Title : Prevalence of rickets in children of Chakaria

ARM Luthful Kabir, AKM Fazlur Rahman, Khurshid Talukder, Aminur Rahman, Quamrul Hassan, MA Mannan,

Abstract :

An epidemiological survey was conducted on 900 children between 1 through 15 years selected randomly from all 340 villages of Chakaria thana of Bangladesh to determine the prevalence of rickets. After the recruitment of necessary staff, a six-day training was conducted in the local SARPV office at Chakaria about the purpose and procedure of the study. The geographical reconnaissance (GR) sheets were used by the Health Assistants of the selected 30 villages to identify and collect the children with the help of an identification slip to a particular place. Interview of the parents was taken and children were examined for evidences of rickets and necessary radiological and blood examination (serum calcium, phosphorus, and ALP) were done in all clinically suspected cases and in control of every eighth child. Out of 900 children, there were 498(55.3%) male and 402(44.7%) female. The commonest food intake, other than rice, in last 24 hours was dry fish(49.6%) followed by fresh fish (46.6%). Only 11.9% children took milk or milk products and 16% had taken meat on the previous day. Seventy eight (8.6%) children had at least one feature suggestive of 'clinical rickets'. Pectus carinatum was the most common clinical feature in 26 (33.3%) followed by genu valgum in 23 (29.4%) cases. Among them 20 (2.2%) children had raised ALP level ('biochemical rickets') including all 8 (0.9%) having radiological features of rickets (confirmed rickets). Among 111 control children 22 (19.8%) had raised level of ALP. Further study is needed to find out the exact aetiology of 'only biochemical' (1.3%) (children having clinical features and raised ALP but negative radiology) and 'only clinical rickets' (6.4%) (children having clinical features but negative biochemistry and radiology) and immediate intervention is to be started to treat the already affected children.

Title : Prevalence of wheeze and asthma in children in a coastal community

ARM Luthful Kabir, AKM Fazlur Rahman, MA Mannan, Sanchoy Kumar Chanda, Abul Taimur Chowdhury

Abstract :

An epidemiological survey was conducted on 900 children between 1 through 15 years chosen randomly out of 30 villages of Chakaria thana of Bangladesh to determine the prevalence of wheeze and asthma through a validated asthma symptoms questionnaire. After the recruitment of necessary staff a 2-day orientation was conducted at Chakaria about the purpose and procedure of the study. Geographical reconnaissance (GR) sheets were used by the Health Assistants of selected 30 villages to identify and collect the children to a particular place. Interview of the parents was taken to collect data about socio-economic status, health characteristics and the children were examined for nutritional status. Out of 900 children, there were 498 (55.3%) male and 402 (44.7%) female. Eighty one percent fathers had poor education, 38.7% fathers had occupation of day labour and 61.7% parents were very poor as reflected by monthly budget deficit. The commonest food intake, other than rice, in last 24 hours was dry fish (49.6%) followed by fresh fish (46.6%). Only 11.9% children took milk or milk products and 16% had taken meat on the previous day. The prevalence of 'wheeze ever' was 25.9%. About 21.7% mothers had the idea that their children had asthma and in 13.4% cases asthma was diagnosed by the local local doctors. The prevalence of 'recent wheeze' was 23%, night cough 39.7% and in 34.9% cases children used to wake up from sleep coughing. Twenty five percent mothers resorted to treatment for their 'asthmatic' children. The prevalence of asthma (having all above seven features present altogether in a child) was 11.8%. Family history of asthma was found in 20.2% cases. Alopathy (53.7%) and homeopathy (16.7%) were the main modes of therapy which the mothers consulted for. Almost all mothers 888(98.6%) had no idea about inhalation therapy in asthma. Asthma in a coastal community of Bangladesh is as common as the prevalence of that in a developed country. Further study is needed to see the prevalence of wheeze and asthma in urban and other rural areas of the country.