children. A total of 158 children were randomized to a milk-powder-based dietary supplement given daily, 6 days/week, and providing either 50, 250, or 500 mg Ca, or 500 mg Ca plus multivitamins, iron, and zinc. Upon initial screening, 194 healthy children presented with no rachitic leg signs and had serum AP in the upper decile...

Rickets in Bangladeshi children: a small focus or a widespread problem ?

A survey in 1997 in Chakaria sub-district near Cox’s Bazar in south-east Bangladesh found that 4% of children aged 1 to 15 years had lower limb deformities due to rickets. The social, health and economic implications of this high rate of physical deformity triggered concerns about whether rickets occurs elsewhere in Bangladesh. Taking advantage of the nationwide survey sites of the Nutritional Surveillance Project (NSP), a special module was added to the NSP in October 2000 to rapidly estimate the prevalence of lower limb deformities. This bulletin describes how the survey was done and what was found.

[ Bulletin as  PDF ]

Rapid assessment of the prevalence of lower limb clinical rickets in Bangladesh

This study attempted to measure the prevalence of lower limb clinical rickets using a rapid assessment methodology in Cox's Bazaar, a coastal district of Bangladesh. The study populations were drawn from 28 random villages representing all seven ‘thanas’ (subdistricts) of the district. Data were collected on 25 891 children and young people aged 1–20 years in two phases. In the first phase, 30 trained, local, non-medical people listed 490 children suffering from visible signs of any physical disability. To achieve this, they demonstrated a multicoloured poster showing the features of lower limb clinical rickets to key informants in the villages. In the second phase, two teams of medically...

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