Rachitic deformities of lower members in congolese children

Abstract

Background. To analyse risk factors in rachitic Congolese children with serious deformities in their lower members and to describe the lesions. Methods. The authors analysed the parameters obtained in a survey of two groups of children: a group of 194 rachitic children with severe deformities of their members and another control group of 107 healthy children of similar ages. The types of deformity and the degrees of rachitism were described. Results. The most frequent deformity was genu varum (58.2%), followed by windsept (23.7%) and genu valgum (13.9%). Genu varum predominated in girls of between 2-4 years (p=0.0025). We found florid rickets in 19.1% of the cases, moderate in 15.5%, minimal in 14.2% and osseous deformities alone without active rachitism in 41.2%. Of the parameters analysed, the most important risk factor was being a twin (OR=25.43 ; 95% CI=3.76-1098.27), followed by lack of sunlight (OR=18.39, 95% CI=6.69-61.55) and having a rachitic sibling. Maternal feeding was a protective factor (OR=0.94, 95% CI=0.90-0.98). Premature birth and low weight at birth had no influence. Walking age was 15.4 months in the rachitic cases and 12.4 months in the control group (p<0,01). Conclusion. Severe deformities of lower members as a sequel to rickets are frequent; they are associated with being a twin, lack of sunlight and precocious weaning.