Seasonal variation in the incidence rate of tuberculous meningitis is associated with sunshine hours.
Tuberculous meningitis (TBM) is a severe complication of tuberculosis and occurs mainly during early childhood. The incidence rate of TBM varies with season, and serum vitamin D levels, which are dependent on sunlight, might play a role. We studied the association between TBM incidence rate and hours of sunshine in Cape Town, South Africa and found a significant association between the incidence rate of TBM and hours of sunshine 3 months earlier (incidence rate ratio per 100 sunshine hours 0·69, 95% confidence interval 0·54-0·88, P = 0·002). The association supports the hypothesis that vitamin D might play a role in the pathophysiology of TBM. Further prospective studies in which vitamin D status is measured are necessary to determine causality.
Department of Paediatric Infectious Diseases - Immunology and Rheumatology, VU University Medical Center, Amsterdam, The Netherlands.
D H
DH
Visser
Department of Paediatrics and Child Health, Tygerberg Hospital, University of Stellenbosch, Cape Town, South Africa.
J F
JF
Schoeman
Department of Paediatric Infectious Diseases - Immunology and Rheumatology, VU University Medical Center, Amsterdam, The Netherlands.
A M
AM
VAN Furth
D002675:Child, Preschool; D005260:Female; D006801:Humans; D015994:Incidence; D007223:Infant; D008297:Male; D012189:Retrospective Studies; D012621:Seasons; D013019:South Africa / Q000453:epidemiology; D013472:Sunlight; D013997:Time Factors; D014390:Tuberculosis, Meningeal / Q000453:epidemiology* / Q000209:etiology; D014808:Vitamin D Deficiency / Q000150:complications