title: Vitamin D deficiency and its characteristics among patients with acute stroke at a national referral hospital in Kampala Uganda.
abstract: BACKGROUND
  Vitamin D deficiency has been associated with acute stroke and other cardiovascular diseases in the developed world. Low 25-hydroxyvitamin D (25OHD) has been described in some populations in Sub-Saharan Africa (SSA) in spite of adequate sunshine all year round. There is no information on the magnitude of vitamin D deficiency among patients with stroke and other cardiovascular diseases in Uganda or SSA. The aim of this study was to determine the burden and characteristics of vitamin D deficiency among patients with acute stroke, the most common form of cardiovascular events in SSA.
  
  
  METHODS
  We conducted a cross-sectional study between October 2012 and March 2013. We consecutively recruited 142 subjects with acute stroke admitted to the medical wards of Mulago hospital. We administered a pre-tested questionnaire to the study participants, and did a detailed physical examination and laboratory evaluation. Serum levels of 25OHD were determined using an electrochemiluminescence assay. Data were analyzed using STATA version 12 software.
  
  
  RESULTS
  The prevalence of vitamin D deficiency (25OHD < 20 ng/ml) was 15 %. Longer hours of sunshine exposure decreased the likelihood vitamin D deficiency significantly (adjusted OR 0.85, p = 0.03). Higher HDL cholesterol had a significant inverse association with vitamin D deficiency (adjusted OR 0.15, p = 0.02). In addition, the likelihood of vitamin D deficiency increased with rising age (adjusted OR 1.03, p = 0.05).
  
  
  CONCLUSIONS
  There was a relatively low burden of vitamin D deficiency among patients with acute stroke in Uganda. With increasing longevity and indoor lifestyles vitamin D deficiency may assume a greater role in stroke and other cardiovascular diseases in tropical sub Saharan Africa. Future studies on the mechanisms of vitamin D deficiency and its relationship to outcomes among patients with stroke may be necessary.
authors.affiliation: Department of Medicine, College of Health Sciences, Makerere University, Kampala, Uganda. dchiggundu@gmail.com.
authors.forename: Daniel S
authors.initials: DS
authors.lastname: Kiggundu
authors.affiliation: Department of Medicine, College of Health Sciences, Makerere University, Kampala, Uganda. edrisamutebi@yahoo.com.
authors.forename: Edrisa
authors.initials: E
authors.lastname: Mutebi
authors.affiliation: Department of Medicine, Uganda Martyrs Hospital, Lubaga, Kampala, Uganda. daviskibirige@gmail.com.
authors.forename: Davis
authors.initials: D
authors.lastname: Kibirige
authors.affiliation: Department of Medicine, Case Western Reserve University, Cleveland, OH, USA. rebecca.boxer@uhhospitals.org.
authors.forename: Rebecca
authors.initials: R
authors.lastname: Boxer
authors.affiliation: Uganda Heart Institute, Mulago Hospital, Kampala, Uganda. barbarakakande@yahoo.com.
authors.forename: Barbara
authors.initials: B
authors.lastname: Kakande
authors.affiliation: Uganda Virus Research Institute, Entebbe, Uganda. bkigozi@uvri.go.ug.
authors.forename: Brian K
authors.initials: BK
authors.lastname: Kigozi
authors.affiliation: Department of Medicine, College of Health Sciences, Makerere University, Kampala, Uganda. ekatabira@chs.mak.ac.ug.
authors.forename: Elly
authors.initials: E
authors.lastname: Katabira
mesh_terms: D000368:Aged; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010281:Parathyroid Hormone / Q000097:blood; D015995:Prevalence; D012017:Referral and Consultation; D012621:Seasons; D020521:Stroke / Q000453:epidemiology / Q000209:etiology*; D014454:Uganda / Q000453:epidemiology; D014807:Vitamin D / Q000031:analogs & derivatives* / Q000097:blood; D014808:Vitamin D Deficiency / Q000097:blood / Q000150:complications*
chemical_list: D010281:Parathyroid Hormone; D014807:Vitamin D; C104450:25-hydroxyvitamin D