DOI: http://dx.doi.org/10.18203/2349-3291.ijcp20202622

Vitamin D deficiency among hospitalized infants with acute lower respiratory tract infection

Kumari Pratima, Shivlok Narayan Ambedkar, Jagannath Mohapatra

Abstract


Background: Vitamin D plays important role in immunity and its deficiency might be associated with increased risk of lower respiratory tract infection. This study aimed to determine whether vitamin D deficiency is commoner in infants with acute lower respiratory tract infection as compared to normal infants and to correlate the severity of vitamin D deficiency with severity of ALRTI.

Methods: A hospital based prospective case-control study was conducted in a tertiary care hospital. A total of 208 infants (109 cases and 99 controls) older than 7 days to 12 months of age, were enrolled. Cases were selected according to the definition of ALRTI given by WHO (2). Controls were chosen from children attending paediatric outpatients department for immunization or minor short duration aliments. Primary outcome measured as serum 25-hydroxy vitamin D3 (25OHD3) levels and severity of ALRTI was independent variable.

Results: Among 109 cases suffering from ALRTI, vitamin D deficiency was present in 65.11%, 92.3%, 88.9% children of ‘pneumonia, severe pneumonia and very severe pneumonia group respectively. It was found that vitamin D deficiency was commoner in cases as compared to controls (80.70 % vs 25.50% ) with OR of 12.40 (95 % CI was 6.13 - 25.38). There was inverse relationship between the severity of ALRTI and Vitamin D levels (p value <0.001 and Pearson correlation coefficient -0.32).

Conclusions: Vitamin D levels were significantly lower in ALRI cases as compared to controls and had negative correlation between vitamin D levels and severity of pneumonia.


Keywords


Infants, Lower respiratory tract infection, Pneumonia, Vitamin D deficiency

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References


United State Agency for International Development: Acute respiratory infection Programs. Global Health-child survival. USAID. Washington DC: 2002:21.

World Health organization. The management of Acute Respiratory Infection in children: Practical Guidelines for outpatient care. Geneva WHO: France, Macmilan; 1995:14-26.

Walker VP, Modlin RL. The Vitamin D connection to pediatric infection and immune function. Paediatr Res. 2009;65:106-13.

Roth DE, Caulfield L, Ezzati M, Black R. Acute lower respiratory infections in childhood: opportunities for reducing the global burden through nutritional interventions. Bull World Health Organ. 2008;86:356-64.

Jovanovich AJ, Ginde A, Holu J, Jablonski K, Allaya RL. Vitamin D level and risk of community acquired Pneumonia and sepsis. Nutrients. 2014;6:2196-205.

Zhou YF, Luo BA, Qin LL. The association between vitamin D deficiency and community-acquired pneumonia: A meta-analysis of observational studies. Medicine(Baltimore). 2019 Sep;98(38):e17252.

Banajeh SM, Al-Sunbali NN, Sanhani S. Clinical characteristics and outcome of children aged under 5 years hospitalized with severe pneumonia in Yemen. Am Trop Paediatr. 1997;17:321-6.

Wayse V, Yousafzai A, Mogale K, Filteau S. Association of subclinical vitamin D deficiency with severe acute lower respiratory infection in Indian children under 5 year. Eur J Clin Nutr. 2004;58:563-7.

McNally JD, Leis K, Matheson LA, Karuananyake C, Sankaran K, Rosenberg AM. Vitamin D deficiency in young children with severe acute lower respiratory infection. Pediatr Pulmonol. 2009;44:981-8.

Inamo Y, Hasegawa M, Saito K, Hayashi R, Ishikawa T, Yoshino Y, et al. Serum vitamin D concentrations and associated severity of acute lower respiratory tract infections in Japanese hospitalized children. Pediatr Intern. 2011 Apr;53(2):199-201.