The Prevalence of hypocalcemia and Vitamin D3 deficiency among the underprivileged orphans of Azad Jammu and Kashmir, Pakistan
Prevalence of hypocalcemia among orphans
Keywords:
hypocalcemia, vitamin D3 deficiency, prevalence of hypocalcemia, hypocalcemia associated vitamin d3 deficiency, hypocalcemia among orphansAbstract
Background: Rickets, an infantile condition stemming from hypocalcemia, is observed to be escalating among children. Vitamin D deficiency, deemed the primary cause of impaired calcium absorption from the gut, has been linked to the onset of hypocalcemia and subsequent rickets. Despite this, no prior investigations have scrutinized the prevalence of hypocalcemia among orphan children residing in urban settings in Pakistan. This study aims to evaluate the extent of calcium deficiency in orphaned children across various regions of Azad Jammu & Kashmir, Pakistan. Methodology: A screening study encompassed 544 underprivileged orphan children (300 males and 244 females) in Hattian Bala (Jhelum Valley), Kotli, Bagh, and district Bhimber, Azad Kashmir. Fasting blood samples were obtained, and serum calcium levels were assessed using the o-cresol-phthalein complexion color development method. Additionally, serum 1α,25-(OH)2D3 levels were assayed via the 1α,25-(OH)2D3 RIA method employing a kit from Mitsubishi Kagaku Bio-Clinical Labs, Inc., Japan. A comprehensive health examination conducted by a qualified physician aimed to identify other health concerns among the orphans. Statistical analyses were performed using GraphPad Prism (Version 7.04) software. Results: Among the total orphan population, 24.8% exhibited hypocalcemia, with a distribution of 56.3% females and 43.7% males. Vitamin D3 deficiency was observed in 5.3% of orphans, with a gender discrepancy of 27.6% males and 72.4% females. The mean age, calculated with a 95% Confidence Interval, was 12.0±0.3, with a standard deviation of 3.1. The age group of 5 to 9 years demonstrated the highest prevalence of both serum calcium (56.1%) and vitamin D3 (14.3%) deficiencies. A significant correlation (p<0.0001) between vitamin D3 deficiency and hypocalcemia was identified. District Kotli exhibited the highest prevalence of hypocalcemia, while district Hattian Bala (Jhelum Valley) showed a higher prevalence of low vitamin D3 levels. Conclusion & Recommendations: The underprivileged orphan population in Azad Kashmir, Pakistan, manifests low vitamin D3 levels, strongly associated with the prevalence of hypocalcemia. Notably, vitamin D3 insufficiency and hypocalcemia are more prevalent in the female population. To address this, the Government of Azad Jammu and Kashmir, Pakistan, is urged to institute policies providing sufficient and meaningful endowment funds for the state's orphans. Additionally, a national campaign should be initiated to raise awareness about malnutrition and the importance of a balanced diet.