increase in childhood cases in

increase in childhood cases in
increase in childhood cases in France

A study reports an increase in scurvy disease among children in since the Covid-19 pandemic. The worrying return of this disease linked to a profound vitamin C deficiency “highlights the possible consequences of the increase in socio-economic insecurity since 2020 on the nutritional state of children in France”, indicate the authors. The results were the subject of a publication published on December 6, 2024 in the journal The Lancet Regional Health – Europe [1] .

Increase in cases of scurvy and severe malnutrition

Carried out by the teams of the general pediatrics department and the reference center for inflammatory rheumatism and systemic autoimmune diseases in children (RAISE) of the Robert-Debré AP-HP hospital, Inserm, the university Cité and the pediatrics department of hospital in Guyana, the study aimed to evaluate trends in the incidence of scurvy among children hospitalized in France over a period nine years and examine the impact of the Covid-19 pandemic. The study also analyzed the evolution of malnutrition, differentiating severe forms from moderate and mild forms.

Researchers noted an increase in scurvy-related hospitalizations estimated at +34.5% after the pandemic.

It included patients aged 18 and under, suffering from scurvy and severe malnutrition, between January 2015 and November 2023, therefore covering two distinct periods: pre-pandemic (2015-2020) and post-pandemic (2020-2023). The researchers relied on data collected from the national PMSI (program for medicalization of information systems), knowing that socio-economic factors such as the consumer price index were integrated to assess the correlations with the incidence of diseases.

Over the period studied, 888 patients with scurvy (average age: 11 years) were hospitalized. Taking the Covid-19 pandemic as a benchmark, researchers noted an increase in hospitalizations estimated at 34.5% post-pandemic. At the same time, researchers observed an increase in cases of severe malnutrition, estimated at 20.3% over the same period, which reinforces the link of scurvy with a deterioration in the nutritional status of children. The increase in cases of scurvy and severe malnutrition was associated with worsening socio-economic insecurity and inflation. “This association does not necessarily constitute a causal relationship, although plausible,” specify the authors.

The role of inflation on foodstuffs

How can we explain this re-emergence? Researchers cite different causes including environmental and social factors but also linked to eating habits. They also highlight “the unexpected impact of the pandemic and the global socio-economic and political crises that followed it, on the worsening of food insecurity”. In France, food price inflation reached 15% at the start of 2023, particularly affecting precarious families.

This study could give rise to recommendations, in particular with regard to “the implementation of targeted food aid programs, improving access to nutritious and affordable foods, as well as strengthening training clinical practice for the prevention and early detection of nutritional deficiencies”.

This disease, responsible for high mortality among sailors until the 19th centurye century and which has almost disappeared in developed countries, can cause serious health problems: bone pain, muscle weakness or even hemorrhages. Indeed, vitamin C contributes to the stability of collagen and scurvy can be considered a connective tissue disease.

Scurvy today

“At the end of the 19th centurye century, scurvy appeared among babies in Europe and the United States in wealthy and educated families,” explains the Pr Patrick Berche in an article devoted to the history of scurvy. This infantile scurvy, described in 1883 by the English doctor Thomas Barlowwas linked to the abandonment of breast-feeding for industrial cow's milk treated at high temperatures and therefore devoid of vitamin C. In the 21st centurye century, we can still encounter scurvy which accompanies poverty and malnutrition. The honorary director of the Pasteur Institute in cites as an example the refugee camps in Sudan or Somalia in 1989 where the disease posed a public health problem, reaching 14 to 44% of the population of 6 camps. In developed countries, scurvy can appear whenever socio-economic conditions do not allow a varied and balanced diet. However, it remains rare. More recently, it has been observed in the United States, among adolescents with an aberrant exclusive diet: donuts and black coffee, peanut butter sandwiches, etc. “Similarly in France, cases have been reported among young people with bad habits. eating habits in 2014 and 2015, as well as in Australia in 2016,” recalls the biologist.

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