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Vitamin D Status in Botswana Children Under 2 Years Old With and Without Active Tuberculosis
Jonathan Ludmir1, Loeto Mazhani2, Mark S Cary2
1Botswana-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.
Insights
Low vitamin D status does not appear to increase the risk of active tuberculosis (TB) in young children in Botswana. This study found no significant difference in vitamin D levels between children with and without TB.
Area of Science:
- Pediatrics
- Infectious Diseases
- Nutritional Science
Background:
- Tuberculosis (TB) prevention and treatment strategies require enhancement.
- Vitamin D may possess antimycobacterial properties, but its role in TB risk for African children is unclear.
Purpose of the Study:
- To investigate the association between serum 25-hydroxyvitamin D (25(OH)D) levels and active TB in children under two years old in Gaborone, Botswana.
Main Methods:
- A case-control study involving 80 children (39 with active TB, 41 controls) under two years old.
- Serum 25(OH)D concentrations were measured in cases and controls.
- Clinical characteristics, including weight loss and weight-for-age percentile, were analyzed.
Main Results:
- No significant difference in median 25(OH)D levels was observed between children with active TB and controls (P = 0.84).
- Vitamin D deficiency (25(OH)D < 20 ng/mL) prevalence was similar in both groups (21% vs 17%, P = 0.69).
- Weight loss was significantly associated with TB diagnosis (P = 0.047), but age and low weight percentile were not.
Conclusions:
- Vitamin D status does not appear to be a significant risk factor for active TB in this cohort of young children in Gaborone.
- Further research is needed to understand TB pathogenesis and prevention in vulnerable populations.
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.
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