AN EPIDEMIOLOGICAL STUDY ON CASES OF UNUSUAL SKELETAL DISORDER IN PARTS OF DAMATURU TOWN OF YOBE STATE

By

Author

Presented To

Department of Medicine

ABSTRACT
The study was carried out in Pawari and shehuri communities of Damaturu town, the Yobe State capital that were afflicted with an unusual skeletal disorder affecting the children (0 - 14yrs.) of the area. The study was aimed at finding out the nature and magnitude of the disorder as well as the principal determinants of the occurrence of the disorder. It was also aimed at verifying the strength of the claim that the disorder was probably caused by certain abnormal constituents of their water. The study design was that of a case control study. All the 63 affected households (i.e. households with at least a case of the disorder) formed the group of cases while the control households were randomly selected from the list of the remaining 109 households without at least a case of the disorder. The findings were that 110 children, between 0 - 14yrs, out of the 557 children in that age group living in the area, representing 19.75%, were affected by the disorder. The prevalence was found to be more amongst males than females - 25.10% and 14.78% respectively. There was no case of an infant with the deformity while most of the cases were between the ages of 1 - 9yrs (91/110 or 82.73%), but the age specific prevalence with respect to the population of children in the affected households was highest in the 1 - 4yrs age group (56%). About 61.36% and 79.55% of the affected children were found to be underweight and stunted respectively; this was significantly higher than the corresponding figures for their unaffected siblings within the same households ie. 33.33% and 44.44% respectively as well as that of the children of the control household i.e. 14.81% and 22.22% for underweight and stunting respectively. Similarly the proportion of all the under fives (both affected and unaffected) in the affected households with under weight and stunting i.e. 48.75% or 39/80 and 51/80 or 63.75% respectively are higher significantly than the corresponding proportions in the control households i.e. 4/27 or 14.81% and 6/27 or 22.22%.AIso the proportions were significantly higher in the unaffected children of the affected households(33.33% and 44.44%) than in the children of the control households(14.81%and 22.22%) for underweight and stunting respectively. There were no evidences to support either a familial / genetic predisposition to the development of the disease. Similarly, epidemiological as well as laboratory analyses carried out did not support the claim that the disorder was associated with water or chemicals used in the households. Clinical and laboratory evidences however supported the most likely diagnoses of the disorder being rickets, and relating this to the findings of the epidemiological analyses, concluded that the rickets was most likely nutritional in origin and most probably due to inhibition of calcium and vitamin D absorption and reabsorption in the small intestine by some food constituents Based on this conclusions, it was suggested that a further analytical study is required to confirm this conclusions; and that in the mean time, a nutritional intervention programme be commenced in the communities using the strategy of community level nutrition information system of action (COLNISA).