Prevalence and Factors Associated with Rickets-like Bone Deformities in Rural Cameroon: A Cross-sectional Study of Children in M’mockmbie Village in the Southwest Region

Abstract

Background: Rickets remains a significant public health concern in resource-limited settings, causing bone deformities through impaired mineralization. While traditionally linked to vitamin D deficiency, calcium deficiency appears predominant in Sub-Saharan Africa (SSA). Nevertheless, studies have not examined rickets-like bone deformities (RLBD) in rural Cameroon. This study assessed RLBD prevalence and associated factors in M'mockmbie village, in the southwest region of Cameroon. Methodology: We conducted a community-based cross-sectional study from October 2021 to July 2022, employing a multi-step stratified random sampling technique across M'mockmbie's 12 quarters. The study population comprised children aged 6 months to 16 years (n=455). Data collection included sociodemographic, nutritional status, vaccination history, and clinical features of RLBD. Statistical analysis used Epi-Info version 7.2.5.0, with multivariate logistic regression to identify factors associated with RLBD (p≤0.05 significance). Results: From the 455 children included, the study revealed a 12.31% RLBD prevalence, predominantly knock-knee deformities (60.71%). Most cases (76.79%) manifested by age 2. Significant associations emerged with incomplete vaccination (aOR=2.78, p=0.033), poor nutrition (aOR=0.57, p=0.025), parental loss (aOR=0.36, p=0.033), and family history of RLBD (aOR=0.31, p=0.017). Nutritional data revealed 58.9% of children experienced food insecurity, with 91.7% consuming carbohydrate-dominated diets and only 6.2% regularly consuming protein-rich foods. Healthcare-seeking behaviour showed 42.9% visited hospitals for deformities, while 25.0% used self-medication. Conclusion: The high RLBD burden in M'mockmbie reflects intersecting nutritional and healthcare access challenges. Our findings highlight the critical need for integrated interventions addressing childhood malnutrition, incomplete vaccination coverage, and targeted screening for at-risk families. The predominance of early-onset cases suggests vulnerability during critical growth periods, warranting focused prevention strategies.