Author(s)

Victor Urio^1*, Victor Musiime^1,2, Thereza Piloya¹, Phillip Kasirye³, Stephen Swanson^4,5

¹Department of Paediatrics and Child Health, School of Medicine, College of Health Sciences, Makerere University, Kampala, Uganda.
²Research Department, Joint Clinical Research Centre, Kampala, Uganda.
³Department of Paediatrics and Child Health, Mulago National Referral Hospital, Kampala, Uganda.
⁴Global Pediatrics Program, Department of Pediatrics, University of Minnesota Medical School, Minneapolis, Minnesota, USA.
⁵Department of Paediatrics, Arusha Lutheran Medical Centre, Arusha, Tanzania.

Background: Globally there is a high burden of low serum vitamin D deficiency (VDD) with children being acknowledged at risk due to low vitamin D content in both breastmilk and available foods and inadequate cutaneous synthesis of vitamin D. Even in countries with abundant sunshine, vitamin D deficiency (VDD) remains a problem. There is little characterization of the status of vitamin D among infants in East Africa. This study aimed to determine the prevalence and factors associated with vitamin D deficiency among infants attending the Reproductive and Child Health (RCH) Clinic in Arusha, Tanzania. Methods: A cross-sectional study of 304 infants aged 6 weeks to 12 months was conducted at Arusha Lutheran Medical Centre (ALMC). Infants were enrolled during the warm season between November 2018 and January 2019. A pre-coded questionnaire was used to collect data on sociodemographic characteristics of the infant with consent from their caretakers. Physical examination was done for anthropometric measures and signs of rickets. Blood was drawn for assessment of serum 25-hydroxyvitamin D 25(OH)D, calcium, phosphorus and alkaline phosphate. Vitamin D deficiency was defined as 25(OH)D level below 20 ng/ml (<50 nmol/L) and Vitamin D insufficiency defined as a 25(OH)D level 20 - 30 ng/ml (50 - 75 nmol/L). Statistical analysis was performed using STATA 14 version and factors associated with VDD explored with multivariate analysis. Results: The mean serum 25(OH)D among infants was 34.51 ng/ml (±15.53). Vitamin D deficiency was found in 67/304 (22%) infants and Vitamin D insufficiency in 50 (16.5%) infants. Hypocalcemia was observed in 33 (10.9%) infants and clinical findings of rickets were found in 11 infants (3.6%). Factors independently associated with VDD included age < 6 months (Adjusted Odds Ratio (AOR) 1.56, 95% CI 1.19 - 4.0, p value < 0.026), serum signs of rickets and serum hypocalcemia (p-value < 0.001 and <0.002, respectively). Conclusion and Recommendation: A high prevalence of Vitamin D deficiency (22%) and insufficiency (16.5%) was observed among infants attending RCH Clinic in Arusha, Tanzania. Age < 6 months, a single serum measurement of hypocalcemia and the presence of the clinical sign of rickets were independently associated with VDD. Clinicians should actively assess for VDD and supplement with vitamin D as indicated, especially among infants < 6 months.

Vitamin D Deficiency, Rickets, Infants, RCH Clinic, Tanzania

Urio, V. , Musiime, V. , Piloya, T. , Kasirye, P. and Swanson, S. (2021) Vitamin D Status among Infants Attending a Reproductive and Child Health Clinic in Arusha, Tanzania: A Cross-Sectional Study. Open Journal of Pediatrics, 11, 421-437. doi: 10.4236/ojped.2021.113040.