FREQUENCY OF VITAMIN D DEFICIENCY AMONG CHILDREN PRESENTING WITH ACUTE RESPIRATORY TRACT INFECTIONS: A CROSS-SECTIONAL STUDY
Main Article Content
Keywords
Vitamin D deficiency, acute respiratory tract infections, children, immune health, ARI, pediatric infection, Pakistan, cross-sectional study
Abstract
Background: Acute respiratory tract infections (ARIs) are a leading cause of pediatric morbidity and mortality worldwide, particularly in low- and middle-income countries. Emerging evidence suggests that Vitamin D plays a vital role in immune regulation, with its deficiency linked to increased susceptibility and severity of infections. However, the relationship between Vitamin D deficiency and ARI outcomes in children remains underexplored in developing regions like Pakistan.
Objective: The primary objective of this study was to determine the prevalence of Vitamin D deficiency among children presenting with ARIs. Secondary objectives included assessing the association between Vitamin D levels and ARI severity, as well as the demographic factors influencing this relationship.
Methods: A descriptive cross-sectional study was conducted at the Pediatrics Department of Kuwait Teaching Hospital, Peshawar, from January 1, 2023, to December 31, 2023. A total of 129 children aged 3 months to 5 years with ARI were recruited consecutively. Serum Vitamin D levels were measured using the enzyme-linked immunosorbent assay (ELISA) technique, with a deficiency defined as levels below 20 ng/mL. Data were analyzed using SPSS version 25.0, applying descriptive statistics, chi-square tests, t-tests, and logistic regression to evaluate the relationships between Vitamin D levels and clinical outcomes.
Results: Among the 129 children, 100 (77.5%) were found to be Vitamin D deficient. The mean serum Vitamin D level was 18.7 ng/mL (SD ± 6.3). A significant association was observed between Vitamin D deficiency and prolonged disease duration (>2 weeks) (p=0.000). Younger children (aged 3-12 months) and males were more likely to be Vitamin D deficient, with 84.4% of younger children affected (p=0.046). No major complications were reported, but Vitamin D-deficient children had a longer hospital stay.
Conclusion: This study demonstrates a high prevalence of Vitamin D deficiency among children presenting with ARIs, with deficiency associated with prolonged illness. These findings suggest the need for routine Vitamin D screening and potential supplementation to improve clinical outcomes in pediatric ARI cases.
References
2. Walker CL, Rudan I, Liu L, et al. Global burden of childhood pneumonia and diarrhoea. Lancet. 2013;381(9875):1405-1416.
3. Aranow C. Vitamin D and the immune system. J Investig Med. 2011;59(6):881-886.
4. Holick MF, Binkley NC, Bischoff-Ferrari HA, et al. Evaluation, treatment, and prevention of vitamin D deficiency: an Endocrine Society clinical practice guideline. J Clin Endocrinol Metab. 2011;96(7):1911-1930.
5. Martineau AR, Jolliffe DA, Hooper RL, et al. Vitamin D supplementation to prevent acute respiratory infections: systematic review and meta-analysis of individual participant data. BMJ. 2017;356.
6. Wayse V, Yousafzai A, Mogale K, et al. Association of subclinical vitamin D deficiency with severe acute lower respiratory infection in Indian children under 5 years. Eur J Clin Nutr. 2004;58(4):563-567. doi:10.1038/sj.ejcn.1601845.Holick MF, Binkley NC, Bischoff-Ferrari HA, et al. Evaluation, Treatment, and Prevention of Vitamin D Deficiency: An Endocrine Society Clinical Practice Guideline. J Clin Endocrinol Metab. 2011;96(7):1911-1930.
7. Yakoob MY, Salam RA, Khan FR, et al. Vitamin D supplementation for preventing infections in children under five years of age. Cochrane Database Syst Rev. 2016;(11)
9. Aranow C. Vitamin D and the immune system. J Investig Med. 2011;59(6):881-886. doi:10.231/JIM.0b013e31821b8755.
10. Martineau AR, Jolliffe DA, Hooper RL, et al. Vitamin D supplementation to prevent acute respiratory infections: systematic review and meta-analysis of individual participant data. BMJ. 2017;356. doi:10.1136/bmj.i6583.
11. Ritu G, Gupta A. Vitamin D deficiency in India: Prevalence, causalities and interventions. Nutrients. 2014;6(2):729-775. doi:10.3390/nu6020729.
12. Mansbach JM, Ginde AA, Camargo CA Jr. Serum 25-hydroxyvitamin D levels among US children aged 1 to 11 years: Do children need more vitamin D? Pediatrics. 2009;124(5):1404-1410. doi:10.1542/peds.2008-2041.
13. Laaksi I, Ruohola JP, Mattila V, et al. Vitamin D supplementation for the prevention of acute respiratory tract infection: a randomized, double-blinded trial among young Finnish men. J Infect Dis. 2010;202(5):809-814. doi:10.1086/655898.
14. Hatun S, Ozkan B, Bereket A. Vitamin D deficiency and prevention: Turkish experience. Acta Paediatr. 2011;100(9):1195-1199. doi:10.1111/j.1651-2227.2011.02359.x.
15. Javaid MK, Crozier SR, Harvey NC, et al. Maternal vitamin D status during pregnancy and childhood bone mass at age 9 years: a longitudinal study. Lancet. 2006;367(9504):36-43. doi:10.1016/S0140-6736(06)67922-1.
16. Wayse V, Yousafzai A, Mogale K, et al. Association of subclinical vitamin D deficiency with severe acute lower respiratory infection in Indian children under 5 years. Eur J Clin Nutr. 2004;58(4):563-567. doi:10.1038/sj.ejcn.1601845.
17. Ginde AA, Mansbach JM, Camargo CA Jr. Association between serum 25-hydroxyvitamin D level and upper respiratory tract infection in the Third National Health and Nutrition Examination Survey. Arch Intern Med. 2009;169(4):384-390. doi:10.1001/archinternmed.2008.560.
18. Camargo CA Jr, Ganmaa D, Sidbury R, et al. Randomized trial of vitamin D supplementation and risk of acute respiratory infection in Mongolia. Pediatrics. 2012;130(3). doi:10.1542/peds.2011-3029.
Article Sidebar
Article Details
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
All articles published in JPTCP are licensed under Copyright Creative Commons Attribution-NonCommercial 4.0 International License.
Dr Adnan Khan
Registrar, Department of Pediatrics, Kuwait Teaching Hospital, Peshawar, Pakistan
Dr Hanif Muhammad
Medical Officer of Pediatrics Unit, Town Women and Children Hospital, Peshawar, Pakistan
Dr Salman Hakim
Senior Lecturer, Sahara Medical College Narowal, Pakistan.
Dr Muhammad Idrees Khan
Registrar of Family Medicine, Sahara Medical College Narowal, Pakistan.