<p> <b><span style="font-family:Verdana;">Background: </span></b><span style="font-family:;" "=""><span style="font-family:Verdana;"&...<p> <b><span style="font-family:Verdana;">Background: </span></b><span style="font-family:;" "=""><span style="font-family:Verdana;">Globally there is a high burden of low serum vitamin D deficiency (VDD) with children being acknowledged at risk due to low vitamin D content in both breastmilk and available foods and inadequate cutaneous synthesis of vitamin D. Even in countries with abundant sunshine, vitamin D deficiency (VDD) remains a problem. There is little characterization of the status of vitamin D among infants in East Africa. This study aimed to determine the prevalence and factors associated with vitamin D deficiency among infants attending the Reproductive and Child Health (RCH) Clinic in Arusha, Tanzania. </span><b><span style="font-family:Verdana;">Methods: </span></b><span style="font-family:Verdana;">A cross-sectional study of 304 infants aged 6 weeks to 12 months was conducted at Arusha Lutheran Medical Centre (ALMC). Infants were enrolled during the warm season between November 2018 and January 2019. A pre-coded questionnaire was used to collect data on sociodemographic characteristics of the infant with consent from their caretakers. Physical examination was done for anthropometric measures and signs of rickets. Blood was drawn for assessment of serum 25-hydroxyvitamin D 25(OH)D, calcium, phosphorus and alkaline phosphate. Vitamin D deficiency was defined as 25(OH)D level below 20 ng/ml (<50 nmol/L) and Vitamin D insufficiency defined as a 25(OH)D level 20 - 30 ng/ml (50 - 75 nmol/L). Statistical </span><span><span style="font-family:Verdana;">analysis was performed using STATA 14 version and factors associated with VDD explored with multivariate analysis. </span><b><span style="font-family:Verdana;">Results:</span></b><span style="font-family:Verdana;"> The mean serum 25(OH)D </span></span><span style="font-family:Verdana;">among infants was 34.51 ng/ml (±15.53). Vitamin D deficiency was found in 67/304 (22%) infants and Vitamin D insufficiency in 50 (16.5%) infants. Hypocalcemia was observed in 33 (10.9%) infants and clinical findings of rickets were found in 11 infants (3.6%). Factors independently associated with VDD included age < 6 months (Adjusted Odds Ratio (AOR) 1.56, 95% CI 1.19 - 4.0, p value < 0.026), serum signs of rickets and serum hypocalcemia (p-value < 0.001 and <0.002, respectively). </span><b><span style="font-family:Verdana;">Conclusion and Recommendation: </span></b><span style="font-family:Verdana;">A high prevalence of Vitamin D deficiency (22%) and insufficiency (16.5%) was observed among infants attending RCH Clinic in Arusha, Tanzania. Age < 6 months, a single serum measurement of hypocalcemia and the presence of the clinical sign of rickets were independently associated with VDD. Clinicians should actively assess for VDD and supplement with vitamin D as indicated, especially among infants < 6 months.</span></span> </p>展开更多
文摘<p> <b><span style="font-family:Verdana;">Background: </span></b><span style="font-family:;" "=""><span style="font-family:Verdana;">Globally there is a high burden of low serum vitamin D deficiency (VDD) with children being acknowledged at risk due to low vitamin D content in both breastmilk and available foods and inadequate cutaneous synthesis of vitamin D. Even in countries with abundant sunshine, vitamin D deficiency (VDD) remains a problem. There is little characterization of the status of vitamin D among infants in East Africa. This study aimed to determine the prevalence and factors associated with vitamin D deficiency among infants attending the Reproductive and Child Health (RCH) Clinic in Arusha, Tanzania. </span><b><span style="font-family:Verdana;">Methods: </span></b><span style="font-family:Verdana;">A cross-sectional study of 304 infants aged 6 weeks to 12 months was conducted at Arusha Lutheran Medical Centre (ALMC). Infants were enrolled during the warm season between November 2018 and January 2019. A pre-coded questionnaire was used to collect data on sociodemographic characteristics of the infant with consent from their caretakers. Physical examination was done for anthropometric measures and signs of rickets. Blood was drawn for assessment of serum 25-hydroxyvitamin D 25(OH)D, calcium, phosphorus and alkaline phosphate. Vitamin D deficiency was defined as 25(OH)D level below 20 ng/ml (<50 nmol/L) and Vitamin D insufficiency defined as a 25(OH)D level 20 - 30 ng/ml (50 - 75 nmol/L). Statistical </span><span><span style="font-family:Verdana;">analysis was performed using STATA 14 version and factors associated with VDD explored with multivariate analysis. </span><b><span style="font-family:Verdana;">Results:</span></b><span style="font-family:Verdana;"> The mean serum 25(OH)D </span></span><span style="font-family:Verdana;">among infants was 34.51 ng/ml (±15.53). Vitamin D deficiency was found in 67/304 (22%) infants and Vitamin D insufficiency in 50 (16.5%) infants. Hypocalcemia was observed in 33 (10.9%) infants and clinical findings of rickets were found in 11 infants (3.6%). Factors independently associated with VDD included age < 6 months (Adjusted Odds Ratio (AOR) 1.56, 95% CI 1.19 - 4.0, p value < 0.026), serum signs of rickets and serum hypocalcemia (p-value < 0.001 and <0.002, respectively). </span><b><span style="font-family:Verdana;">Conclusion and Recommendation: </span></b><span style="font-family:Verdana;">A high prevalence of Vitamin D deficiency (22%) and insufficiency (16.5%) was observed among infants attending RCH Clinic in Arusha, Tanzania. Age < 6 months, a single serum measurement of hypocalcemia and the presence of the clinical sign of rickets were independently associated with VDD. Clinicians should actively assess for VDD and supplement with vitamin D as indicated, especially among infants < 6 months.</span></span> </p>
