Title: Rickets: a potential cause of child disability at Chakaria.

POPLINE Document Number: 076075

Author(s):

Quasem MF

Source citation:

IN TOUCH 1992 Jun;11(106):8.

Abstract:

Rickets is a disease in growing children in which endochondral ossification is inhibited by delayed calcification of maturing cartilage cells in the growth plates at the end of the bones. It results in deformities of the long bones, with severe bowing of the legs or severe "Knoch Knee." Rickets interfere with the usual shape and size of the body and also inhibit the natural growth in relation with age. It obstructs the movement, sports and in every step of daily life of a child. He bounds to negotiate with the usual events that is, the disability. What is happening at Chakaria? This area seems to be unique in the high incidence of rickets. No explanation has yet been found for this high incidence of rickets in this particular locality. I went to Chakaria Upazila of Cox's Bazar district to work for the disabled persons caused by the cyclone and tidal bore of 29th April of 1991 on behalf of a NGO and I worked there for about 2 1/2 months. I attended 799 disabled persons. Out of total attended patients 45.31% were below of 10 years old and 18.52 were the victims of rickets. I was surprised at this alarming condition. A great % of children of Chakaria becoming disable only by a simple disease that is, rickets. One can treat the patient by dietary changes, medication and braces or surgery to correct the deformities. But it is a very hard job. Much counselling the time is needed to deal with such patients. Many areas of Chakaria Upazila are far from medical centers. Like all of our Upazila Health Complexes there is neither surgical not prosthesis facilities in Chakaria Upazila Health Complex, or in Cox's Bazar district hospital. Most of the people are uneducated, and their knowledge of things outside their immediate vicinity is very limited. Most of the people are also very poor and it is very difficult for them the make a trip to Chittagong Medical College Hospital or any other specialized hospital where surgical and prosthesis and orthodosis facilities are available, and to stay there during the course of treatment. In this I like to mention here that prosthesis and orthodosis are neglected in our country. But if is well known that we cannot treat the disabled persons. Without the help of prosthesis or orthodosis. What can we do? The easiest way to solve the problem is through prevention. If we want to prevent rickets, at first we have to find out the cause. As I mentioned earlier the cause of rickets at Chakaria is not yet detected. Rickets is a disease of vitamin D deficiency. Due to vitamin D deficiency bone cannot accumulate calcium and phosphorus. So bone becomes softened and distorted. When the child begins to walk this soft bone bears the weight of the whole body and naturally it is deformed. Causes of vitamin D deficiency: 1. Dietary lack. 2. Inadequate exposure to sunlight with reduced endogenous synthesis of vitamin D processors. 3. Malabsorption of lipid, including vitamin D. 4. Derangements in metabolism of vitamin D (as chronic renal failure). 5. End organ resistance to vitamin D. 6. Other uncommon hereditary and acquired disorder of vitamin D metabolism. There is neither inadequate sunlight not lack of dietary vitamin D at Chakaria. Then we can come to the conclusion that the cause of rickets at Chakaria is limited between no. 3-6. Which is not yet identified by scientific experiments. If we want to prevent rickets, a potential cause of child disability at Chakaria we have to find out the cause at first by laboratory investigation and then to prevent and treat accordingly. (full text)

Keywords:

Bangladesh
Vitamins and Minerals
Disease Transmission Control
Morbidity
Child
Incidence
Counseling
Calcium
Inorganic Chemicals
Asia, Southern
Asia
Developing Countries
Physiology
Biology
Prevention and Control
Diseases
Youth
Age Factors
Population Characteristics
Demographic Factors
Population
Measurement
Research Methodology
Clinic Activities
Program Activities
Programs
Organization and Administration
Metals
Ingredients and Chemicals