Perception and knowledge of mothers on causes and treatment of rickets associated knee deformity in Ile-Ife, Osun State, Nigeria

This descriptive cross-sectional community-based study was carried out in Ile-Ife; Nigeria to assess the knowledge of mother's on the aetiology of rickets associated knee deformities and the cultural perception of its treatment. Data collection was done using interviewer based semi structured questionnaires. A total of 464 questionnaires were administered with a response rate of 86.9. Over half (59.8; N=241) and 36.5(147) of the mothers were aware of children with knee deformity and rickets; respectively. Ninety-one (22.6) mothers had the correct knowledge and perception of the true meaning of rickets. Rickets associated knee deformity aetiology was wrongly perceived to be mainly hereditary (53.8); cancer (50.9) and bone infection (48.1). Very low proportions of mothers had correct knowledge on the causes of rickets such as inadequate exposure to sunshine (21.3) or inadequate intake of calcium (21.1). The knowledge of aetiology of rickets was influenced by education (P0.02); skilled occupation (P0.0001) and the previous birth of a child with knee deformity from rickets (P0.001). The mother's cultural perceptions of treatment for childhood rickets associated knee deformities was significantly affected by age (P0.001); education; (P0.001); skilled occupation (P0.000); history of knee deformity (P0.04) and mothers with children diagnosed to have knee deformity (P0.004). Lack of finance; poor compliance to treatment; too long treatment periods; lack of information on where to seek for treatment and unaffordable treatment were among the important factors affecting completeness of treatment of knee deformity due to rickets. In conclusion; the awareness of mothers about rickets in Nigeria is still very low. It is a major reason for late presentation or complete failure to seek for adequate treatment of the knee deformity due to rickets. Increase and sustain public health enlightenment programmes are necessary for prevention. Health policy should incorporate free surgical fees for the established knee deformity to encourage community participation in the management of the condition

Nutritional rickets in Ghanaian children

Eighteen (18) Ghanaian children with nutritional rickets seen in the Department of Child Health; Korle-Bu Teaching Hospital (KBTH) from 1985-1994 are reported. Their ages ranged from 14 months to 44 months. Their mean age at presentation is 29.4 months. There were eight (8) boys and ten (10) girls. None of these 18 children was receiving the daily recommended allowance (DRA) of Vitamin D. They all had characteristic diagnostic X-ray findings in their wrist and ankle bones. The product of their serum calcium (Ca2+) and serum inorganic phosphate (Pi) that is (Ca2+ x Pi) was less than 30 in all of them and all had markedly raised serum alkaline phosphatase levels