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Incidence of vitamin D deficiency rickets among Australian children: an Australian Paediatric Surveillance Unit study.
Med J Aust. 2012 Apr 16; 196(7):466-8.MJ

Abstract

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] ≤ 50 nmol/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, 5-50 nmol]) 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 tre@vitamin D deficiency, especially in high-risk groups, are essential.

Authors+Show Affiliations

Institute of Endocrinology and Diabetes, Children's Hospital at Westmead, Sydney, NSW. craigm2@chw.edu.auNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

22509879

Citation

Munns, Craig F., et al. "Incidence of Vitamin D Deficiency Rickets Among Australian Children: an Australian Paediatric Surveillance Unit Study." The Medical Journal of Australia, vol. 196, no. 7, 2012, pp. 466-8.
Munns CF, Simm PJ, Rodda CP, et al. Incidence of vitamin D deficiency rickets among Australian children: an Australian Paediatric Surveillance Unit study. Med J Aust. 2012;196(7):466-8.
Munns, C. F., Simm, P. J., Rodda, C. P., Garnett, S. P., Zacharin, M. R., Ward, L. M., Geddes, J., Cherian, S., Zurynski, Y., & Cowell, C. T. (2012). Incidence of vitamin D deficiency rickets among Australian children: an Australian Paediatric Surveillance Unit study. The Medical Journal of Australia, 196(7), 466-8.
Munns CF, et al. Incidence of Vitamin D Deficiency Rickets Among Australian Children: an Australian Paediatric Surveillance Unit Study. Med J Aust. 2012 Apr 16;196(7):466-8. PubMed PMID: 22509879.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Incidence of vitamin D deficiency rickets among Australian children: 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 - ,, PY - 2012/4/19/entrez PY - 2012/4/19/pubmed PY - 2012/7/6/medline SP - 466 EP - 8 JF - The Medical journal of Australia JO - Med. J. Aust. VL - 196 IS - 7 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] ≤ 50 nmol/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, 5-50 nmol]) 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 tre@vitamin D deficiency, especially in high-risk groups, are essential. SN - 1326-5377 UR - https://www.unboundmedicine.com/medline/citation/22509879/Incidence_of_vitamin_D_deficiency_rickets_among_Australian_children:_an_Australian_Paediatric_Surveillance_Unit_study_ L2 - https://www.mja.com.au/public/issues/196_07_160412/mun10662_fm.html DB - PRIME DP - Unbound Medicine ER -