New UK-wide surveillance data reveal the persistence of nutritional rickets in the UK, with serious clinical consequences in some cases.
A study published in the Archives of Disease in Children describes the incidence, presentation and clinical management of children below 16 years of age with nutritional rickets in the UK presenting to secondary care.
Prospective data were collected monthly between March 2015 and March 2017 from 3500 consultant paediatricians using British Paediatric Surveillance Unit methodology.
The data identified 125 cases of rickets, an annual incidence of 0.48 (95% CI, 0.37-0.62) per 100,000 children aged below 16 years. Of these, 116 children per 100,000 were below 5 years of age (annual incidence, 1.39; 95% CI, 1.05-1.81).
Boys were significantly more likely to be affected than girls (OR, 2.17; 95% CI, 1.25-3.78). The majority were of black (43%) or South Asian (38%) ethnicity.
Serious complications and unexpected deaths, particularly in black and South Asian children aged below 5 years, occurred. Complications included delayed gross motor development (26.4%), fractures (9.6%), hypocalcaemic seizures (8%) and dilated cardiomyopathy (3%). Two children died (1.6%).
More than 77 per cent of children were not taking vitamin D supplements despite being eligible.
The authors say further attention is needed on what and how public health messages can target and reinforce vitamin D supplementation and sun exposure policy.