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Vitamin D deficiency and severity of pneumonia in Indonesian children
Vicka Oktaria1,2,3,4, Rina Triasih4,5, Stephen M Graham1,2
1Faculty Medicine, Department of Paediatrics, Dentistry and Health Sciences, The University of Melbourne, Melbourne, Australia.
Insights
Nearly one in five Indonesian children hospitalized with pneumonia had vitamin D deficiency. However, vitamin D levels were not linked to pneumonia severity in these young patients.
Area of Science:
- Pediatric Infectious Diseases
- Nutritional Biochemistry
Background:
- Pneumonia is a leading cause of childhood mortality globally.
- Vitamin D deficiency is prevalent in many populations and may impact immune function.
- The role of vitamin D in pediatric pneumonia severity requires further investigation.
Purpose of the Study:
- To determine the prevalence of vitamin D deficiency in Indonesian children hospitalized with pneumonia.
- To evaluate the association between vitamin D status and the severity of pneumonia in this cohort.
Main Methods:
- A cross-sectional study was conducted in Indonesian hospitals involving children aged 2-59 months with pneumonia.
- Serum 25-hydroxyvitamin D levels were measured using liquid chromatography-tandem mass spectrometry.
- Pneumonia severity was assessed using WHO criteria, including danger signs, hypoxemia, and ICU admission.
Main Results:
- Of 127 children with determined vitamin D status, 19% were deficient (serum vitamin D <50 nmol/L).
- Mean vitamin D concentration was 67 nmol/L.
- Vitamin D deficiency was not associated with danger signs, prolonged hospitalization, or hypoxemia.
Conclusions:
- A significant proportion of hospitalized pediatric pneumonia cases in Indonesia present with vitamin D deficiency.
- Vitamin D status does not appear to be associated with pneumonia severity in this population.
Objective:
To determine the prevalence of vitamin D deficiency in Indonesian children hospitalized with pneumonia and evaluate the association between vitamin D status and severity of pneumonia.
Methods:
A hospital-based cross-sectional study was conducted from February 2016 to July 2017 in two district hospitals in Yogyakarta province, Indonesia. Infants and young children aged 2-59 months hospitalized with pneumonia were recruited. Serum blood samples were collected on admission and analyzed for total serum 25-hydroxyvitamin D3 and 25-hydroxyvitamin D2 concentrations using liquid chromatography-tandem mass spectrometry. Vitamin D deficiency was defined as a level of serum vitamin D <50 nmol/L. The association between vitamin D deficiency and severity of hospitalized pneumonia according to WHO criteria, including the presence of danger signs, hypoxemia (SpO2 in air below 90%), duration of hospitalization, and admission to Intensive Care Unit (ICU), was analyzed using logistic regression.
Results:
133 children with WHO-defined pneumonia were enrolled in the study and 127 (96%) had their vitamin D status determined. The mean vitamin D concentration was 67 (± 24 SD) nmol/L and 19% of participants were vitamin D deficient. Age younger than 6 months was associated with prolonged hospitalization (> 5 days) and low birth weight and poor nutritional status on admission were risk factors for hypoxemia. However, vitamin D status was not associated with the presence of danger signs, duration of hospitalization, or hypoxemia.
Conclusions:
One in every five children hospitalized with pneumonia was vitamin D deficient. Vitamin D status was not associated with the severity of pneumonia.
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