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01-12-2021 | Malaria | Research article

Prevalence and predictors of vitamin D deficiency in young African children

Authors: Reagan M. Mogire, Alireza Morovat, John Muthii Muriuki, Alexander J. Mentzer, Emily L. Webb, Wandia Kimita, Francis M. Ndungu, Alex W. Macharia, Clare L. Cutland, Sodiomon B. Sirima, Amidou Diarra, Alfred B. Tiono, Swaib A. Lule, Shabir A. Madhi, Manjinder S. Sandhu, Andrew M. Prentice, Philip Bejon, John M. Pettifor, Alison M. Elliott, Adebowale Adeyemo, Thomas N. Williams, Sarah H. Atkinson

Published in: BMC Medicine | Issue 1/2021

Abstract

Background

Children living in sub-Saharan Africa have a high burden of rickets and infectious diseases, conditions that are linked to vitamin D deficiency. However, data on the vitamin D status of young African children and its environmental and genetic predictors are limited. We aimed to examine the prevalence and predictors of vitamin D deficiency in young African children.

Methods

We measured 25-hydroxyvitamin D (25(OH)D) and typed the single nucleotide polymorphisms, rs4588 and rs7041, in the GC gene encoding the vitamin D binding protein (DBP) in 4509 children aged 0–8 years living in Kenya, Uganda, Burkina Faso, The Gambia and South Africa. We evaluated associations between vitamin D status and country, age, sex, season, anthropometric indices, inflammation, malaria and DBP haplotypes in regression analyses.

Results

Median age was 23.9 months (interquartile range [IQR] 12.3, 35.9). Prevalence of vitamin D deficiency using 25(OH)D cut-offs of < 30 nmol/L and < 50 nmol/L was 0.6% (95% CI 0.4, 0.9) and 7.8% (95% CI 7.0, 8.5), respectively. Overall median 25(OH)D level was 77.6 nmol/L (IQR 63.6, 94.2). 25(OH)D levels were lower in South Africa, in older children, during winter or the long rains, and in those with afebrile malaria, and higher in children with inflammation. 25(OH)D levels did not vary by stunting, wasting or underweight in adjusted regression models. The distribution of Gc variants was Gc1f 83.3%, Gc1s 8.5% and Gc2 8.2% overall and varied by country. Individuals carrying the Gc2 variant had lower median 25(OH)D levels (72.4 nmol/L (IQR 59.4, 86.5) than those carrying the Gc1f (77.3 nmol/L (IQR 63.5, 92.8)) or Gc1s (78.9 nmol/L (IQR 63.8, 95.5)) variants.

Conclusions

Approximately 0.6% and 7.8% of young African children were vitamin D deficient as defined by 25(OH)D levels < 30 nmol/L and < 50 nmol/L, respectively. Latitude, age, season, and prevalence of inflammation and malaria should be considered in strategies to assess and manage vitamin D deficiency in young children living in Africa.

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Title: Prevalence and predictors of vitamin D deficiency in young African children
Authors: Reagan M. Mogire
Alireza Morovat
John Muthii Muriuki
Alexander J. Mentzer
Emily L. Webb
Wandia Kimita
Francis M. Ndungu
Alex W. Macharia
Clare L. Cutland
Sodiomon B. Sirima
Amidou Diarra
Alfred B. Tiono
Swaib A. Lule
Shabir A. Madhi
Manjinder S. Sandhu
Andrew M. Prentice
Philip Bejon
John M. Pettifor
Alison M. Elliott
Adebowale Adeyemo
Thomas N. Williams
Sarah H. Atkinson
Publication date: 01-12-2021
Publisher: BioMed Central
Keywords: Malaria
Underweight
Vitamin D Deficiency
Underweight
Published in: BMC Medicine / Issue 1/2021
Electronic ISSN: 1741-7015
DOI: https://doi.org/10.1186/s12916-021-01985-8

At a glance: The STEP trials

Springer Medicine

Prevalence and predictors of vitamin D deficiency in young African children

Abstract

Background

Methods

Results

Conclusions

At a glance: The STEP trials

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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