title: High prevalence of asymptomatic vitamin D and iron deficiency in East African immigrant children and adolescents living in a temperate climate.
abstract: OBJECTIVE
  Vitamin D deficiency (VDD) is common in immigrant children with increased skin pigmentation living in higher latitudes. We assessed the pattern of and risk factors for VDD in immigrant East African children living in Melbourne (latitude 37 degrees 49' South).
  
  
  METHODS
  A prospective survey of 232 East African children attending a clinic in Melbourne. Data were collected by questionnaire, medical assessment and laboratory tests.
  
  
  RESULTS
  Low 25-hydroxyvitamin D (25-OHD) levels (<50 nmol/l) occurred in 87% of children, and VDD (25-OHD <25 nmol/l) in 44%. Risk factors included age <5 years, female gender, increased time in Australia, decreased daylight exposure and winter/spring season. Anaemia (20%), vitamin A deficiency (20%) and iron deficiency (19%) were also identified.
  
  
  CONCLUSIONS
  Asymptomatic VDD is common in East African immigrant children residing at a temperate latitude. Risk factors for VDD limit endogenous vitamin D production. Screening of immigrant children with increased skin pigmentation for VDD, anaemia, iron and vitamin A deficiency is appropriate. VDD in adolescent females identifies an increased risk of future infants with VDD.
authors.affiliation: Murdoch Children's Research Institute, Melbourne, Australia.
authors.forename: George
authors.initials: G
authors.lastname: McGillivray
authors.forename: Susan A
authors.initials: SA
authors.lastname: Skull
authors.forename: Gabrielle
authors.initials: G
authors.lastname: Davie
authors.forename: Sarah E
authors.initials: SE
authors.lastname: Kofoed
authors.forename: Alexis
authors.initials: A
authors.lastname: Frydenberg
authors.forename: James
authors.initials: J
authors.lastname: Rice
authors.forename: Regina
authors.initials: R
authors.lastname: Cooke
authors.forename: Jonathan R
authors.initials: JR
authors.lastname: Carapetis
mesh_terms: D000293:Adolescent; D000351:Africa, Eastern / Q000208:ethnology; D018798:Anemia, Iron-Deficiency / Q000208:ethnology / Q000209:etiology; D044383:Black People / Q000706:statistics & numerical data*; D002648:Child; D002664:Child Nutritional Physiological Phenomena; D002675:Child, Preschool; D054242:Emigrants and Immigrants / Q000706:statistics & numerical data; D004812:Epidemiologic Methods; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D000090463:Iron Deficiencies; D008297:Male; D010281:Parathyroid Hormone / Q000097:blood; D011829:Radiation Dosage; D013472:Sunlight; D014466:Ultraviolet Rays; D014739:Victoria / Q000453:epidemiology; D014807:Vitamin D / Q000031:analogs & derivatives / Q000097:blood; D014808:Vitamin D Deficiency / Q000208:ethnology* / Q000209:etiology
chemical_list: D010281:Parathyroid Hormone; D014807:Vitamin D; C104450:25-hydroxyvitamin D