Worldwide, nutritional
rickets continues to be an evolving problem with several causes. This paper provides an updated literature review characterising the prevalence, aetiology, pathophysiology and treatment of nutritional
rickets worldwide. A systematic review of articles on nutritional
rickets from various geographical regions was undertaken. For each region, key information was extracted, including prevalence, cause of
rickets specific to the region, methods of confirming the diagnosis and current treatment and preventive measures.
Calcium deficiency continues to be a major cause of
rickets in Africa and Asia.
Vitamin D deficiency rickets is perhaps increasing in the Americas, Europe and parts of the Middle East. There continues to be a distinct presentation of
calcium-predominant versus
vitamin D predominant
rickets, although there are overlapping features. More careful diagnosis of
rickets and reporting of 25-OHD concentrations has improved accurate knowledge of
rickets prevalence and better delineated the cause. Nutritional
rickets continues to be an evolving and multi-factorial problem worldwide. It is on a spectrum, ranging from isolated
vitamin D deficiency to isolated
calcium deficiency. Specific areas which require emphasis include a consistent community approach to screening and diagnosis,
vitamin D supplementation of infants and at-risk children, prevention of maternal
vitamin D deficiency and the provision of
calcium in areas with low
calcium diets.