Preventable but neglected: rickets in an informal settlement, Nairobi, Kenya

SETTING

The primary care clinics of Médecins Sans Frontières within the informal settlement of Kibera, Nairobi, Kenya.

OBJECTIVE

To describe the demographic and clinical characteristics of children clinically diagnosed with rickets from September 2012 to October 2013.

DESIGN

Descriptive retrospective case review of diagnosis and treatment course with vitamin D and calcium using routine programme data.

RESULTS

Of the 82 children who met the clinical diagnosis of rickets, 57% were male, with a median age of 12 months and 14 months for females. Children with rickets were found to have ⩽3 hours/week sunlight exposure for 71% of the children and malnutrition in 39%. Clinical findings on presentation revealed gross motor developmental delays in 44%. The loss to follow-up rate during treatment was 40%.

CONCLUSIONS

This study found that rickets is a common clinical presentation among children living in the informal settlement of Kibera and that there are likely multiple factors within that environment contributing to this condition. As rickets is a simply and inexpensively preventable non-communicable disease, we suggest that routine vitamin D supplementation be formally recommended by the World Health Organization for well-child care in Africa, especially in the contexts of informal settlements.