Clinical and radiographic improvement of rickets in Bangladeshi children as a result of nutritional advice

Josiane Arnaud, J. M. Pettifor, J. P. Cimma, P. R. Fischer, T. Craviari, C. Meisner, S. Haque, B. Abbas, S. K. Roy, H. Asirul, M. Chowdhury, A. Faruque, M. S. Gani, M. Imran, F. Karim, P. Claquin, S. Kelley, M. Q.K. Talukder, S. Shafique, C. WittenH. Torlesse, A. Nizam, N. Hassan, B. Aroumougom, J. M. Bouvard, J. Grison, L. Gallegos, M. Garabedian, G. F. Combs, R. M. Welch, P. Tebben, T. Thacher

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Abstract

Background: Calcium-deficiency rickets is common in south-east Bangladesh and responds to calcium supplementation. Aim: 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.

Original languageEnglish (US)
Pages (from-to)185-191
Number of pages7
JournalAnnals of Tropical Paediatrics
Volume27
Issue number3
DOIs
StatePublished - Sep 2007

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ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health

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Arnaud, J., Pettifor, J. M., Cimma, J. P., Fischer, P. R., Craviari, T., Meisner, C., Haque, S., Abbas, B., Roy, S. K., Asirul, H., Chowdhury, M., Faruque, A., Gani, M. S., Imran, M., Karim, F., Claquin, P., Kelley, S., Talukder, M. Q. K., Shafique, S., ... Thacher, T. (2007). Clinical and radiographic improvement of rickets in Bangladeshi children as a result of nutritional advice. Annals of Tropical Paediatrics, 27(3), 185-191. https://doi.org/10.1179/146532807X220299