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A household-level study to identify risk factors for rickets in Bangladesh



A household-level study to identify risk factors for rickets in Bangladesh



FASEB Journal 16(4): A275-A276



A comprehensive, multi-round survey was conducted of the food system of an area of Bangladesh with prevalent rickets, Chakaria, Cox's Bazaar District. Surveys were conducted in four rounds corresponding to traditional periods of relative food adequacy or shortage. The study was designed as a household (HH)-level case-control study, with 199 households (in 6 villages) with at least one child showing physical signs consistent with rickets, and 281 HHs in the same villages with no affected children. Results show that rickets-affected HHs had more children and fewer adults than HHs not affected by the disease. Affected HHs tended to rely on farming for their livelihood, to have more outstanding debt than their neighbors, and to have diets based on cereals and starchy vegetables, with little or no calcium (Ca)-rich foods. Low Ca intakes appeared to be widespread. Rice and dried fish were the major sources of Ca for most HHs, although dairy products, when used, were very important Ca sources particularly for young children. Although fewer than 10% of HHs used dairy products, their use, in contrast to that of other micronutrient-dense foods, was the only HH-level food use characteristic associated with increased Ca intakes of children and other HH members. In contrast, HH use of meats was associated with reduced Ca supplies to most members. HHs with rickets were at significantly greater risk of pneumonia than were other HHs.

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