Serum vitamin D status in children with protein-energy malnutrition admitted to a national referral hospital in Uganda.
BACKGROUND
Vitamin D deficiency is a world-wide epidemic with recent estimates indicating that greater than 50% of the global population is at risk. In Uganda, 80% of healthy community children in a survey were found to be vitamin D insufficient. Protein-energy malnutrition is likely to be associated with vitamin D intake deficiency. The aim of this study was to determine the prevalence of vitamin D deficiency and the associated factors among children admitted with protein-energy malnutrition to the pediatrics wards of Mulago hospital in Kampala, Uganda.


METHODS
Consecutive sampling was done with 158 children, aged 6-24 months, enrolled in a cross sectional study. One hundred and seventeen malnourished and 41 non malnourished children were enrolled from the Acute Care unit, pediatrics in-patient wards, outpatient and immunization clinics, following informed consent obtained from the children's parents/guardians. Children with protein energy malnutrition were categorized based on anthropometric measurements of weight-for-height and weight for length compared with the recommended WHO reference Z-score. Serum 25-hydroxyvitamin D, calcium and phosphate were assayed.


RESULTS
One hundred seventeen malnourished and 41 non malnourished children were enrolled. The majority of study participants were male, 91 (57.6%). The mean serum vitamin D levels among the malnourished was 32.5 mmol/L (±12.0 SD) and 32.2 mmol/L (10.9 SD) among the malnourished, p = 0.868. Fifteen (36.6%) of the non malnourished children and 51 (43.6%) of the malnourished had suboptimal levels, p = 0.689. Malnourished children admitted with meningitis and cerebral palsy had lower serum vitamin D levels than those with other infections.


CONCLUSIONS
There was no statistically significant difference in vitamin D values between the malnourished and non malnourished children. Clinicians should actively screen for children for serum vitamin D levels regardless of nutritional status.
Department of Physiology, College of Health Sciences, Makerere University, Kampala, Uganda. hwnabeta@gmail.com.
Henry W
HW
Nabeta
Department of Physiology, College of Health Sciences, Makerere University, Kampala, Uganda. josephinekasolo@yahoo.com.
Josephine
J
Kasolo
Department of Physiology, College of Health Sciences, Makerere University, Kampala, Uganda. reubenkaaja@yahoo.com.
Reuben K
RK
Kiggundu
Infectious Diseases Institute, College of Health Sciences, Makerere University, Kampala, Uganda. agnes.kiragga@gmail.com.
Agnes N
AN
Kiragga
Department of Pediatrics and Child Health, College of Health Sciences, Makerere University, Kampala, Uganda. skwalube@yahoo.co.uk.
Sarah
S
Kiguli
D001827:Body Height; D001835:Body Weight; D002118:Calcium / Q000097:blood; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D007223:Infant; D008297:Male; D010710:Phosphates / Q000097:blood; D011502:Protein-Energy Malnutrition / Q000097:blood* / Q000453:epidemiology; D012017:Referral and Consultation; D018570:Risk Assessment / Q000379:methods / Q000706:statistics & numerical data; D012307:Risk Factors; D014454:Uganda / Q000453:epidemiology; D014807:Vitamin D / Q000097:blood*; D014808:Vitamin D Deficiency / Q000097:blood* / Q000175:diagnosis / Q000453:epidemiology
D010710:Phosphates; D014807:Vitamin D; D002118:Calcium