The number of children suffering from rickets has been increasing day by day since the last three decades, which is estimated over 5 lakh in different upazilas across the country. The prevalence of patients suffering from rickets is more in coastal belt areas. The cases of rickets are also found in six divisions with Sylhet and Chittagong predominantly. Rickets is a crippling disease of growing children. The symptoms of rickets are emerged with the growth of children. Rickets can develop as early as six months of age. Vitamin D deficiency is the primary cause of the disease. Calcium deficiency is now considered the main cause of rickets. Rickets results in physical deformities especially in legs. It sometimes decays muscle and leads to permanent disability. The first case of rickets was found in Cox's Bazar after the devastating cyclone in 1990. Experts apprehended that tidal wave, storm and cultivation in the salty water may be the risk factors of people's getting infected into rickets as the density of calcium reduces due to the salty water. Though it was thought that the people in Bangladesh would not be affected by rickets, the disease is caused mainly due to lack of vitamin D as people can get plenty of vitamin D from the sunray. But the fact is that a huge number of children have been affected with the disease because of calcium deficiency, said ICDDR,B scientist SK Roy. Experts said if the body does not have enough calcium, it will not be able to use the Vitamin D that would result in causing rickets. People suffering from rickets become disable gradually and resistance power of their bodies is reduced while psychiatric problems are also seen among them. The daily calcium intake should be 500-800 mg for the children under age five. Whereas, most of the children are receiving calcium from 150 to 200 mg through their daily food consumption, they added. They further said at the same time, around 35 percent children in the country are born with low birth rate, that is, they are born with calcium deficiency. Lack of exclusive breast-feeding aggravates it. According to the survey of Social Assistance and Rehabilitation for the Physically Vulnerable (SARPV) in 2006, it was found that 9 percent children have been suffering from rickets. The survey was conducted at 24 villages of Chokoria upazila in Cox's Bazar. Helen Keller International in association with SARPV also conducted a survey in 2004 that revealed around 5 lakh children suffering from the disease. The survey conducted at 28 upazilas in six divisions found that 16 upazilas are most affected with the disease. The rickets-affected children were found mostly in Sylhet and Chittagong. The research revealed that the percentage of children suffering from rickets is 1.4 in Cox's Bazar and 0.8 at Chouddagram in Comilla. The rate is 1.13 at Srimangal in Moulvibazar and 0.58 in Naogaon. "If we pay little heed to this group, it is possible to protect the children from the dreadfulness of rickets,' said SARPV Chief Executive Dr Shahidul Haque, adding that intake of calcium-rich vegetables like cabbage, cauliflower, arum, beans, pulse, small fish and milk should be increased in our daily meals. At the same time, if slight sodium carbonate can be added while cooking rice, it would meet the need of calcium, he said. The cause of rickets is not poverty, rather it is due to food habit and environment which should be addressed through study, he added. It is important to start public health nutrition programme for rickets prevention and to establish regional treatment centers for the patients suffering from the disease as it is found that some 75 children were cured through receiving proper treatment in Chokoria, experts suggested. Nutrition treatment is also important, experts said adding that study shows 66 percent of a group of children aged between two and four became normal after receiving nutrition treatment for three years. However, A Rickets Interest Group (RIG) has been formed with Brac, ICDDR,B, Unicef, Care Bangladesh and National Nutrition Programme (NNP) that has been reviewing the situation and analysing the causes, prevention strategies and providing treatment to combat rickets. A national survey also is going to be conducted on rickets. But it is very much important to formulate rickets policy by the government for situation analysis and to take necessary steps regarding the policy. While talking to The Daily Star, Assistant Director of National Nutrition Programme Dr SM Mostafizur Rahman said it is urgent to conduct a national survey on why the prevalence of rickets is so high in the coastal areas. "We have prepared a proposal to address the issue and it has been sent to the health ministry,' he said, adding that process is going on to conduct a survey in this regard.