Rickets in Sudanese Children

1. Vitamin D-Defficiency or Infantile Rickets: This is extremely rare in the Sudan owing to the availability of sun-shine throughout the year. Since infantile rickets is common in some other African countries where sun-shine is also constant throughout the year, other factors, which obstruct the natural ultraviolet irradiation e.g. crowded housing and overprotection of infants must be operating. It is now almost agreed that ultraviolet irradiation alone may be sufficient to prevent rickets. Dietary sources of vitamin Dare only required when a child is shielded from effective sunshine by clothing, housing conditions, or industrial smog. (Stamp, 1973). In the Sudan, sun-shine is constant throughout the year. The predominent use of simple housing with plenty of open-air space and the use of light clothing to children owing to the hot weather have made sun-shine irradiation quite effective in preventing rickets. During the last 15 years only two cases of vitamin-D deficiency rickets were seen, both induced by environmental factors :l. A male infant, aged 9 months, the last born baby after a series of nine girls, showed the mainfestations of rickets, The main precepitating factor was over-protection by the mother because of fear of illness and evil eye. He recovered with vitamin D therapy and exposure to sun-light. 2. A gril, aged 10 months, who was referred to me from a district hospital, where she was kept indoors for 6 months because of severe haemolytic anaemia·