title: Vitamin D deficiency in medical patients at a central hospital in Malawi: a comparison with TB patients from a previous study.
abstract: OBJECTIVE
  To determine the prevalence of vitamin D deficiency (VDD) in adult medical, non-tuberculous (non-TB) patients. To investigate associations with VDD. To compare the results with a similar study in TB patients at the same hospital.
  
  
  METHODS
  Cross-sectional sample.
  
  
  METHODS
  Central hospital in Malawi.
  
  
  METHODS
  Adult non-TB patients (n = 157), inpatients and outpatients.
  
  
  METHODS
  The primary outcome was the prevalence of VDD. Potentially causal associations sought included nutritional status, in/outpatient status, HIV status, anti-retroviral therapy (ART) and, by comparison with a previous study, a diagnosis of tuberculosis (TB).
  
  
  RESULTS
  Hypovitaminosis D (≤75 nmol/L) occurred in 47.8% (75/157) of patients, 16.6% (26/157) of whom had VDD (≤50 nmol/L). None had severe VDD (≤25 nmol/L). VDD was found in 22.8% (23/101) of in-patients and 5.4% (3/56) of out-patients. In univariable analysis in-patient status, ART use and low dietary vitamin D were significant predictors of VDD. VDD was less prevalent than in previously studied TB patients in the same hospital (68/161 = 42%). In multivariate analysis of the combined data set from both studies, having TB (OR 3.61, 95%CI 2.02-6.43) and being an in-patient (OR 2.70, 95%CI 1.46-5.01) were significant independent predictors of VDD.
  
  
  CONCLUSIONS
  About half of adult medical patients without TB have suboptimal vitamin D status, which is more common in in-patients. VDD is much more common in TB patients than non-TB patients, even when other variables are controlled for, suggesting that vitamin D deficiency is associated with TB.
authors.affiliation: Department of Medicine, College of Medicine, University of Malawi, Blantyre, Malawi.
authors.forename: Yamikani
authors.initials: Y
authors.lastname: Mastala
authors.forename: Phempo
authors.initials: P
authors.lastname: Nyangulu
authors.forename: Rodrick V
authors.initials: RV
authors.lastname: Banda
authors.forename: Bongani
authors.initials: B
authors.lastname: Mhemedi
authors.forename: Sarah A
authors.initials: SA
authors.lastname: White
authors.forename: Theresa J
authors.initials: TJ
authors.lastname: Allain
mesh_terms: D015652:25-Hydroxyvitamin D 2 / Q000097:blood; D000293:Adolescent; D000328:Adult; D000368:Aged; D003430:Cross-Sectional Studies; D005260:Female; D015658:HIV Infections / Q000097:blood / Q000150:complications; D006769:Hospitals, General; D006801:Humans; D008295:Malawi; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012307:Risk Factors; D014376:Tuberculosis / Q000097:blood / Q000150:complications; D014808:Vitamin D Deficiency / Q000150:complications / Q000453:epidemiology*; D055815:Young Adult
chemical_list: D015652:25-Hydroxyvitamin D 2
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