Objective: To test the association between vitamin D deficiency rickets and protein-energy malnutrition in Ethiopian children.
Setting: Ethio-Swedish Children's Hospital, a tertiary health facility catering for children coming from Addis Ababa and the surrounding districts.
Design: A case-control study.
Subjects: One hundred and fifty seven children under three years of age who had vitamin D deficiency rickets constituted the cases. Controls were the same number of children matched with cases for sex and age within one month and were seen within a week of case recruitment.
Results: Cases and controls were similar (p < 0.5) in terms of maternal education, paternal age, paternal education and family size. Factors strongly and independently associated with rickets were underweight, nutritional status [OR = 12.7 (95% CI 4.47-11.08)], marasmus [OR = 6.3 (95% CI 2.81-19.66)], lack of exposure to sunshine [OR = 3.5 (95% CI 1.33-5.84)] and non-married maternal marital status [OR = 5.1 (95% CI 2.90-10.62)].
Conclusion: Protein-energy-malnutrition is strongly associated with vitamin D deficiency rickets. Intervention strategies targeting vitamin D deficiency rickets should give emphasis to children with protein energy malnutrition. Further work will be required to define the causal links between rickets and the risk factors identified in the present study.
PIP: This case-control study assessed the association between vitamin D deficiency rickets and protein-energy malnutrition in Ethiopian children. Data were collected over a period of 18 months (January 1997 to May 1998) from 157 children with rickets and from an equal number of age- and sex-matched controls. Findings revealed that both cases and controls were similar in terms of maternal education, paternal age, paternal education, and family size. The factors strongly and independently associated with rickets were underweight condition, nutritional status, marasmus, lack of exposure to sunshine, and maternal nonmarried status. Therefore, this study suggest that intervention strategies targeting vitamin D deficiency rickets should give emphasis to children with protein-energy malnutrition, since it is strongly and independently associated with vitamin D deficiency rickets.