Oral Abstract Abstract

(Paediatric), #220515299366

Ramadan fasting in paediatrics patients with congenital adrenal hyperplasia (CAH)

Dr. Gan Cheng Guang, Hospital Putrajaya; Dr. Alexis Anand Dass A/L Lordudass, Hospital Putrajaya; Dr. Cheng Hooi Peng, Hospital Putrajaya; Dr. Noor Arliena Binti Mat Amin, Hospital Putrajaya; Dr. Teoh Sze Teik, Hospital Putrajaya; Dr Wong Sze Lyn Jeanne, Hospital Putrajaya; Dr. Nalini Selveindran, Hospital Putrajaya; Dr. Janet Hong Yeow Hua, Hospital Putrajaya

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All post-pubescent Muslims, with exceptions, are requested to fast during Ramadan. However, patients with illnesses often want to fast despite medical risks to health. To our knowledge there are no studies on fasting in children with CAH and the risks of prolonged fasting are not known. We seek to explore their experiences during fasting.


This is a cross sectional study using questionnaire over an estimated period of 6 months. All children with CAH in Hospital Putrajaya who had attempted to fast during Ramadan or wish to fast in the future were included.


18 girls and 16 boys with mean age of 9.6 ± 0.982 years(3–17) were recruited. Twenty-seven patients(79.4%) tried to fast with only twelve(44%) seek advice from paediatrician. Nine(75%) fasted despite being advised against fasting. Complications occurred in 13 cases(48.2%): asthenia(92.3%), thirst(30.7%), dehydration(23%) and hypoglycaemia symptoms(61%). None was hospitalised. Twelve patients (44%) were able to fast for the whole month.

Non-fasters was significantly younger than fasters (adjusted OR (95%CI)=1.9437 (1.09–3.43),p=0.02). Fasters were less aware about the potential complications from fasting (adjusted OR (95%CI)=0.07(0.007–0.68),p=0.02). The frequency of adequate knowledge on safety fasting was significantly lower in full-month-fasters vs. partial-month-fasters (adjusted OR (95%CI)=0.079(0.008–0.781),p=0.02). Non-compliant-fasters significantly more likely to experience complications vs. compliant-fasters during fasting (adjusted OR (95%CI)=8.3(1.47–47.22),p=0.01).


High numbers of patients fasting without paediatrician’s advice is a cause of concerns. In paediatric CAH patients, fasting can cause complications especially if compliance to medications is an issue.

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