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Incidence and characteristics of vitamin D deficiency rickets in New Zealand children: a New Zealand Paediatric Surveillance Unit study.
Aust N Z J Public Health 2015; 39(4):380-3AN

Abstract

OBJECTIVE

To investigate the incidence and characteristics of vitamin D deficiency rickets in New Zealand (NZ).

METHODS

Prospective surveillance among paediatricians of Vitamin D Deficiency Rickets was conducted by the New Zealand Paediatric Surveillance Unit (NZPSU) for 36 months, from July 2010 to June 2013, inclusive. Inclusion criteria were: children and adolescents <15 years of age with vitamin D deficiency rickets (defined by low serum 25-hydroxyvitamin D and elevated alkaline phosphatase levels, and/or radiological rickets).

RESULTS

Fifty-eight children with confirmed vitamin D deficiency rickets were identified. Median age was 1.4 (range 0.3-11) years, 47% were male, and 95% of the children were born in NZ; however, the majority of the mothers (68%) were born outside NZ. Overall annual incidence of rickets in children aged <15 years was 2.2/100,000 (95%CI 1.4-3.5); with incidence in those <3 years being 10.5/100,000 (95%CI 6.7-16.6). Skeletal abnormalities, poor growth and motor delay were the most common presenting features, with hypocalcaemic convulsion in 16% of children. Key risk factors identified were: darker skin pigment, Indian and African ethnicity, age <3 years, exclusive breast feeding, and southern latitude, particularly when combined with season (winter/spring). Of the patients reported, none had received appropriate vitamin D supplementation.

CONCLUSIONS

Vitamin D deficiency rickets remains a problem for NZ children. Key risk factors remain similar to those identified in the international literature. Preventative targeted vitamin D supplementation, as per existing national guidelines, was lacking in all cases reported.

IMPLICATIONS

Vitamin D deficiency rickets is the most significant manifestation of vitamin D deficiency in growing children. To reduce the incidence of this disease among those at high risk, increasing awareness and implementation of current public health policies for targeted maternal, infant and child supplementation are required.

Authors+Show Affiliations

Department of Women's and Children's Health, Dunedin School of Medicine, University of Otago, New Zealand. Paediatric Endocrinology, Southern District Health Board, New Zealand.New Zealand Paediatric Surveillance Unit, Department of Women's and Child Health, Dunedin School of Medicine, University of Otago, New Zealand.Department of Human Nutrition, University of Otago, New Zealand.Department of Pediatrics, University of Ottawa, Canada.New Zealand Paediatric Surveillance Unit, Department of Women's and Child Health, Dunedin School of Medicine, University of Otago, New Zealand.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

26122859

Citation

Wheeler, Benjamin J., et al. "Incidence and Characteristics of Vitamin D Deficiency Rickets in New Zealand Children: a New Zealand Paediatric Surveillance Unit Study." Australian and New Zealand Journal of Public Health, vol. 39, no. 4, 2015, pp. 380-3.
Wheeler BJ, Dickson NP, Houghton LA, et al. Incidence and characteristics of vitamin D deficiency rickets in New Zealand children: a New Zealand Paediatric Surveillance Unit study. Aust N Z J Public Health. 2015;39(4):380-3.
Wheeler, B. J., Dickson, N. P., Houghton, L. A., Ward, L. M., & Taylor, B. J. (2015). Incidence and characteristics of vitamin D deficiency rickets in New Zealand children: a New Zealand Paediatric Surveillance Unit study. Australian and New Zealand Journal of Public Health, 39(4), pp. 380-3. doi:10.1111/1753-6405.12390.
Wheeler BJ, et al. Incidence and Characteristics of Vitamin D Deficiency Rickets in New Zealand Children: a New Zealand Paediatric Surveillance Unit Study. Aust N Z J Public Health. 2015;39(4):380-3. PubMed PMID: 26122859.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Incidence and characteristics of vitamin D deficiency rickets in New Zealand children: a New Zealand Paediatric Surveillance Unit study. AU - Wheeler,Benjamin J, AU - Dickson,Nigel P, AU - Houghton,Lisa A, AU - Ward,Leanne M, AU - Taylor,Barry J, Y1 - 2015/06/29/ PY - 2014/09/01/received PY - 2015/01/01/revised PY - 2015/01/01/accepted PY - 2015/7/1/entrez PY - 2015/7/1/pubmed PY - 2016/8/10/medline KW - hypocalcaemia KW - rickets KW - vitamin D KW - vitamin D deficiency SP - 380 EP - 3 JF - Australian and New Zealand journal of public health JO - Aust N Z J Public Health VL - 39 IS - 4 N2 - OBJECTIVE: To investigate the incidence and characteristics of vitamin D deficiency rickets in New Zealand (NZ). METHODS: Prospective surveillance among paediatricians of Vitamin D Deficiency Rickets was conducted by the New Zealand Paediatric Surveillance Unit (NZPSU) for 36 months, from July 2010 to June 2013, inclusive. Inclusion criteria were: children and adolescents <15 years of age with vitamin D deficiency rickets (defined by low serum 25-hydroxyvitamin D and elevated alkaline phosphatase levels, and/or radiological rickets). RESULTS: Fifty-eight children with confirmed vitamin D deficiency rickets were identified. Median age was 1.4 (range 0.3-11) years, 47% were male, and 95% of the children were born in NZ; however, the majority of the mothers (68%) were born outside NZ. Overall annual incidence of rickets in children aged <15 years was 2.2/100,000 (95%CI 1.4-3.5); with incidence in those <3 years being 10.5/100,000 (95%CI 6.7-16.6). Skeletal abnormalities, poor growth and motor delay were the most common presenting features, with hypocalcaemic convulsion in 16% of children. Key risk factors identified were: darker skin pigment, Indian and African ethnicity, age <3 years, exclusive breast feeding, and southern latitude, particularly when combined with season (winter/spring). Of the patients reported, none had received appropriate vitamin D supplementation. CONCLUSIONS: Vitamin D deficiency rickets remains a problem for NZ children. Key risk factors remain similar to those identified in the international literature. Preventative targeted vitamin D supplementation, as per existing national guidelines, was lacking in all cases reported. IMPLICATIONS: Vitamin D deficiency rickets is the most significant manifestation of vitamin D deficiency in growing children. To reduce the incidence of this disease among those at high risk, increasing awareness and implementation of current public health policies for targeted maternal, infant and child supplementation are required. SN - 1753-6405 UR - https://www.unboundmedicine.com/medline/citation/26122859/Incidence_and_characteristics_of_vitamin_D_deficiency_rickets_in_New_Zealand_children:_a_New_Zealand_Paediatric_Surveillance_Unit_study_ L2 - https://doi.org/10.1111/1753-6405.12390 DB - PRIME DP - Unbound Medicine ER -