title: Vitamin D Status in Botswana Children Under 2 Years Old With and Without Active Tuberculosis.
abstract: Additional strategies are needed to prevent and treat tuberculosis (TB). Although vitamin D may have antimycobacterial effects, it is unknown whether low vitamin D status confers a risk for active TB in African children. This case-control study assessed serum 25-hydroxyvitamin D (25(OH)D) concentration in children with and without active TB in Gaborone, Botswana. A total of 80 children under 2 years old with and without active TB, seen at hospitals and clinics in the greater Gaborone area between September 2010 and November 2012, were enrolled. Of these, 39 cases did not differ from the 41 controls in median 25(OH)D levels (P = 0.84). The 25(OH)D was < 20 ng/mL in 8/39 (21%) cases and 7/41 (17%) controls (P = 0.69, χ(2)). Univariate analyses of subject clinical characteristics (other than 25(OH)D levels) showed that any degree of weight loss was associated with a diagnosis of TB (P = 0.047). Other clinical characteristics, including age (P = 0.08) or weight below third percentile (P = 0.58), showed no association with TB. There was no significant difference in vitamin D status between children under 2 years old with and without active TB. Lower vitamin D status did not appear to be a risk factor for TB in this small Gaborone cohort.
authors.affiliation: Botswana-UPenn Partnership, Gaborone, Botswana; University of Maryland Medical Center, Baltimore, Maryland; Department of Paediatrics and Adolescent Health, University of Botswana, Gaborone, Botswana; Department of Public Health Medicine Unit, Faculty of Medicine, University of Botswana, Gaborone, Botswana; Department of Biostatistics and Epidemiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania; Botswana-Harvard Partnership, Gaborone, Botswana; MRC/Wits Developmental Pathways for Health Research Unit, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa; Internal Medicine-Pediatrics, University of Miami/Jackson Memorial Hospital, Miami, Florida; Children's Hospital of Philadelphia, Philadelphia, Pennsylvania; Department of Medicine (Infectious Diseases), Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania jludmir@medicine.umaryland.edu.
authors.forename: Jonathan
authors.initials: J
authors.lastname: Ludmir
authors.affiliation: Botswana-UPenn Partnership, Gaborone, Botswana; University of Maryland Medical Center, Baltimore, Maryland; Department of Paediatrics and Adolescent Health, University of Botswana, Gaborone, Botswana; Department of Public Health Medicine Unit, Faculty of Medicine, University of Botswana, Gaborone, Botswana; Department of Biostatistics and Epidemiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania; Botswana-Harvard Partnership, Gaborone, Botswana; MRC/Wits Developmental Pathways for Health Research Unit, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa; Internal Medicine-Pediatrics, University of Miami/Jackson Memorial Hospital, Miami, Florida; Children's Hospital of Philadelphia, Philadelphia, Pennsylvania; Department of Medicine (Infectious Diseases), Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania.
authors.forename: Loeto
authors.initials: L
authors.lastname: Mazhani
authors.affiliation: Botswana-UPenn Partnership, Gaborone, Botswana; University of Maryland Medical Center, Baltimore, Maryland; Department of Paediatrics and Adolescent Health, University of Botswana, Gaborone, Botswana; Department of Public Health Medicine Unit, Faculty of Medicine, University of Botswana, Gaborone, Botswana; Department of Biostatistics and Epidemiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania; Botswana-Harvard Partnership, Gaborone, Botswana; MRC/Wits Developmental Pathways for Health Research Unit, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa; Internal Medicine-Pediatrics, University of Miami/Jackson Memorial Hospital, Miami, Florida; Children's Hospital of Philadelphia, Philadelphia, Pennsylvania; Department of Medicine (Infectious Diseases), Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania.
authors.forename: Mark S
authors.initials: MS
authors.lastname: Cary
authors.affiliation: Botswana-UPenn Partnership, Gaborone, Botswana; University of Maryland Medical Center, Baltimore, Maryland; Department of Paediatrics and Adolescent Health, University of Botswana, Gaborone, Botswana; Department of Public Health Medicine Unit, Faculty of Medicine, University of Botswana, Gaborone, Botswana; Department of Biostatistics and Epidemiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania; Botswana-Harvard Partnership, Gaborone, Botswana; MRC/Wits Developmental Pathways for Health Research Unit, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa; Internal Medicine-Pediatrics, University of Miami/Jackson Memorial Hospital, Miami, Florida; Children's Hospital of Philadelphia, Philadelphia, Pennsylvania; Department of Medicine (Infectious Diseases), Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania.
authors.forename: Unoda A
authors.initials: UA
authors.lastname: Chakalisa
authors.affiliation: Botswana-UPenn Partnership, Gaborone, Botswana; University of Maryland Medical Center, Baltimore, Maryland; Department of Paediatrics and Adolescent Health, University of Botswana, Gaborone, Botswana; Department of Public Health Medicine Unit, Faculty of Medicine, University of Botswana, Gaborone, Botswana; Department of Biostatistics and Epidemiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania; Botswana-Harvard Partnership, Gaborone, Botswana; MRC/Wits Developmental Pathways for Health Research Unit, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa; Internal Medicine-Pediatrics, University of Miami/Jackson Memorial Hospital, Miami, Florida; Children's Hospital of Philadelphia, Philadelphia, Pennsylvania; Department of Medicine (Infectious Diseases), Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania.
authors.forename: John M
authors.initials: JM
authors.lastname: Pettifor
authors.affiliation: Botswana-UPenn Partnership, Gaborone, Botswana; University of Maryland Medical Center, Baltimore, Maryland; Department of Paediatrics and Adolescent Health, University of Botswana, Gaborone, Botswana; Department of Public Health Medicine Unit, Faculty of Medicine, University of Botswana, Gaborone, Botswana; Department of Biostatistics and Epidemiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania; Botswana-Harvard Partnership, Gaborone, Botswana; MRC/Wits Developmental Pathways for Health Research Unit, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa; Internal Medicine-Pediatrics, University of Miami/Jackson Memorial Hospital, Miami, Florida; Children's Hospital of Philadelphia, Philadelphia, Pennsylvania; Department of Medicine (Infectious Diseases), Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania.
authors.forename: Mooketsi
authors.initials: M
authors.lastname: Molefi
authors.affiliation: Botswana-UPenn Partnership, Gaborone, Botswana; University of Maryland Medical Center, Baltimore, Maryland; Department of Paediatrics and Adolescent Health, University of Botswana, Gaborone, Botswana; Department of Public Health Medicine Unit, Faculty of Medicine, University of Botswana, Gaborone, Botswana; Department of Biostatistics and Epidemiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania; Botswana-Harvard Partnership, Gaborone, Botswana; MRC/Wits Developmental Pathways for Health Research Unit, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa; Internal Medicine-Pediatrics, University of Miami/Jackson Memorial Hospital, Miami, Florida; Children's Hospital of Philadelphia, Philadelphia, Pennsylvania; Department of Medicine (Infectious Diseases), Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania.
authors.forename: Abiona
authors.initials: A
authors.lastname: Redwood
authors.affiliation: Botswana-UPenn Partnership, Gaborone, Botswana; University of Maryland Medical Center, Baltimore, Maryland; Department of Paediatrics and Adolescent Health, University of Botswana, Gaborone, Botswana; Department of Public Health Medicine Unit, Faculty of Medicine, University of Botswana, Gaborone, Botswana; Department of Biostatistics and Epidemiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania; Botswana-Harvard Partnership, Gaborone, Botswana; MRC/Wits Developmental Pathways for Health Research Unit, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa; Internal Medicine-Pediatrics, University of Miami/Jackson Memorial Hospital, Miami, Florida; Children's Hospital of Philadelphia, Philadelphia, Pennsylvania; Department of Medicine (Infectious Diseases), Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania.
authors.forename: Virginia A
authors.initials: VA
authors.lastname: Stallings
authors.affiliation: Botswana-UPenn Partnership, Gaborone, Botswana; University of Maryland Medical Center, Baltimore, Maryland; Department of Paediatrics and Adolescent Health, University of Botswana, Gaborone, Botswana; Department of Public Health Medicine Unit, Faculty of Medicine, University of Botswana, Gaborone, Botswana; Department of Biostatistics and Epidemiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania; Botswana-Harvard Partnership, Gaborone, Botswana; MRC/Wits Developmental Pathways for Health Research Unit, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa; Internal Medicine-Pediatrics, University of Miami/Jackson Memorial Hospital, Miami, Florida; Children's Hospital of Philadelphia, Philadelphia, Pennsylvania; Department of Medicine (Infectious Diseases), Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania.
authors.forename: Robert
authors.initials: R
authors.lastname: Gross
authors.affiliation: Botswana-UPenn Partnership, Gaborone, Botswana; University of Maryland Medical Center, Baltimore, Maryland; Department of Paediatrics and Adolescent Health, University of Botswana, Gaborone, Botswana; Department of Public Health Medicine Unit, Faculty of Medicine, University of Botswana, Gaborone, Botswana; Department of Biostatistics and Epidemiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania; Botswana-Harvard Partnership, Gaborone, Botswana; MRC/Wits Developmental Pathways for Health Research Unit, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa; Internal Medicine-Pediatrics, University of Miami/Jackson Memorial Hospital, Miami, Florida; Children's Hospital of Philadelphia, Philadelphia, Pennsylvania; Department of Medicine (Infectious Diseases), Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania.
authors.forename: Andrew P
authors.initials: AP
authors.lastname: Steenhoff
mesh_terms: D001902:Botswana / Q000453:epidemiology; D016022:Case-Control Studies; D005260:Female; D015658:HIV Infections / Q000150:complications / Q000453:epidemiology; D006801:Humans; D007223:Infant; D008297:Male; D014376:Tuberculosis / Q000097:blood / Q000150:complications* / Q000453:epidemiology*; D014807:Vitamin D / Q000031:analogs & derivatives* / Q000097:blood; D014808:Vitamin D Deficiency / Q000097:blood / Q000150:complications* / Q000453:epidemiology*
chemical_list: D014807:Vitamin D; C104450:25-hydroxyvitamin D