Rickets is the most common non-communicable disease in low and middle income countries and is re-emerging in countries such as the UK where it was once thought to be eradicated. Rickets is a bone disease which affects growing children and is caused by the undermineralisaton of the growth plate of long bones. Rickets can lead to osteomalacia, disabling bone deformities of the lower-limbs, stunting, increased fracture risk and in severe cases circulating bone mineral disturbances can result in hypocalcaemic seizures and death. The majority of nutritional rickets worldwide is thought to be driven by vitamin D deficiency due to inadequate skin exposure to UVB-containing sunshine. In many countries in Africa however, 25-hydroxyvitamin D concentrations (the status marker for vitamin D) are above those generally associated with vitamin D deficiency thus indicating alternative causes of rickets. This presentation will explore some of our work on the role of the vitamin D-calcium-phosphate axis on nutritional rickets in a selection of African countries; highlighting the potential roles of calcium and iron deficiency. This presentation will also explore whether aetiology may differ depending on setting i.e. urban vs rural and the various treatment methods for rickets including surgical correction of bone deformities, nutritional supplementation and prophylactic treatment strategies for rickets prevention.
Funded by MRC programmes U105960371, U123261351, MC-A760-5QX00 and DfID under the MRC/DfID Concordat.
20 - 23 May 2017
European Society of Endocrinology