TY - JOUR
T1 - Incidence of vitamin D deficiency rickets among Australian children
T2 - an Australian Paediatric Surveillance Unit study
AU - Munns, Craig F.
AU - Simm, Peter J.
AU - Rodda, Christine P.
AU - Garnett, Sarah P.
AU - Zacharin, Margaret R.
AU - Ward, Leanne M.
AU - Geddes, Janet
AU - Cherian, Sarah
AU - Zurynski, Yvonne
AU - Cowell, Christopher T.
AU - APSU Vitamin D Study Group
AU - Burgner, David P.
AU - Davis, Elizabeth
AU - Harris, Mark
AU - Batch, Jennifer
AU - Pascoe, Mark
AU - Fairchild, Jan
AU - Lafferty, Anthony
AU - Whybourne, Annie
AU - Morley, Ruth
AU - Solis-Chacon, Julieta
PY - 2012/4/16
Y1 - 2012/4/16
N2 - Objective: To determine the incidence of and factors associated with vitamin D deficiency rickets in Australian children. Design: 18-month questionnaire-based prospective observational study, using Australian Paediatric Surveillance Unit (APSU) data. Setting: Australian paediatricians and child health workers, January 2006 - July 2007. Participants: Children aged ≤ 15 years with vitamin D deficiency rickets (25-hydroxyvitamin D [25OHD] ≤ 50nmol/L, and elevated alkaline phosphatase levels [> 229 IU/L] and/or radiological rickets). Main outcome measures: Incidence of vitamin D deficiency rickets. Description of demographics, clinical presentation, identification and further analysis of overrepresented groups, and treatment regimens compared with best-practice guidelines. Results: We identified 398 children with vitamin D deficiency (55% male; median age, 6.3 years [range, 0.2-15 years]). The overall incidence in children ≤ 15 years of age in Australia was 4.9/100 000/year. All had a low 25OHD level (median, 28 nmol/L [range, 5-50nmol]) and an elevated alkaline phosphatase level (median, 407 IU/L [range, 229-5443 IU/L]), and 48 (12%) were hypocalcaemic. Ninety-five children had wrist x-rays, of whom 67 (71%) had rachitic changes. Most (98%) had dark or intermediate skin colour and 18% of girls were partially or completely veiled. Most children were born in Africa (252; 63%) and 75% of children were refugees. Duration of exclusive breastfeeding was inversely related to serum vitamin D levels in children < 3 years of age. Empirical vitamin D treatment was given to 4% of children before diagnosis. Conclusions: Vitamin D deficiency rickets is a significant problem in Australia among known high-risk groups. Public health campaigns to prevent, identify and treat vitamin D deficiency, especially in high-risk groups, are essential.
AB - Objective: To determine the incidence of and factors associated with vitamin D deficiency rickets in Australian children. Design: 18-month questionnaire-based prospective observational study, using Australian Paediatric Surveillance Unit (APSU) data. Setting: Australian paediatricians and child health workers, January 2006 - July 2007. Participants: Children aged ≤ 15 years with vitamin D deficiency rickets (25-hydroxyvitamin D [25OHD] ≤ 50nmol/L, and elevated alkaline phosphatase levels [> 229 IU/L] and/or radiological rickets). Main outcome measures: Incidence of vitamin D deficiency rickets. Description of demographics, clinical presentation, identification and further analysis of overrepresented groups, and treatment regimens compared with best-practice guidelines. Results: We identified 398 children with vitamin D deficiency (55% male; median age, 6.3 years [range, 0.2-15 years]). The overall incidence in children ≤ 15 years of age in Australia was 4.9/100 000/year. All had a low 25OHD level (median, 28 nmol/L [range, 5-50nmol]) and an elevated alkaline phosphatase level (median, 407 IU/L [range, 229-5443 IU/L]), and 48 (12%) were hypocalcaemic. Ninety-five children had wrist x-rays, of whom 67 (71%) had rachitic changes. Most (98%) had dark or intermediate skin colour and 18% of girls were partially or completely veiled. Most children were born in Africa (252; 63%) and 75% of children were refugees. Duration of exclusive breastfeeding was inversely related to serum vitamin D levels in children < 3 years of age. Empirical vitamin D treatment was given to 4% of children before diagnosis. Conclusions: Vitamin D deficiency rickets is a significant problem in Australia among known high-risk groups. Public health campaigns to prevent, identify and treat vitamin D deficiency, especially in high-risk groups, are essential.
UR - http://www.scopus.com/inward/record.url?scp=84861122364&partnerID=8YFLogxK
U2 - 10.5694/mja11.10662
DO - 10.5694/mja11.10662
M3 - Article
C2 - 22509879
AN - SCOPUS:84861122364
SN - 0025-729X
VL - 196
SP - 466
EP - 468
JO - Medical Journal of Australia
JF - Medical Journal of Australia
IS - 7
ER -