title: Vitamin D insufficiency is common in Ugandan children and is associated with severe malaria.
abstract: Vitamin D plays an increasingly recognized role in the innate and adaptive immune response to infection. Based on demonstrated roles in up-regulating innate immunity, decreasing inflammation, and reducing the severity of disease in illnesses such as tuberculosis and influenza, we hypothesized that poor vitamin D status would be associated with severe malaria. We measured 25-hydroxyvitamin D [25(OH)D] by immunoassay in a sample of Ugandan children aged 18 months-12 years with severe malaria (cerebral malaria or severe malarial anemia, n = 40) and in healthy community children (n = 20). Ninety-five percent of children with severe malaria (n = 38) and 80% of control children (n = 16) were vitamin D-insufficient [plasma 25(OH)D <30 ng/mL]. Mean plasma 25(OH)D levels were significantly lower in children with severe malaria than in community children (21.2 vs. 25.3 ng/mL, p = 0.03). Logistic regression revealed that for every 1 ng/mL increase in plasma 25(OH)D, the odds of having severe malaria declined by 9% [OR = 0.91 (95% CI: 0.84, 1.0)]. These preliminary results suggest that vitamin D insufficiency may play a role in the development of severe malaria. Further prospective studies in larger cohorts are indicated to confirm the relationship of vitamin D levels to severity of malaria infection and to investigate causality.
authors.affiliation: Department of Pediatrics, University of Minnesota, Minneapolis, Minnesota, United States of America.
authors.forename: Sarah E
authors.initials: SE
authors.lastname: Cusick
authors.affiliation: Department of Pediatrics, University of Minnesota, Minneapolis, Minnesota, United States of America; Department of Paediatrics, College of Health Sciences, Makerere University, Kampala, Uganda.
authors.forename: Robert O
authors.initials: RO
authors.lastname: Opoka
authors.affiliation: Department of Pediatrics, University of Minnesota, Minneapolis, Minnesota, United States of America.
authors.forename: Troy C
authors.initials: TC
authors.lastname: Lund
authors.affiliation: Department of Pediatrics, University of Minnesota, Minneapolis, Minnesota, United States of America.
authors.forename: Chandy C
authors.initials: CC
authors.lastname: John
authors.affiliation: Department of Pediatrics, Los Angeles Biomedical Research Institute at Harbor, University of California Los Angeles, Los Angeles, California, United States of America.
authors.forename: Lynda E
authors.initials: LE
authors.lastname: Polgreen
mesh_terms: D002648:Child; D002675:Child, Preschool; D006801:Humans; D006887:Hydroxycholecalciferols / Q000097:blood*; D007113:Immunity, Innate; D007223:Infant; D016778:Malaria, Falciparum / Q000097:blood* / Q000453:epidemiology* / Q000276:immunology; D010963:Plasmodium falciparum / Q000254:growth & development; D011446:Prospective Studies; D012307:Risk Factors; D014454:Uganda / Q000453:epidemiology; D014808:Vitamin D Deficiency / Q000097:blood* / Q000453:epidemiology* / Q000276:immunology
chemical_list: D006887:Hydroxycholecalciferols